science, health & technology
New guide on preventing violence against children
by the World Health Organization
The World Health Organization (WHO) has issued a practical new guide to help countries prevent violence against children. Children are the victims of startling levels of violence, often at the hands of those who should be protecting them. This new guide, published by WHO and the International Society for Prevention of Child Abuse and Neglect (ISPCAN), demonstrates that violence against children can and must be prevented.
According to the recently released UN Secretary-General's Study on Violence Against Children, much of the violence endured by children aged 0-14 years occurs in the home at the hands of parents, caregivers, and family members. The consequences of this violence hinder children's health and development and can last well into adulthood, negatively affecting health and increasing the risks of further victimization and becoming a perpetrator of violence.
Preventing child maltreatment: a guide to taking action and generating evidence is intended to assist countries to design and deliver programs for the prevention of child maltreatment by parents and caregivers. The guide is a practical tool that will help governments implement the recommendations of the UN Study on Violence Against Children.
Country reports in the UN study show that children under 10 years of age are at significantly greater risk than older children of severe violence perpetrated by family members and people closely associated with the family. The study also reports WHO estimates that in children under 18 years of age the worldwide prevalence of sexual violence involving forced intercourse and touch is 73 million for boys and 150 million for girls.
Research shows that child maltreatment can be prevented. The need to increase investment in prevention is urgent and global. Promising strategies include reducing unintended pregnancies; improving access to high-quality pre- and post-natal care; reducing harmful levels of alcohol and illicit drug use during pregnancy and by new parents; providing home visitation services by nurses and social workers to families at risk of maltreatment, and training parents on child development, non-violent discipline and problem-solving skills. The UN study and the guide make it clear that responsibility for implementing such strategies lies with governments, and should involve other stakeholders, including non-governmental organizations (NGOs), research councils and the international community.
"For too long now the response to child maltreatment has been dominated by systems for reacting to cases once maltreatment has already started. The scientific evidence for preventing physical, sexual and psychological abuse from occurring in the first place is already quite strong, and the time is ripe for a paradigm shift from reaction to prevention," said Dr. Anders Nordström, WHO acting director general.
The new WHO-ISPCAN guide provides technical advice for professionals working in governments, research institutes and NGOs on how to measure the extent of child maltreatment and its consequences and how to design, implement and evaluate prevention programs. The guide also notes that the strong relationships between child maltreatment, economic inequality and poverty mean that reducing inequality and poverty are likely to make a significant contribution to preventing child maltreatment.
"We welcome the WHO-ISPCAN guide on preventing child maltreatment," said Ann M. Veneman, executive director of UNICEF. "This is an important new tool for addressing violence against children."
A unique aspect of preventing child maltreatment is its recognition that child maltreatment and other childhood adversities are associated with a broad range of risk-taking behaviors in later life, including smoking, high-risk sexual behaviors, unintended pregnancy and harmful alcohol and drug use.
According to a recent WHO study, the lifetime impacts of child sexual abuse account for approximately six percent of cases of depression; six percent of alcohol and or drug abuse/dependence; eight percent of suicide attempts; 10 percent of panic disorders, and 27 percent of post traumatic stress disorders.
Such risk factors and behaviors can lead to some of the principal causes of death, disease and disability.
"What happens to people in childhood still has a major effect 30, 40 and even 50 years later. One person might be driven to chronic depression, or to alcoholism, another to suicide, another to drug use leading to chronic hepatitis.
But these linkages are concealed by time, shame, secrecy, and by social taboos against discussing these things," said Dr. Vincent Felitti, chief of preventive medicine at the Kaiser Permanent Medical Care Program in the USA, and a contributor to the guide. "These concealed life-long consequences mean that governments everywhere are already spending a substantial portion of their health budgets treating the consequences of maltreatment, resources that would be far more effectively spent on prevention".
"We have enough information to take preventive action. We cannot delay. Children cannot wait. By following the recommendations contained in this guide countries can immediately start to implement child maltreatment prevention programs while building the evidence base further," said Professor Barbara Bonner, president of ISPCAN.
The Guide can be found at: http://whqlibdoc.who.int/publications/2006/9241594365_eng.pdf
WHO, Department of Injuries and Violence Prevention, Prevention of Violence:
International Society for Prevention of Child Abuse and Neglect: http://www.ispcan.org/.
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