Summary of included papers.

Background
Half of the world’s children experience violence every year, but the meaning of violence is not universally agreed. We may therefore risk failing to measure, and address, the acts that matter most to children and adolescents. In this paper, we describe and synthesise evidence on how children and adolescents in sub-Saharan Africa conceptualise different behavioural acts which are deemed violence in childhood under WHO and UN CRC definitions.
Methods and findings
We conducted a systematic review of qualitative studies. We searched PsychINFO, CINAHL, Embase, Global Health, Medline and ERIC for all publications released prior to March 2023. 30 papers met inclusion criteria. We synthesised primary data from children and adolescents and drew upon theoretical and contextual interpretations of authors of included studies. Only 12 of more than 45 sub-Saharan African countries were represented with relevant research. Of the 30 included papers, 25 came from three countries: South Africa, Uganda and Ghana. Only 10 of 30 papers reported data from young children (pre-adolescence), and 18 of 30 papers primarily focused on sexual violence. 14 studies used child friendly and/or participatory methods. From this limited evidence, we identified six overarching themes in how children and adolescents conceptualised their experiences of acts internationally recognised as violence: 1) adults abusing or neglecting responsibility; 2) sexual violence from peers, family and community members; 3) violence in established intimate relationships; 4) emotional violence surrounding sex from peers and community members; 5) fighting and beating between peers; 6) street and community dangers. No studies meeting our inclusion criteria specifically examined children or adolescents’ conceptualisations of homophobic or transphobic violence; violence against children with disabilities; boys’ experiences of sexual violence from male perpetrators; trafficking, modern slavery or conflict; child labour; or female genital mutilation. We found that three dimensions were important in how children and adolescents constructed conceptualisations of violence: their age, relationship to the perpetrator, and the physical location of acts they had experienced. These dimensions were interrelated and gendered.
Conclusion
The current limited evidence base suggests children and adolescents’ conceptualisations of violence overlapped with, but were also distinct from, the WHO and UNCRC definitions of violence. Currently international survey tools focus on measuring types and frequencies of particular acts and neglect to focus on children’s understandings of those acts. Relationship to perpetrator, age of child, physical location are all important in how children conceptualise their experiences of acts internationally recognised as violence, and therefore might be important for their health and social outcomes. Those developing measures should account for these dimensions when developing items for testing.

背景
全球每年有半数儿童遭受暴力侵害，但学界对暴力的定义尚未达成普遍共识。据此，我们或难以精准衡量并切实解决对儿童与青少年而言最为关键的暴力行为，进而错失干预良机。本研究旨在描述并综合撒哈拉以南非洲地区儿童与青少年对各类行为的认知，这些行为在世界卫生组织（World Health Organization, WHO）及《儿童权利公约》（United Nations Convention on the Rights of the Child, UN CRC）的定义中均被视为儿童期暴力。

方法与研究结果
本研究采用系统综述方法，纳入质性研究。我们检索了PsycINFO、CINAHL、Embase、Global Health、MEDLINE及ERIC数据库，获取2023年3月之前发表的所有相关文献，最终有30篇文献符合纳入标准。研究团队对来自儿童与青少年的原始数据进行综合分析，并借鉴纳入文献作者的理论与情境化解读。
在撒哈拉以南非洲的45个国家中，仅有12个国家开展了相关研究；在纳入的30篇文献中，有25篇来自南非、乌干达及加纳三个国家。30篇文献中仅10篇涉及幼儿（青春期前）相关数据，另有18篇主要聚焦于性暴力议题。14项研究采用了以儿童为中心的友好型及/或参与式研究方法。
基于上述有限的研究证据，我们归纳出儿童与青少年对国际公认暴力行为的认知可分为六大核心主题：1. 成年人虐待或疏于履行监护责任；2. 来自同伴、家庭成员及社区成员的性暴力；3. 既定亲密关系中的暴力行为；4. 同伴与社区成员围绕性活动实施的情感暴力；5. 同伴之间的斗殴与殴打；6. 街头与社区环境中的暴力风险。
本研究纳入的文献中，无一项专门探讨儿童与青少年对以下暴力类型的认知：基于性取向与性别认同的仇恨暴力（恐同及跨性别仇恨暴力）、针对残疾儿童的暴力、男性施暴者针对男性儿童的性暴力经历、人口贩运与现代奴役及冲突相关暴力、童工问题，以及女性外阴残割（Female Genital Mutilation, FGM）。
研究发现，儿童与青少年构建暴力认知的核心维度包括三者：自身年龄、与施暴者的关系，以及暴力行为发生的物理场景。上述维度相互关联，且具有鲜明的性别特征。

结论
现有有限的研究证据表明，儿童与青少年对暴力的认知与世界卫生组织及《儿童权利公约》的暴力定义既有重叠，也存在显著差异。当前的国际调研工具多聚焦于特定暴力行为的类型与发生频率，却忽视了儿童对这些行为的主观认知。与施暴者的关系、儿童年龄及暴力发生场景，均会影响儿童对国际公认暴力行为的认知构建，因此这些因素可能对其健康与社会结局产生重要影响。开发暴力测评工具的相关人员在编制测试条目时，应将上述维度纳入考量范畴。