The studies included in this review show evidence of improvements in protective behaviours and knowledge among children exposed to school-based programmes, regardless of the type of programme. The results might have differed had the true ICCs or cluster-adjusted results been available. There is evidence that children's knowledge does not deteriorate over time, although this requires further research with longer-term follow-up. Programme participation does not generate increased or decreased child anxiety or fear, however there is a need for ongoing monitoring of both positive and negative short- and long-term effects. The results show that programme participation may increase the odds of disclosure, however there is a need for more programme evaluations to routinely collect such data. Further investigation of the moderators of programme effects is required along with longitudinal or data linkage studies that can assess actual prevention of child sexual abuse.

Objective: To assess evidence of the effectiveness of school-based education programs for the prevention of child sexual abuse (CSA). The programs deliver information about CSA and strategies to help children avoid it and encourage help seeking. Methods: Systematic review including meta-analysis of randomized controlled trials (RCTs), cluster RCTs, and quasi-RCTs. Results: Twenty-four studies with 5,802 participants were included. Child self-protective skills, odds ratio ¼ 5.71, confidence interval ¼ [1.98, 16.51]; factual, standardized mean difference (SMD) ¼ 0.61 [0.45, 0.78]; and applied knowledge, SMD ¼ 0.45 [0.24, 0.65], increased in the intervention group, and knowledge gains were retained at 6 months, SMD ¼ 0.69 [0.51, 0.87].There were no differences in anxiety or fear, SMD ¼ À0.08 [0.22, 0.07], and findings regarding disclosure of abuse were inconclusive. Conclusion: Children's self-protective skills and knowledge can be increased by participation in school-based sexual abuse prevention programs. However, it is unknown whether gains in skills and knowledge actually decrease the likelihood of CSA.

Aim: To propose a framework for good practice to promote improved access, equity and quality of care in service delivery for newly arrived refugee children. Methods: Development of a framework based on national and international literature and current service models in Australian paediatric refugee health. Results: Ten elements of a framework for good practice were identified: comprehensive health screening; coordination of initial and ongoing health care; integration of physical, developmental and psychological health care; consumer participation; culturally and linguistically appropriate service provision; inter-sectoral collaboration; accessible and affordable services and treatments; data collection and evaluation to inform evidence-based practice; capacity building and sustainability; and advocacy. Conclusions: High-quality care can be achieved through a range of service models. The elements identified provide a framework for evaluating current services and for planning future service development. The framework for good practice can be applied to facilitate improvements in refugee health care and to reduce the gap between health needs and currently available services.

The COVID-19 pandemic and associated system disruptions are impacting all children and young people (CYP) in Australia. For vulnerable groups of CYP, who already experience poorer health and well-being, these impacts are amplified. Challenges include reduced access to usual services, reduced community supports, financial instability, unemployment and other life circumstances that threaten to widen pre-existing inequities. This article aims to present the reasons for vulnerability of CYP during the pandemic, and to focus on actions by health professionals that mitigate additional challenges to their health and well-being. Using a rapid review of the literature and team-based discussions, eight vulnerable groups were identified: CYP with disabilities, mental health conditions and chronic diseases; CYP facing financial hardship; within the child protection system; Aboriginal; migrant and refugee; in residential care; rural; and isolated CYP. Recommendations for action are required at the level of governments, health professionals and researchers and include enhancing access to health and social supports, prioritising vulnerable CYP in resuming health activity and elevating the voice of CYP in designing the response. The pandemic can be conceptualised as an opportunity to create a more equitable society as we document the inequities that have been exacerbated. Vulnerable groups of CYP must be recognised and heard, and targeted actions must focus on improving their health outcomes during the pandemic and beyond.

Objective To assess the cost effectiveness of vertical transmission prevention strategies by using a mathematical simulation model. Design A Markov chain model was used to simulate the cost effectiveness of four formula feeding strategies, three antiretroviral interventions, and combined formula feeding and antiretroviral interventions on a cohort of 20 000 pregnancies. All children born to HIV positive mothers were followed up until age of likely death given current life expectancy and a cost per life year gained calculated for each strategy. Setting Model of working class, urban South African population. Results Low cost antiretroviral regimens were almost as effective as high cost ones and more cost effective when formula feeding interventions were added. With or without formula feeding, low cost antiretroviral interventions were likely to save lives and money. Interventions that allowed breast feeding early on, to be replaced by formula feeding at 4 or 7 months, seemed likely to save fewer lives and offered poorer value for money. Conclusions Antiretroviral interventions are probably cost effective across a wide range of settings, with or without formula feeding interventions. The appropriateness of formula feeding was highly cost effective only in settings with high seroprevalence and reasonable levels of child survival and dangerous where infant mortality was high or the protective effect of breast feeding substantial. Pilot projects are now needed to ensure the feasibility of implementation.

