Studies from different parts of sub-Sahara Africa have reported rising cases of juvenile justice contact among adolescents. Maru et al. in 2003 reported a rise of about 21% in the number of adolescents coming to juvenile justice courts in Nairobi Kenya [7]. A situation analysis conducted by UNICEF in Uganda also established similar trends of increase in Kampala city [8]. The comptroller of Nigerian prisons also reported that the number of adolescents processed in the juvenile justice wing of the Prison Services has tripled between the year 2008 and 2011[9]. Life of want, deprivation, abuse and neglect has also led a lot of children and adolescents in the region to take to the streets as destitute [2,5,10], many of whom also invariably come in contact with the juvenile justice system. This is not unconnected with the fact that subsistence on the street often times requires children to recourse to crime [11,12] and in many jurisdictions in the region being a street-child itself is a status offence. Assiago in 2002 reported that a large proportion of adolescents in Kenyan juvenile justice institutions were street children who had not broken any law beyond being homeless [13].

Despite the apparently high burden of juvenile delinquency and need for child and adolescent social welfare services in many parts of sub-Saharan Africa, the juvenile justice and social welfare systems in these regions are still poorly developed [14,15]. Childcare services in many of sub-Saharan African countries utilise mostly incarcerating methods of custodial care. Also, criminalisation of child destitution in many sub-Saharan African countries entails that there is no clear distinction between juvenile crime or delinquency and youth abandonment or destitution. In a study in Kenya, adolescents who were found destitute were among the adolescents brought before a district juvenile court for ‘sentencing’ to remand homes [7]. Okumu in 2007 reported that maltreated or neglected adolescents as well as juvenile offenders were in about equal proportions among the ‘inmates’ of the Getathuru Children's Rehabilitation Centre in Nairobi Kenya [16]. Similarly in Nigeria, Bella et al. in 2010 reported that neglected adolescents in need of care and protection as well as status offenders, young minor offenders and adolescents declared as ‘beyond parental control’ were processed through the same legal framework and remanded together in the same confinement [17]. This scenario has created a situation whereby being a victim of child neglect became criminalised with diminished chances of attending to the peculiar needs of such adolescents. The scenario also created a situation of lack of clear distinction in the programmes and schemes for the care, reformation, rehabilitation and re-integration of the different categories of children and adolescents in childcare custodial services. The result of this is that current prevention strategies and service provision for children and adolescents in custodial care in sub-Sahara Africa, where it exists at all, assume that the needs and challenges of the inmates are the same irrespective of their entry pathways.

In line with this assumption, previous studies on predisposing factors and psychosocial needs-assessments of children and adolescents within the juvenile justice system in sub-Sahara Africa, though very few, had arbitrarily viewed them as one and the same without cognizance of their different reasons for contact [7,16-19]. These studies presuppose that the predisposing factors and the psycho-social needs of children and adolescents within the juvenile justice system are the same irrespective of their different pathways into the system. They also made blanket recommendations on prevention strategies and service provisioning for all categories of adolescents in custodial care based on these assumptions. While it is a common and safe assumption that most children in difficult circumstances in sub-Sahara Africa share a lot in common in terms of vulnerabilities and psychosocial needs [6,13], these assumptions has not been put to objective test in the context of adolescents in the juvenile justice system.

There is no doubt that any pre-emptive or preventive strategies towards, or any form of service provisioning framework on the issue of children and adolescents coming in contact with the juvenile justice system in sub-Sahara Africa are worthwhile. However, rather than continuing the practice of viewing all the different categories of children and adolescents coming in contact with the juvenile justice system in this region as one and the same, identifying the fundamental similarities and differences in their social, physical and psychological needs will provide a framework for a better focussed strategy. Such information can serve as a more reliable template for common and specific targets in large scale prevention programmes. Aside this, understanding the unique and distinct psychosocial needs of children and adolescents within the juvenile justice and social welfare systems can, and has been found to, facilitate the provision of the appropriate services for them [20,21]. Provision of needed psychosocial and rehabilitative services to children and adolescents in institutional custody will improve their quality of life, enhance their societal re-integration and reduce the risk of recidivism.

