9789240004191-eng.pdf - GLOBAL STATUS REPORT ON PREVENTING...

This preview shows page 1 out of 352 pages.

Unformatted text preview: GLOBAL STATUS REPORT ON PREVENTING VIOLENCE AGAINST CHILDREN 2020 GLOBAL STATUS REPORT ON PREVENTING VIOLENCE AGAINST CHILDREN 2020 Global status report on preventing violence against children 2020 ISBN 978-92-4-000419-1 (electronic version) ISBN 978-92-4-000420-7 (print version) © World Health Organization 2020 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; ). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. Global status report on preventing violence against children. Geneva: World Health Organization; 2020. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at . Sales, rights and licensing. To purchase WHO publications, see . int/bookorders. To submit requests for commercial use and queries on rights and licensing, see . Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-partyowned component in the work rests solely with the user. General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. Designed by Inis Communication Front cover photography credits: WHO/Christopher Black WHO/Chapal Khasnabis WHO/TDR/Julio Takayama World Bank/Kibae Park/Sipa WHO/Christopher Black WHO/TDR/Julio Takayama WHO/Christopher Black Contents Foreword v Acknowledgements vii Executive summary ix Introduction 1 PART 1. CURRENT GLOBAL STATE OF PREVENTING VIOLENCE AGAINST CHILDREN 7 Chapter 1. Global burden of violence against children 11 Chapter 2. Governance and monitoring to end violence against children 21 Multisectoral collaboration with clear leadership 21 National action plans and funding 23 Availability and use of nationally representative data 25 Chapter 3. Implementation of INSPIRE strategies and approaches 29 Existence of government support for INSPIRE strategies 29 Implementation and enforcement of laws approaches 32 Preventing and responding to violence against children 41 Education and life skills approaches 45 Parent and caregiver support approaches 48 Norms and values approaches 51 Income and economic strengthening approaches 54 Safe environments approaches 56 Response and support services 58 Global status report on preventing violence against children 2020 iii Chapter 4. The way forward 61 Recommendations 63 Conclusion 66 References 67 PART 2. COUNTRY AND AREA PROFILES PART 3. ANNEXES 75 227 Annex 1. Technical notes 229 Annex 2. Statistical annex 241 Annex 3. Overview of INSPIRE strategies, approaches and cross-cutting activities 329 iv Global status report on preventing violence against children 2020 FOREWORD Foreword The Sustainable Development Goals contain a bold, ambitious and clear call to eliminate violence against children, and the Convention on the Rights of the Child includes a right to freedom from violence. This report is about the extent to which governments around the world are taking evidence-based actions to achieve these targets, and it provides a baseline against which governments can monitor their progress over the course of the next decade. An estimated one billion children – or one out of two children worldwide suffer some form of violence each year. In addition to its immediate harms to individuals, families and communities, violence against children has pernicious, lifelong effects that undermine the potential of individuals, and when aggregated across billions of people, may impede economic development. The COVID-19 pandemic and the physical distancing measures imposed in response to it have greatly increased the risk of intra-family violence and online abuse. School closures have impacted more than 1.5 billion children and youth. Movement restrictions, loss of income, isolation, and overcrowding have heightened levels of stress and anxiety in parents, caregivers and children, and cut families and individuals off from their usual sources of support. As this report shows, reports of child abuse and of children witnessing violence between their parents and caregivers have increased. Ending violence against children is increasingly within our reach. Data to identify the scale of the problem are available in a growing number of countries. We know what works to prevent violence against children, and technical guidance on how to do this is readily accessible in the seven INSPIRE strategies, a collection of evidencebased recommendations on how to prevent and respond to violence against children, including implementation and enforcement laws; norms and values; safe environments; parent and caregiver support; income and economic strengthening; response and support services; and education and life skills. As experience has shown, stopping the epidemic of violence against children can provide wide-ranging and substantial health, social, and economic benefits, both nationally and globally, as well as for subsequent generations. Success will mean that children can grow up free from violence and can thrive, becoming a new generation of adults able to experience healthy and prosperous lives. These rewards clearly justify - and outweigh the cost of - the resources expended on preventing violence against children. For this report, over 1000 decisionmakers from 155 countries collaborated to build a picture of global efforts to end violence against children. This collaboration has revealed a growing uptake of evidence-based solutions, Global status report on preventing violence against children 2020 v alongside untapped potential to accelerate implementation. Government officials from all countries acknowledge the need to scale up their efforts. For instance, the report shows that on average, 88% of countries have laws in place for preventing violence against children, but just 47% of government respondents felt that these laws were being enforced strongly enough to ensure violators would be penalized. And while around 56% of countries provide some national support for