The Campbell Collaboration (C2) was founded on the principle that systematic reviews on the effects of interventions will inform and help improve policy and services. C2 offers editorial and methodological support to review authors throughout the process of producing a systematic review. A number of C2's editors, librarians, methodologists and external peerreviewers contribute. The Campbell Collaboration SynopsisSchool-based programmes for preventing child sex abuse may improve knowledge and selfprotective behaviours but also increase anxiety; further research is needed Childhood sexual abuse is a serious problem for school aged children worldwide. There is no consistent definition of sexual abuse. Some studies restrict sexual abuse to instances of sexual body contact with the child, while others define sexual abuse as any sexual behaviour in a child's presence. Whatever its form, childhood sexual abuse can have a very negative impact on a child. The United Nations' Convention on the Rights of the Child states that "children have the right to be protected from being hurt and mistreated, physically or mentally" and the international community needs to investigate ways this can be done effectively. One widespread method used is to teach school aged children, using school-based programs, about child sexual abuse and how to protect themselves from it. It is important to know if this approach works, for how long it works and if it causes any unintended harm to children and adolescents. This is the purpose of this systematic review.While this review found improvements in knowledge and protective behaviours among children who had received school-based programs, these results should be interpreted with caution. The reasons for a need for caution is that there were problems with the way that many of the original studies were analysed, children's knowledge was tested only a short time period after the program, the studies were conducted in North America and therefore may not apply to other countries and cultures, and several studies reported harms, such as increased anxiety in children. Potential harms need to be closely monitored in future studies and existing school based programs. It is difficult to know if the changes in children's knowledge and protective behaviours seen in the studies will result in prevention of child sexual abuse. As such, school-based programs should, at best, be seen as part of a community approach to the prevention of child sexual abuse.School-based education programmes for the prevention of child sexual abuse 5 Abstract Background Child sexual abuse is a significant problem that requires an effective means of prevention. ObjectivesTo assess: if school-based programmes are effective in improving knowledge about sexual abuse and self-protective behaviours; whether participation results in an increase in disclosure of sexual abuse and/or produces any harm; knowledge retention and the effect of programme type or setting.

Studies evaluated in this review report significant improvements in knowledge measures and protective behaviours. Results might have differed had the true ICCs from studies been available or cluster-adjusted results been available. Several studies reported harms, suggesting a need to monitor the impact of similar interventions. Retention of knowledge should be measured beyond 3-12 months. Further investigation of the best forms of presentation and optimal age of programme delivery is required.

BackgroundAustralian Aboriginal children experience a disproportionate burden of social and health disadvantage. Avoidable hospitalizations present a potentially modifiable health gap that can be targeted and monitored using population data. This study quantifies inequalities in pediatric avoidable hospitalizations between Australian Aboriginal and non-Aboriginal children.MethodsThis statewide population-based cohort study included 1 121 440 children born in New South Wales, Australia, between 1 July 2000 and 31 December 2012, including 35 609 Aboriginal children. Using linked hospital data from 1 July 2000 to 31 December 2013, we identified pediatric avoidable, ambulatory care sensitive and non-avoidable hospitalization rates for Aboriginal and non-Aboriginal children. Absolute and relative inequalities between Aboriginal and non-Aboriginal children were measured as rate differences and rate ratios, respectively. Individual-level covariates included age, sex, low birth weight and/or prematurity, and private health insurance/patient status. Area-level covariates included remoteness of residence and area socioeconomic disadvantage.ResultsThere were 365 386 potentially avoidable hospitalizations observed over the study period, most commonly for respiratory and infectious conditions; Aboriginal children were admitted more frequently for all conditions. Avoidable hospitalization rates were 90.1/1000 person-years (95 % CI, 88.9–91.4) in Aboriginal children and 44.9/1000 person-years (44.8–45.1) in non-Aboriginal children (age and sex adjusted rate ratio = 1.7 (1.7–1.7)). Rate differences and rate ratios declined with age from 94/1000 person-years and 1.9, respectively, for children aged <2 years to 5/1000 person-years and 1.8, respectively, for ages 12- < 14 years. Findings were similar for the subset of ambulatory care sensitive hospitalizations, but in contrast, non-avoidable hospitalization rates were almost identical in Aboriginal (10.1/1000 person-years, (9.6–10.5)) and non-Aboriginal children (9.6/1000 person-years (9.6–9.7)).ConclusionsWe observed substantial inequalities in avoidable hospitalizations between Aboriginal and non-Aboriginal children regardless of where they lived, particularly among young children. Policy measures that reduce inequities in the circumstances in which children grow and develop, and improved access to early intervention in primary care, have potential to narrow this gap.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0706-7) contains supplementary material, which is available to authorized users.