Among the countries in sub-Sahara Africa, Nigeria is of particular interest in terms of the risk of exponential rise in the number of children and adolescents coming in contact with the juvenile justice system. Other than having a predominantly youthful population; Nigeria accounts for almost a quarter of the entire child and adolescent population of sub-Sahara Africa [22]. Aside this, the country has one of the highest rate of household poverty and among the countries with the lowest Human Development Index in the region [23]. Expectedly, recent reports suggest that the burden of children and adolescents coming or at risk of coming in contact with the social-welfare and juvenile justice systems in Nigeria is rising [9]. There are also reports that the streets of Nigeria are being inundated daily with hordes of different categories of neglected children and adolescents [24,25] who are potential entrants into the juvenile justice system. Just like in many countries of sub-Sahara Africa, there is a lack of clear distinction between the criminal and social welfare aspects of childcare services in Nigeria. Neglected adolescents, adolescents adjudged as delinquent, as well as young offenders in the country are all processed through the same system and can be remanded together in the same facility [26].

Though the concept of the ideal family unit may vary across cultures, the chances of optimal care and well-being of the average child is most guaranteed in a stable, consistent and harmonious unit formed by their married biological parents [43]. The two groups of adolescents in this study had a lot in common in terms of problematic indices of family structure, family consistency and family stability. This is in keeping with existing body of evidence that have established an enduring link between chequered family structure and dynamics and a higher risk of both juvenile delinquency and child abuse or neglect. Studies have shown that marital separation or single parenthood increases the risk of delinquent and criminal behaviours in children [44-46] while children from single-parent families and ‘broken homes’ are also known to be at higher risk of abuse and neglect [47,48]. Marital hostility or instability, which may manifest as frequent verbal conflicts or domestic violence has also been implicated as a risk factor for the duo of juvenile delinquency [49-51] and child neglect/abuse [52]. Similarly, considerably robust data have established a link between frequent changes in family structure (family transition) and delinquency [53-57] as well as child neglect [54,58].

Single-parent families, conflict-prone dual-parent families as well as families with rapidly changing composition and structure all have factors inherent in them that make it difficult for them to provide proper parenting and as such with higher risk of child neglect and delinquency among their children. For instance, in single-parent families, parental supervision is compromised by the fact that there is one less person to complement the supervision of children [59] while hostile family environment in unstable dual-families may create a distraction for optimal parenting. Family transitions on the other hand could compromise parenting quality through inconsistent discipline [60], parental loss of authority to exercise control, as well as parental preoccupation with the life changes that comes with family transition [61]. Poor parenting has been suggested to be one of the strongest predictors of delinquency [56] and standard contemporary definitions of child neglect [62] always includes an element of deficient parenting among the acts of omission that constitutes child neglect.

Another area of similarity that may suggest a common risk factor among the adolescents in this study irrespective of categorization includes certain aspects of their pre-contact social situation and lifetime mental health. For instance, more than half of both groups of adolescents had been living on the streets before juvenile justice contact. Leaving home to live on the streets could be a manifestation of the behavioral problems associated with juvenile delinquency [63]. Extant literature also suggests that running away from home to live on the streets could also be a child’s response to neglect [64,65]. In the context of sub-Sahara Africa, it has been argued that poverty-driven life of want, neglect, abuse and denial of the bliss of stable family environment has lead many children to the streets in search of life [10,66]. Whether being on the streets was as a result of neglect or delinquency or both, most street children run equal and continuous risk of juvenile justice contact. As far back as 1978, living or working on the streets had been reported as a common reason for juvenile justice contact in Nigeria [67]. Okunsanya in 2004 also reported that up to 15% of the total residents of remand and borstal facilities in Lagos Nigeria were brought-in after police raids on the streets [26]. In a recent survey of adolescents in the Ibadan Remand Home in Nigeria Bella et al. (2010) also reported that many of the residents in the Home had had some street-life experience irrespective of their reason for admission [17].

