The scourge of Child Abuse and Neglect has
received global attention over the past two decades. There is
serious concern over the increasing incidence of physical and sexual
abuse, child trafficking and child labor. Whereas the consequences
of grievous physical and psychological trauma are well recognized,
all forms of abusive injury in various settings are believed to have
adverse effects on health and development of children. Denial of
health care and education is a major form of neglect in developing
countries.
Neglect and Abuse
Neglect is the failure to provide for the
development of the child in all spheres: health, education,
emotional development, nutrition, shelter, and safe living
conditions, in the context of resource reasonably available to the
family or caretakers, and which causes or has a high probability of
causing harm to the child’s health or physical, mental, spiritual,
moral or social development.
Child abuse constitutes all forms of
physical and or emotional ill-treatment, sexual abuse, neglect or
negligent treatment or commercial or other exploitation, resulting
in actual or potential harm to the child’s health, survival,
development or dignity in the context of relationship of
responsibility trust or power. These definitions have to be
flexible, and each country would need to identify the pressing
issues and take appropriate remedial actions.
Child Abuse and Neglect in Developing Countries
Although physical and sexual abuse is of much
greater concern in economically advanced countries, neglect is
widely prevalent in Asian and other developing countries.
Deprivation of basic health care and education, and exploitation are
more frequent in economically backward regions, where children in
socially marginalized and urban underprivileged communities are
particularly affected. In big cities, there are massive problems of
street children, exploitation in various forms of employment and
child labor. The prevalence of Child Abuse and Neglect is difficult
to ascertain as its identification requires some expertise and
vigilance, and milder forms are mostly disregarded. Physical
punishment is a way of life in poor and illiterate communities and
corporal disciplinary measures are overlooked. Child sexual abuse
(CSA) is reported to be especially common in USA, Europe and South
Africa [1]. In India, a recent study carried out by the Ministry of
Women and Child Development and involving 12,447 children, reported
that 69% were physically abused and 53% were subjected to one or
more forms of sexual abuse [2].
Challenges and Constraints
India has a very large number of children who do
not receive adequate health care and proper nutrition and are
deprived of learning opportunities. A sizable proportion is employed
in organized labor force and non-formal work. Children of migrant
population and street children constitute substantial numbers.
Poverty, illiteracy and large families preclude proper care and
supervision of children, and adverse societal attitudes perpetuate
child abuse and neglect. Centuries old adverse sociocultural
traditions and detrimental practices (such as corporal punishment,
discrimination against girls, employment and exploitation of
children) that deny the child freedom, dignity and development are
extremely difficult to dispel.
Opportunities for Intervention
In recent years there has been global concern
over various issues of child abuse and neglect. The UN General
Assembly declaration (10th May 2002), signed by 192 countries,
mentions that "children must be protected against violence, abuse,
exploitation ..." A large number of national and international
organizations, UNICEF and the International Society for Prevention
of Child Abuse and Neglect (ISPCAN) are actively campaigning for
child rights and prevention of child abuse and neglect. In our
country several Governmental programs have been initiated (some
others such as the Integrated Child Development Scheme are being
strengthened), which would favorably impact child welfare. These
include the right to education that guarantees free primary
education to all children, National Rural Health Mission, and Child
Protection Services. A National Commission for Protection of Child
Rights has been set up with wide responsibilities. Laws and justice
mechanisms are being examined to make them child-centric and impose
deterrent punishment on perpetrators. The civil society and the
elected representatives need to engage and ensure proper
implementation of these measures.
Indian Academy of Pediatrics (IAP) and Child Abuse and Neglect
Although the IAP has largely been occupied with
problems of the sick child, preventive pediatrics, and academic
activities, it has been concerned with the wider issues that affect
child welfare and development. In 1996, IAP adopted "Comprehensive
Child Care" as its motto, and thereafter a Child Abuse, Neglect and
Child Labor Group was established to address these problems [3,4].
The membership of the Group includes various professionals, NGOs and
others working for child welfare. It has interacted with Government
departments and other organizations to advocate on behalf of
children. In 2007, IAP organized a series of training workshops on
Child Abuse and Neglect issues and also brought out guidelines on
pediatricians’ response to child abuse and neglect [5]. Several
pediatricians have been providing voluntary services in rural and
underprivileged communities. Child abuse and neglect issues have
been regularly deliberated at IAP its national and regional
conferences [6].
Asia Pacific Conference on Prevention of Child Abuse and Neglect
Indian CANCL Group, with the help of the Ministry
of Women and Child Development, Government of India, several NGO
partners and the National Law University, organized the 9th
Asia Pacific Conference on Prevention of Child Abuse and Neglect of
ISPCAN on October 5-9, 2011, at which 600 delegates from 40
countries participated. A conference outcome document was prepared,
termed "Delhi Declaration 2011", which was adopted by the
participants. The Declaration emphasizes that neglect includes
denial or deficiency of provision of services such as health care
and education. It mentions our concern over the threats to
children’s right to life before and after birth and throughout the
period of growth and violation of many children’s right to a caring
and protective environment and the unacceptable affront that this
inflicts on children’s dignity. It urges and asserts the urgent and
immediate need to integrate principles, standards and measures in
national planning processes to prevent and respond to violence
against children [7].
At the concluding session the participants
approved the Declaration and took the following pledge: "We the
participants at the 9th
ISPCAN Asia Pacific Regional Conference on Child Abuse and Neglect,
in New Delhi, representing the people of our many countries hereby
declare our commitment to these aims and objectives, and pledge
ourselves to stand against the neglect and abuse of children and to
strive for achievement of child rights and the building of a caring
community for every child, free of violence and discrimination".
The Indian CANCL Group reiterates its commitment
and appeals to pediatricians and all others to support its efforts
and speak up for children.
Funding: None; Competing interests:
None stated.
References
1. Child sexual abuse. Available from
En.wikipedia.org/wiki/Child_sexual_abuse. Accessed on 1 December,
2011.
2. Ministry of Women and Child Development,
Government of India. Study on Child Abuse in India 2007. Available
from wcd.nic.in/childabuse.pdf. Accessed on 1 December, 2011.
3. Srivastava RN. Indian Academy of Pediatrics
and Child Abuse and Neglect and Child Labor. Indian Pediatr.
2003;40:1127-9.
4. Nair MKC. Child abuse. Indian Pediatr.
2004;41:319-20.
5. Aggarwal K, Dalwai S, Galagali P, Mishra D,
Prasad C, Thadhani A, et al. Recommendations on recognition
and response to child abuse and neglect in the Indian setting.
Indian Pediatr. 2010;47:493-504.
6. Thacker N. Child rights and protection. Indian
Pediatr. 2007;44:9-10.
7. Delhi Declaration. Available from
http:www.indianpediatrics.net/delhideclaration2011.pdf. Accessed on
1 December, 2011.
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