violence against children WORLD REPORT ON - CRIN

78Violence against children in the home and familythe family. Home visits also offer an opportunityto link a family with other communityservices as needed.In the USA, the value of home visits by nursesto young first-time mothers in socio-economicdifficulty, for the first two years of the child’slife, were evident 15 years later. 177 In a randomisedtrial, the benefits to the visited familiesincluded a significant reduction in child abuseand neglect, as well as reductions in maternalalcohol/drug problems. Current evidence indicatesthat the most successful home visitationprogrammes focus on families with an elevatedrisk of violence against the child, and begin inpregnancy and continue to at least the secondyear of the child’s life, actively promote positivehealth behaviours, support the family in stressmanagement, and address a range of issues thatare important to the family. 178,179 Programmesshould be flexible in order to adjust to thechanging needs of families.Parenting education, another successful andwidely used prevention strategy, can be offeredeither in the context of home visitation programmesor independently. Programmes usuallyeducate parents about child development andaim to improve their skills for behaviour management.Parents’ and caregivers’ positive behaviourmanagement skills can be improved bydeveloping an understanding of the importanceof follow-through and consistency, rewardingand reinforcing positive behaviour, strategicallyignoring minor negative behaviours, givingeffective instructions, and implementing nonviolentconsequences for misbehaviour. 180 Parentingprogrammes should strive to strengthenthe skills of both mothers and fathers.Parenting programmes are increasingly beingimplemented in middle- and low-income countries.For example, at the instigation of theAll China Women’s Federation, over 200,000Chinese communities organised ‘Parents’Schools’ to help people adapt to parenting inthe one-child family. 181 In Eastern Europe, theRepublic of Moldova is mainstreaming parenteducation in the primary health care system.Health workers are trained to provide parentswith the knowledge and skills needed to meetthe survival, growth, development and protectionneeds of their young children, and alsoto know when and where to go for specialisedservices. The initiative started in 2002; alreadyit is clear that family doctors and nurses whoattended the training programme are morelikely to engage in parent education. This initiativeincludes a specific focus on protectingchildren from all forms of violence, includingphysical punishment and other humiliatingforms of discipline. 182In developing countries, parenting courses areoffered by community-based parents’ centres.For example, services offered by The ParentCentre in Cape Town, South Africa includethe following: 183• Parent groups for mothers and babies,mothers and toddlers, and singleparents• Post-natal depression support• Training on effective discipline fortoddlers• Training for parents of under-5s, under-12s, and teenagers• Counselling for parents and caregivers