As a central common factor, problematic family background seems to be the linking factor that adversely changed the developmental trajectories of the two groups of adolescents in this study. This is because family instability and disruptions as seen in the two groups of adolescents in this study can trigger a cascade of events that terminates in juvenile justice contact. For instance, family instability can increase the risk of both child maltreatment [68] and conduct problems among children [69,70]. Living on the streets for children from unstable homes in sub-Sahara Africa is commonly a response to child maltreatment or an indicator of onset of conduct problems [13,63]. Once on the streets, children continue to run the risk of juvenile justice contact either as a status offender, due to involvement in crimes or involvement in substance use/abuse [26,71]. Though a cross-sectional study like this one can not establish causality, this study found all the factors needed to set up this cascade of events that terminates in juvenile justice contact among the two groups of adolescents. This include the combination of a high prevalence of indices of family instability on one hand, and other adverse factors like physical abuse, conduct disorder and experience of street life on the other hand.

On a different note, if the adolescents in this study share in common this much in terms of pre-contact primary support resources and social circumstance, what factors could have influenced their differential pathways (neglect or delinquency) to institutional care? The answer may lie in the fundamental differences in the pre-contact social situation and primary support resources of the two groups of adolescents in this study. Despite their stunning similarities, the two groups of adolescents have some distinct differences in terms of their family background, pre-contact social situation and their current anthropometric and lifetime mental health status. These differences may explain their differential pathways into institutional care and may have implications for specific prevention strategies and for service provision in-house. Though an element of abuse/neglect can be inferred in the life of both groups of adolescents in this study (e.g. street life, school drop-out, physical abuse etc.), the child-neglect group of adolescents had significantly worse indices in some neglect areas. For instance they had a higher risk of having witnessed domestic violence; they were more likely to have dropped out of school and had a significantly lower body mass index (BMI) compared with their counterparts on ‘criminal code’. These differences were despite the fact that the length of the mean period of incarceration among the two groups of adolescents was not significantly different. This observation may suggest that the two groups of adolescents in institutional care in Nigeria represents two points in a continuum of pathological social outcome of children, with the ‘child neglect’ pathway being the worst end of the continuum.

This assertion presupposes that the ‘criminal code’ group represents a pathway which resulted from a milder form of inadequate parenting and child neglect, while the ‘child-neglect’ group resulted from a more severe form of parental deficiency and neglect. The younger age, the worse indices of family transitions and the higher prevalence of physical disabilities among the child-neglect group in this study could all have put them at a higher risk of neglect and maltreatment. Studies have established an inverse relationship between the age of a child and the risk and severity of child maltreatment and neglect [72]. Younger children due to their earlier developmental status and higher need for care can be particularly vulnerable to maltreatment and neglect. With advancing age of a child, the pressures of parenting and the burden of childcare which may increase the tendency towards child maltreatment and neglect [73]; tend to reduce. In the same vein, if family transition becomes too rapid, the chances of coming in contact with abusive caregivers increase. Likewise, chronic disabling neurological disorders are additional risk factors for being abused or neglected [74,75]. Widespread misconceptions about the causation of childhood seizure disorders and neurological disorders in this region in particular have been cited as a major risk for neglect of children with such conditions [76]. These factors could have put the ‘child neglect’ group of adolescents in this study on a higher risk of worse forms of neglect and an institutional entry pathway under the neglect category.

Child neglect itself is a well documented precursor of delinquency [77,78]. This fact may suggest that adolescents with a more severe form of neglect will come in early contact with childcare services as a ‘neglect case’ while those with milder forms of neglect will progress further into ‘delinquency’ and will come in contact with childcare services much later. The observation that the ‘child neglect’ group in this study reported a lower mean number of months on the streets before juvenile justice or social-welfare contact compared with the ‘criminal code’ group supports this view. Another interesting observation which supports this view is the finding that more than half of the adolescents on ‘criminal code’ in this study were actually brought to the juvenile justice and social-welfare officers as the case may be, by their parent(s) or guardian(s) on the grounds that the adolescents were ‘beyond parental control’. This observation may suggest that being declared as ‘beyond parental control’ as an adolescent in Nigeria is a ‘milder’ or ‘formalized’ form of abandonment/neglect due to child behavioral problems and dwindling quality of primary support.

