Various issues concerning child abuse, neglect and exploitation have been a matter of increasing concern over the past three decades. The extent and seriousness of physical and sexual abuse has been recognized. The problems have been discussed by International and Regional Organizations (UN, WHO, UNICEF, ISPCAN and others) at several conventions and conferences, and clear policy statements brought out. Child rights, definitions of child abuse and neglect have been globally agreed upon and the governments have promised to take necessary steps to implement various recommendations.
Instances of violence and sexual crimes against children are very often being reported in the media, which may not necessarily be reflective of an increase in such acts, but a willingness to discuss and engage the society. Governments, NGOs and all those working for child welfare need to work together to tackle the problem and find solutions. Leaders in the community and motivated citizens must realize their duty and do their utmost to protect children from harm and support all efforts to ensure optimal development of all children.
The majority of incidents of child abuse are not reported to the appropriate authorities by the doctors and allied multidisciplinary professionals. Unfortunately, even in cases where there is an opportunity to detect and conduct an appropriate intervention, the medical professionals are not trained to recognize the presenting symptoms and signs of various types of child abuse and how to manage and provide support to the children and their families? Several times children may present with symptoms and signs, such as accidental injury, which on the initial assessment may not look like a case of child abuse, but a more detailed multidisciplinary approach may to needed to arrive at the correct diagnosis.
This present handbook has been brought out to serve as a guide to pediatricians and allied medical professionals to identify children who have been subjected to various forms of child abuse and the actions that need to be taken immediately and thereafter. The responsibilities of the first contact physician include providing the necessary urgent treatment and taking proper measures to meet forensic and legal requirements. These issues were extensively discussed by leading experts from related disciplines at three workshops June 9–10, August 5–6 and September 30, 2018, at India Habitat Center, New Delhi, with support from UNICEF India. The views of the experts and their advice have guided the preparation of this handbook.
Medical doctors in the specialty of pediatrics, family and community health, gynecology and obstetrics, mental health, forensic medicine, medicolegal services, health administration, planning and communication may come in contact with abused and exploited children in the course of their professional work. Thus, this handbook is for them and for all allied healthcare professionals who have a responsibility to provide primary healthcare, development, protection and welfare to children: in all settings where they have to respond to situations in which child abuse is likely to occur or could have occurred. It aims to provide guidelines for early recognition, investigation and response to child abuse in Indian settings.