Violence against children in Latin America and Caribbean countries: a comprehensive review of national health sector efforts in prevention and response

Abstract

BackgroundViolence against children (VAC) remains a global problem. The health sector has an opportunity and responsibility to be part of the multi-sector collaboration to prevent and respond to VAC. This review aimed to assess the health sector’s response to VAC among Latin American & Caribbean (LAC) countries, particularly as it relates to physical violence, sexual violence, and neglect.MethodNational protocols for the identification and provision of health care to child survivors of violence, abuse and neglect were solicited in partnership with UNICEF and PAHO/WHO country offices within the LAC region. A parallel systematic review was undertaken in January 2015 to review studies published in the last 10 years that describe the regional health sector response to VAC.ResultsWe obtained health sectors guidelines/protocols related to VAC from 22 of 43 (51 %) countries and reviewed 97 published articles/reports that met the review inclusion criteria. Country protocols were presented in Spanish (n = 12), Portuguese (n = 1), and English (n = 9). Thematic areas of country protocols included: 1) identifying signs and symptoms of VAC, 2) providing patient-centered care to the victim, and 3) immediate treatment of injuries related to VAC. The systematic review revealed that health professionals are often unaware of national protocols and lack training, resources, and support to respond to cases of VAC. Further, there is limited coordination between health and social protection services.ConclusionsVAC remains an international, public health priority. Health professionals are well-positioned to identify, treat and refer cases of VAC to appropriate institutions and community-based partners. However, poor protocol dissemination and training, limited infrastructure, and inadequate human resources challenge adherence to VAC guidelines.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3562-3) contains supplementary material, which is available to authorized users.

Influence of the history of abuse and suicidal attempts behavior among women victims of violence in Nicaragua

“…The results also appear to indicate a correlation between suffering from child abuse and mistreatment and other forms of violence in adulthood among the sample of Nicaraguan women. This problem is very widespread in Latin America (Hillis et al, ; Kohrt et al, ; Wirtz et al, ; Yakubovich et al, ), and could be explained by various approaches and theories (Bandura, ; Banyard et al, ; Bifulco et al, ; Campbell & Lewandowski, ; Doumas et al, ; Fonseka, Minnis, & Gomez, ; Fritz et al, ; Wirtz et al, ). Some authors argue that the diversity of prevalences could be associated with cultural and economic factors (García‐Moreno et al, ), which means that the normalization of violence in family dynamics (Tinoco et al, ) could have led to violence against women and girls becoming very widespread in Nicaragua (Bott et al, ; Boyce et al, ; DÁngelo & Molina, ; Kohrt et al, ).…”

“…Even taking into account all the particularly negative experiences related to violence, the results show that the greatest predictors for suicidal behavior among the victims living in poverty in the sample are physical abuse and sexual abuse suffered in childhood. These data provide relevant information about the concurrence of child abuse and consequences in adulthood, and new knowledge of how the real prevalence of child abuse is underestimated (Wirtz et al, ; Yakubovich et al, ) in Nicaragua.…”

“…The relationship between child abuse and other forms of violence in the home has been examined from the perspective of intergenerational transmission of violence (Campbell & Lewandowski, ; Wirtz et al, ). Other authors argue that social learning theory provides the theoretical framework that explains the relationship between previous experiences of domestic violence and suffering from violence in adulthood (Fritz, Slep, & O'Leary, ).…”

“…Estimates suggest that more than 30% of minors in Latin America have suffered from abuse (Hillis, Mercy, Amobi, & Kress, ). However, these data could be an underestimate of the real prevalence of child abuse (Wirtz et al, ). In addition, as it takes place in private, and few formal complaints are made; the true extent of this phenomenon is unknown (Saunders & Adams, ).…”

Notificação da violência infantil, fluxos de atenção e processo de trabalho dos profissionais da Atenção Primária em Saúde

“…This indicates the poor quality of institutional records, due to an institutional culture of not recognizing records 26 and the need for professional training in care networks 10 . According to a systematic review study that aimed to evaluate the response of the health sector to child violence among Latin American and Caribbean countries 27 , there is a clear gap between the established protocols and the way they are disseminated among health professionals and services, especially as regards the lack of training strategies for the implementation of its guidelines. In addition, there was a need to develop interdisciplinary work to strengthen child violence prevention and improve coping.…”