Right To Play’s intervention to reduce peer violence among children in public schools in Pakistan: a cluster-randomized controlled trial

Rozina Karmaliani, Judith McFarlane, Hussain Maqbool Ahmed Khuwaja, Yasmeen Somani, Shireen Shehzad, Tazeen Saeed Ali, Nargis Asad, Esnat D. Chirwa, Rachel Jewkes

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)


Background: Peer violence is common globally, but a little researched topic in low-and middle-income countries. This study presents the evaluation of a two-year randomized controlled trial of a structured play-based life-skills intervention implemented in schools in Hyderabad, Pakistan. Objective: To determine the impact of the intervention on school-based peer violence (victimization and perpetration) and depression among school children. Methods: 40 single-sex public schools were randomized into two study arms (20 per arm 10 of each sex). A total of 1752 grade 6 students (929 from intervention and 823 from control schools) were enrolled in the trial. The two-year intervention was a biweekly structured game led by a coach followed by critical reflection and discussion for 30 minutes. Primary outcomes (exposure to peer violence exhibited through victimization and perpetration and depression) were evaluated using generalized linear-mixed models. Results: Of the enrolled children (N = 1752) 91% provided data for analysis. There were significant decreases in self-reported peer violence victimization, perpetration and depression. For peer violence victimization, the reductions in the intervention and control arms were: 33.3% versus 27.8% for boys and 58.5% versus 21.3% for girls. For peer violence perpetration, the reductions were: 25.3% versus 11.1% for boys and 55.6% versus 27.6% for girls in the intervention and control arms, respectively. There were significant drops in mean depression scores (boys 7.2% versus 4.8% intervention and control and girls 9.5% versus 5.6% intervention and control). Conclusion: A well-designed and implemented play-based life-skills intervention delivered in public schools in Pakistan is able to effect a significant reduction in peer violence.

Original languageEnglish
Article number1836604
JournalGlobal Health Action
Issue number1
Publication statusPublished - 31 Dec 2020


  • Adolescent mental health
  • Asia
  • corporal punishment
  • empowerment
  • gender attitudes
  • peer violence perpetration
  • peer violence victimization
  • school violence


Dive into the research topics of 'Right To Play’s intervention to reduce peer violence among children in public schools in Pakistan: a cluster-randomized controlled trial'. Together they form a unique fingerprint.

Cite this