violence against children WORLD REPORT ON - CRIN

3For example, environmental health initiativesthat remove lead and other environmentaltoxins from communities can lead to lessphysical violence against children by reducingthe rate of foetal brain damage and subsequentcognitive disorders such as Attention DeficitDisorder (ADD) and hyperactivity, therebydecreasing the number of children with highriskcharacteristics. Similarly, limiting accessto alcohol, for example through controllingthe number of alcohol outlets or raising prices,may help prevent child maltreatment. 193 Similarefforts in developing countries could reducealcohol-related violence against children,although these measures should be consideredcarefully, as they might prompt people whodrink to switch to cheaper and less regulatedhome-brewed alternatives. 194Although few formal evaluations have beenconducted, other promising interventionsinclude providing shelters and crisis centresfor battered women and their children, traininghealth care workers to identify and workwith adults who have experienced violence inchildhood, as well as strengthening the linkagesbetween mental health services, substanceabuse treatment and child protection services.Intervening when violencebecomes knownWhen violence against children is suspected ordisclosed, action must be taken to protect thechildren at risk. The content and legislativefoundation of child protection services varyfrom country to country and often includemechanisms for reporting, referral, investigationand follow-up. Ideally, legal measuresshould be implemented in tandem with healthand social support approaches. Support andassistance without adequate protection canendanger the child’s well-being and development;but a legal focus on investigation andprotection with insufficient follow-up and paralleltreatment can lead to severe and lastingdamage both to the child and to the family.Research is urgently needed to identify effectivesupport, help and treatment-orientedapproaches to child protection and how theymight be implemented in both high- and lowresourcesettings. Although rooted in humanrights and a clear framework of legislation,child protection systems operating at communitylevel need to evolve in consultation withcommunities. While aiming for acceptanceand trust, child protection workers must bemade fully accountable within the context ofthe overall system and its accountabilities.Detection of violence against childrenin the familyThe potential for damage to the child increaseswith increasing frequency and severity of victimisationover time. It is therefore importantto identify violence as early as possible andintervene to stop it. Health professionals havean important role in child protection because,except in very remote rural areas, infants andsmall children are usually taken to the healthcentre on a routine basis. In countries withsocial service networks, they may also be seenoccasionally or on a regular basis by socialworkers.83Violence against children in the home and family