implementing the INSPIRE prevention and response approaches, just 25% considered this support as sufficient to reach all, or nearly all, who need them. By implementing the proven solutions set out in the INSPIRE package, we can nurture generations of children and adults who are free from violence. Providing the necessary financial and Audrey Azoulay Director-General United Nations Educational, Scientific and Cultural Organization (UNESCO) vi technical support to all countries requires a global effort. At the local level, we need to implement evidencebased strategies, and monitor them closely to ensure they are correctly delivered and reach all who need them. We need people-centered action to build a violence-free world, through our roles as parents, teachers, peers and friends. As citizens, we must hold our governments accountable for their commitments to the Sustainable Development Goals. Please join us in using the findings of this report to generate an enduring movement for the further uptake and implementation of INSPIRE and its evidence-based actions. By working together, as a local and global community, we can end the epidemic of violence against children. Tedros Adhanom Ghebreyesus Director-General World Health Organization (WHO) Henrietta Fore Executive Director United Nations Children’s Fund (UNICEF) Najat Maalla M’jid Special Representative of the United Nations Secretary General on Violence Against Children (UNSRSG/VAC) Howard Taylor Executive Director Global Partnership to End Violence Against Children (End Violence) Global status report on preventing violence against children 2020 ACKNOWLEDGEMENTS Acknowledgements The Global status report on preventing violence against children 2020 benefitted from the contributions of several WHO staff and collaborators. Alexander Butchart coordinated the overall project; Stephanie Burrows managed the survey training, data collection and data analysis; and Claire Scheurer provided administrative support. Colin Mathers prepared the Global Health Estimates for child homicides. The report was written by Stephanie Burrows and Alexander Butchart and edited by Angela Burton. Linda Dahlberg provided key suggestions for the narrative structure, and strategic direction for the report was provided by Etienne Krug. From the co-sponsoring agencies, core inputs on the report content and structure were made by Stephen Blight (UNICEF); Christophe Cornu (UNESCO); Najat Maalla M’jid (UNSRSG/VAC) and Sabine Rakotomalala (End Violence). Regional advisors and data coordinators were responsible for trainings, validation and ensuring that final government clearances were obtained: Jean-Marie Dangou, Mundenga Muller and Joseph Kalanzi (African Region); Britta Baer, Alessandra Guedes and Heather Sutton (Region of the Americas); Hala Sakr and Rania Saad (Eastern Mediterranean Region); Jonathon Passmore and Yongjie Yon (European Region); Rajesh Mehta, Neena Raina and Rania Saad (South-East Asia Region); Kira Fortune, Caroline Lukaszyk and Whitney Skowronski (Western Pacific Region). Additional support for trainings in Lusophone countries was provided by Maria Fernanda Tourinho Peres. WHO Representatives and staff at country level facilitated this work and their contributions are gratefully acknowledged. Other WHO staff who contributed include Berit Kieselbach, Tami Toroyan, Laura Sminkey and Florence Rusciano. Country-level data were obtained thanks to the concerted efforts of the National Data Coordinators (see Table A2.1 in the statistical annex), all respondents who participated in the data collection and country consensus meetings, and government officials who supported the project and provided official clearances of the information for inclusion in this report. The following experts were instrumental in developing the survey content, helping to interpret the preliminary findings, and/or reviewing the draft text: Avni Amin; Anna Alvazzi del Frate; Mark Bellis; Susan Bissell; Stephen Blight; Audrey Bollier; Mark Canavera; Lucie Cluver; Christophe Cornu; Bernadette Daelmans; Linda Dahlberg; Manuel Eisner; Begoña Fernandez; David Finkelhor; Kira Fortune; Elena Gaia; Claudia Garcia-Moreno; Bernard Gerbaka; Anna Giudice; Hans Grietens; Global status report on preventing violence against children 2020 vii Andrew Hassett; Kathryn Leslie; Najat Maalla M’jid; Silvia Perel-Levin; Maria Fernanda Tourinho Peres; Katharina Peschke; Karl Pillemer; William Pridemore; Sabine Rakotomalala; Krista Riddley; Jeff Rowland; Sara Sekkenes; Clara Sommarin; David Steven; Teresa Wallace; Catherine Ward; Deogratias Yiga. viii Global status report on preventing violence against children 2020 WHO thanks the Fondation Botnar and the United States Centers for Disease Control and Prevention for their generous financial support for the development and publication of this report. EXECUTIVE SUMMARY Executive summary This report focuses on the interpersonal violence that accounts for most acts of violence against children, and includes child maltreatment, bullying and other types of youth violence, and intimate partner violence (1). Although childhood exposure to interpersonal violence can increase the risk for subsequent selfdirected violence (including suicide and self-harm) (2) and the likelihood of collective violence (including war and terrorism) (3) – and similar root causes underlie all three forms of violence (3,4) – these forms of violence are not covered by the report. Aims of the report The elimination of violence against children is called for in several targets of the 2030 Agenda for Sustainable Development but most explicitly in Target 16.2: “end abuse, exploitation, trafficking and all forms of violence against and torture of children”. Violence against children is predictable and preventable, and governments have committed to ending it through their adoption of these targets within the Sustainable Development Goals (SDGs). The Global status report on preventing violence against children 2020 explores the progress that countries have made in implementing activities to achieve the SDG targets on ending violence against children through the lens of the seven INSPIRE evidence-based strategies for ending violence against children (see Box 1). The specific aims of the report are to document if governments: • have in place national plans of action, policies and laws that are consistent with those identified as effective by INSPIRE; • are accurately measuring fatal and non-fatal instances of violence; • have established quantified baseline and target values against which to monitor their progress in ending violence against children; • are supporting the implementation of evidence-based interventions along the lines of those included under the seven INSPIRE strategies. In a survey administered from mid-2018 to mid-2019, 155 countries reported on their efforts to prevent violence against children, the first time ever that governments are self-reporting on their work to specifically address violence against children. By giving an assessment of efforts to prevent violence against children globally and a snapshot of these efforts by country, the report provides a baseline against which governments can monitor their progress toward reaching the relevant SDG targets over the course of 2020–2030, which the United Nations has declared to be the Decade of Action to deliver the global goals for sustainable development (hereafter the UN Decade of Action) (6). Global status report on preventing violence against children 2020 ix Box 1. INSPIRE: Seven strategies for ending violence against children INSPIRE is a set of seven evidence-based strategies for countries and communities working to eliminate violence against children (5). Launched in 2016 by 10 agencies with a long history of using scientific approaches to understand and prevent violence against children, INSPIRE serves as a technical package and handbook for selecting, implementing and monitoring effective policies, programmes and services to prevent and respond to violence against children. INSPIRE is an acronym, with each letter representing one of the seven strategies: I for the implementation and enforcement of laws; N for norms and values; S for safe environments; P for parent and caregiver support; I for income and economic strengthening; R for response and support services; and E for education and life skills (5). In addition, there are two cross-cutting activities (multisectoral action and coordination, and monitoring and evaluation) that help connect and strengthen the seven strategies and monitor the extent of their implementation and impact on the problem. The World Health Organization (WHO) initiated preparation of INSPIRE, in collaboration with the United States Centers for Disease Control and Prevention (US CDC), the Global Partnership to End Violence Against Children (End Violence), the Pan American Health Organization (PAHO), the President's Emergency Program for AIDS Relief (PEPFAR), Together for Girls, the United Nations Children’s Fund (UNICEF), the United Nations Office on Drugs and Crime (UNODC), the United States Agency for International Development (USAID), and the World Bank. Preventing violence against children: global status Violence affects the lives of up to 1 billion children, with long-lasting and costly emotional, social and economic consequences Globally, it is estimated that one out of two children aged 2–17 years experience some form of violence each year (7). A third of students aged 11–15 years worldwide have been bullied by their peers in the past month, and 120 million girls are estimated to have suffered some form of forced sexual contact before the age of 20 years (8,9). Emotional violence affects one in three children, and worldwide one in four children lives with a mother who is the victim of intimate partner violence (10,11). x Global status report on preventing violence against children 2020 Violence can result in death, injuries and disabilities. Over the course of their lifetime, children exposed to violence are at increased risk of mental illness and anxiety disorders; high-risk behaviours like alcohol and drug abuse, smoking and unsafe sex; chronic diseases such as cancers, diabetes and heart disease; infectious diseases like HIV; and social problems including educational underattainment, further involvement in violence, and crime. The economic costs of these consequences are enormous. In the United States, the estimated lifetime costs of child maltreatment occurring in one year were estimated to be US$ 428 billion, and in East Asia and the Pacific the economic costs of the consequences of child maltreatment equate to between 1.4% and 2.5% of the region’s annual gross domestic product (12,13). The COVID-19 pandemic and societies’ response to it has had a dramatic impact on the prevalence of violence against EXECUTIVE SUMMARY children and is likely to have longlasting negative consequences. School closures have impacted some 1.5 billion children. Movement restrictions, loss of income, isolation, and overcrowding have heightened levels of stress and anxiety in parents, caregivers and children, and cut families and individuals off from their usual sources of support. These consequences have altered the prevalence and patterns of interpersonal violence. Decreases in homicides and violence-related injuries receiving emergency medical treatment (which mostly involve older adolescents and adult males) have been reported, particularly where lockdowns are accompanied by bans on alcohol sales. Spikes in calls to helplines about child abuse and intimate partner violence have been observed, alongside declines in the number of child abuse cases referred to child protection ser...
View Full Document

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture