Posted: Nov 9, 2017
THE CLINICAL MANAGEMENT OF CHILDREN AND ADOLESCENTS WHO HAVE EXPERIENCED SEXUAL VIOLENCE
These Technical Considerations aim to serve as a guide for primary health providers on the appropriate care of children and adolescents who have experienced sexual violence and exploitation based on current, evidence-based practices. They are expected to inform the efforts of PEPFAR implementers and other partners engaged in the clinical care of children as well as in HIV/AIDS prevention, care, and treatment to strengthen community-based responses to children who have experienced sexual violence and exploitation. They should be implemented in line with national guidelines in the provider’s country of practice.
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This document is meant to be used by service providers in health care clinics, to include clinicians, behavioral scientists, social workers, pediatric care providers, child protection workers, HIV specialists, and child-focused clinical service providers. The focus is specifically on the clinical management of children who experience sexual violence and exploitation, but communities should also strive to develop comprehensive systems to respond to the needs and rights of these children. The comprehensive response includes government (e.g., clinics, law enforcement and judiciary, policymakers, social welfare/child protective services, counselors), and nongovernmental and civil society organizations. This comprehensive response is often overlooked, thereby creating a challenge during program implementation (see Chapter 2 for more information on establishing and strengthening the clinical response).
Day, Kim and Jennifer Pierce-Weeks. 2013. The Clinical Management of Children and Adolescents Who Have
Experienced Sexual Violence: Technical Considerations for PEPFAR Programs. Arlington, VA: USAID’s AIDS
Support and Technical Assistance Resources, AIDSTAR-One, Task Order 1. Available at: http://www.jsi.com/JSIInternet/Inc/Common/_download_pub.cfm?id=13938&lid=3
Posted: Nov 9, 2017
Using a child rights approach to strengthen prevention of violence against children
Violence against children is widespread in South Africa. Much of it remains hidden, and social services are thinly stretched. This article therefore focuses on children’s rights to protection and considers the implications for healthcare practice. Children’s rights can be considered both a ‘language of critique’ and a ‘language of possibility’ – encouraging us to evaluate current practice from a child-centred perspective and to re-imagine ways in which we deliver healthcare services. The article outlines the nature, extent and long-term effects of violence against children, introduces a framework for conceptualising violence prevention, and considers ways in which health professionals can better respond to cases of abuse and neglect, and prevent violence against children from taking place.
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Lake L & Jamieson J (2016) Using a child rights approach to strengthen prevention of violence against children. South
African Medical Journal, 106(12): 1168- 1172. http:// DOI:10.7196/SAMJ.2016.v106i12.12128
Posted: Nov 9, 2017
Developing an understanding of fatal child abuse and neglect: Results from the South African child death review pilot study
Fatal child abuse is the severest consequence of violence against children. Yet, little is known about this phenomenon, as routine data do not describe it. Child death review (CDR) teams have been established to systematically review deaths from birth to adolescence as a public health response to better identify child abuse deaths, to develop policy and to improve the child protection response. This article describes the incidence of fatal child abuse and injury patterns associated with such deaths. CDR teams reviewed all child fatalities from 1 January to 31 December 2014 at two pilot sites in South Africa (SA). Data were collected on demographics, causes and circumstances of the death, and family social context. We assessed the feasibility of CDR teams in the SA setting to strengthen the identification of child abuse deaths and influence practice. A total of 707 cases were reviewed. Over half (52.4%) of the deaths were due to natural causes. A third were caused by murder, with nearly half (44%) of all murders attributed to fatal child abuse. The burden of fatal child abuse and neglect was found among the <1-year age group. Abandonment at birth was most common, followed by blunt force injuries and strangulation/asphyxiation deaths. CDR teams are effective in better identifying deaths due to child abuse and neglect via a multidisciplinary approach and regular case reviews.
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Mathews S & Martin L. (2016) Developing an understanding of fatal child abuse and neglect: Results from the South African child death review pilot. South African Medical Journal. 106(12):1160-1163. DOI:10.7196.