From the foregoing, it can be argued that the common factors that led to contact with juvenile justice and social welfare systems among two groups of adolescents in this study (irrespective of their categorisation) lies somewhere in the workings of their families. Family support programmes has been argued, and rightly so, to be one of the universal ways to stem the rising cases of adverse social outcomes for children generally in this region [79]. However, despite this effort, childcare can still be severely affected in deeply troubled families with attendant risks for children. In developed countries, children from families-at-risk can be put in foster families by the social welfare services. The foster families are given adequate funds to cater for the needs of such children including food, clothing, daily supervision, educational materials among others [80]. Though there is robust data that children in foster care experience a myriad of mental health problem that may affect the quality of their adulthood [81-83], the same, if not worse, has been reported among children and adolescents in institutional care [29,33]. Children in foster care are however given an opportunity to grow within a family setting which has been established long ago to be better than growing-up in institutions, from mental health perspectives [84]. Another possible advantage of the foster-care system is that children within this system are able to maintain contact with the community while in custodial care, which is likely to facilitate easy re-integration with own family and society. Nigeria and in deed most countries in sub-Sahara Africa are yet to evolve their foster care arrangements to formal systems and there is virtually no evidence of any research activity going on the feasibility of establishing such. This is ostensibly because of the low level of evolution of the social-welfare systems in this region which is currently focussed on keeping delinquent or offending children as well as neglected children off the streets and within confinement of institutions. This study therefore calls for an urgent research into the feasibility of establishing foster-care systems in Nigeria. A good approach will include research into perceived obstacles among social-welfare and juvenile justice officers, and willingness or reservations of families in the community to participate as destination-families in foster-care systems.

Furthermore, it was observed in this study that the ‘crimes’ committed by the adolescents on ‘criminal code’ were largely a declaration of inability of their parents to continue with their care ostensibly because of a combination of parental factors like social difficulties and child factors like disruptive behaviour disorders. Most of the other offences are either minor or status offences. Rather than the current practice in Nigeria, non-incarcerating methods of custodian care has been described as the ideal for status offenders as well as children in need of care and protection [85,86]. Modern non-incarcerating or semi-incarcerating facilities and diversion schemes in the community which cater for such children and adolescents include approved schools and the family foster care system [85,86]. This should be the way to go for Nigeria and her counterparts in sub-Sahara Africa.

It does appear from the findings of this study however that until the establishment non-incarcerating modes of child services and the full separation of the criminal and social welfare aspects of juvenile justice administration in this region, a common approach to the prevention and management of child neglect and delinquency still have some merit. Aside family interventions high rates of mental health problems in the two groups calls for the establishment of inclusion of mental health services generally and trauma services specifically in the multipurpose juvenile remand facilities scattered around the country. On the contrary, the significantly higher prevalence of disruptive behaviour disorders, substance use disorders and neurological disorders respectively among the ‘criminal code’ and child-neglect group suggests some specific needs. It may be imperative to emphasize behavioural modifications and therapy as a mental health service for the ‘criminal code’ adolescents and paediatric neurology and physical therapy services for the neglect group.

Until such time in Nigeria and indeed sub-Sahara Africa when the social-welfare and the criminal justice sections of child services are fully developed and separated, a reasonable management approach is to raise a local visiting team comprising of child and adolescent mental health experts, special education experts and paediatric neurologists and physical therapists within the vicinity of such institution. Such teams will provide needed services with the common and specific needs of the residents as highlighted in this study in mind. Part of the brief of such team could include some skill transfer to designated officials of the Home through direct trainings and seminars. The team could be sourced from secondary and tertiary health facilities in the vicinity of the juvenile home and could be funded by governments or donor agencies.