Preventing Family Violence

More than half the world’s children report having experienced some form of violence in a previous year. Combined with what we know about the negative consequences of violence on children’s health and wellbeing, its impacts on education and the economy, and its long-lasting effects throughout childhood and well into adulthood, it is crucial that evidence-informed actions are taken at all levels to end VAC.

While the world may have been caught off guard by the size and ramifications of the COVID-19 crisis, it should be prepared to respond to the increased risks to the wellbeing and safety of children and women. Violence against children and violence against women are widespread globally and intrinsically linked, sharing common risk factors and similar adverse and severe consequences. The literature within pandemics may be limited, but we have enough evidence to say unequivocally that related factors—such as confinement, social isolation, increased levels of financial stress, and weak institutional responses—can increase or intensify levels of violence. Indeed, over the past month, reports have warned of the “perfect storm”, manifesting in increased calls to helplines, online support services, and police reports.Indeed, over the past month, reports have warned of the “perfect storm”, manifesting in increased calls to helplines, online support services, and police reports. Multinational organisations quickly took action, issuing statements warning of increased risk of both forms of violence, while researchers reviewed evidence from past crises, proposing policy actions to mitigate against potential harm to populations in situations of vulnerability. As governments ramp up response to COVID-19, what is actually being done to combat violence? 1. Expansion of helplines and information sharingInformation is being shared widely through guides, resources, and advocacy targeting friends and family members. Parenting for Lifelong Health has compiled evidence-supported guidance for safe parenting during quarantine. Helplines and online support platforms are being expanded or established. Italy, one of the countries hardest hit by the pandemic, is preventing “an emergency within an emergency” by advertising the 1522 helpline for violence and stalking. Numerous other countries are committing to keeping helplines and information channels open during and after the peak of COVID-19. 2. Funding shelters and other safe accommodation options for survivorsNumerous countries have acknowledged that additional safe housing is needed during times of quarantine. Safe accommodation allows survivors (and accompanying minors) to temporarily escape abusers. As part of its COVID-19 relief package, Canada has allocated $50 million to women’s shelters and sexual assault centres [March 18]. In France, a €1.1 million funding increase for anti-abuse organisations included 20,000 hotel nights for survivors to escape abusive partners [March 30]. In Trento (Italy), a prosecutor ruled that in situations of domestic violence the abuser must leave the family home rather than the victim [March 28]. Similar rulings have been given in Austria and Germany. Although a laudable decision, it makes guaranteeing the safety of survivors, who remain at home a challenge given that perpetrators know where to reach them and may have access to the home. Sixteen-year-old Julia attends online school from home while her parents telework during the Coronavirus outbreak in New York.3. Expansion of access to services for survivorsAs quarantine limits personal mobility and freedom of movement, some countries are finding ways to expand access to violence-related services. France has initiated ‘pop up’ centres in grocery stores, where women are likely to be already visiting [March 30]. In a number of countries (including France, Italy, and Spain), a specific 'code word' signals to pharmacies to contact the relevant authorities. Some countries have released or improved concealed apps through which women can seek services to avoid calling in close quarters with abusers (see Italy, UK, among others). Protection services for women and children must be considered “essential” and not locked down due to COVID-19.  4. Limiting risk factors associated with violenceSome countries are tackling the negative ways of coping with COVID-19 that may exacerbate the risk of violence. Greenland has banned alcohol sales in its capital Nuuk to reduce the risk of violence against children in the home [March 29]. South Africa has taken similar measures [26 March]. While alcohol abuse and problematic drinking is shown to be linked to more severe violent episodes, the relationship is complex and there is limited evidence of how alcohol-related policies affect violence. Other countries, however, have yet to take proactive steps to limit associated risks. Curtailing gun sales, for example, would limit access to fatal weapons at a time of heightened stress, potentially reducing the risk of female homicide and child deaths. Smart policy action can reduce risk of harm and facilitate positive outlets to reduce stress and promote mental health. 5. Modifications to family law and justice systemsAustralia has implemented a number of modifications to family law to allow the justice system to better respond to cases during quarantine [April 3]. First, they allow courts to impose electronic monitoring requirements for bail and conditionally suspend imprisonment orders. Second, they enable online filing of restraining orders. Third, they create a new offence, increased fine, and extended limitation period for restraining orders. As more countries experience extended periods of curtained justice services, further innovation and amendments are needed to ensure the protection of survivors in challenging situations. These actions are commendable, however many countries have still not committed resources to increase services. Initial policy responses are largely in high-income countries, which may reflect the reality that many resource-poor settings have limited budgets for addressing violence against children and violence against women even when there is no crisis. Where and how should resources be targeted? While reported cases and numbers from existing services give us a signal of what might be happening, they also give an imperfect picture. For example, in some settings, calls to domestic violence hotlines have decreased, possibly because survivors are in ear shot of perpetrators in quarantine and are unable to safely seek help. In others, demand for shelters has decreased, potentially because survivors are afraid of contracting COVID-19 within close quarters at shelters. In addition, some routine detection systems are closed, such as teachers or social workers. Already in the US, several states have reported reductions in child abuse and maltreatment, believed to be due to a reduction in detection, rather than occurrence. Further, increased time spent on phones and using computers to communicate in place of in-person interactions also poses additional avenues for perpetration of new forms of violence online, including sexual harassment, exploitation, and abuse. Mitigation efforts must address the diverse forms of violence connected with COVID-19. Actions taken must be continuously monitored to ensure they are having intended effects, and do not result in unintended harm. “For many women and girls, the threat looms largest where they should be safest. In their own homes.” As the UN Secretary-General urgently calls for peace in homes around the world, we hope that this non-exhaustive list of government responses will provide some inspiration for further action. When it comes to preventing and reducing violence and supporting survivors, everyone has a part to play, particularly in these unprecedented times.   Alessandra Guedes is the Gender & Development Research Manager at UNICEF Innocenti. Amber Peterman is a Social Policy Specialist with UNICEF Innocenti and University of North Carolina at Chapel Hill. Dina Deligiorgis is Policy Specialist on ending violence against women at UN Women.

Understanding prevalence, characteristics and motives of disclosure, help-seeking and reporting of violence against children  Violence against children is a pervasive global phenomenon. Estimates indicate over 1 billion children under the age of 18 experience emotional, physical or sexual violence every year from a range of perpetrators – including parents, peers and intimate or dating partners. Despite these high figures, official figures of VAC are just the tip of the iceberg.How much do we know about children’s disclosure, help-seeking and reporting of violence? Most studies in low- and middle-income countries have narrowly focused on either reporting intimate partner violence among adolescent girls, on specific types of violence, or in specific settings. A new publication, analyzing nationally representative Violence Against Children Survey data from six countries, aims to broaden the focus. The publication, just released in BMC Public Health, led by UNICEF Innocenti, in collaboration with other UNICEF offices and government counterparts, examines data from Cambodia, Haiti, Kenya, Malawi, Nigeria and Tanzania.The study had three objectives:Measure the prevalence of informal disclosure (to family and friends among others), formal help-seeking (from social, health and legal services), formal reporting, and receipt of formal help;Document characteristics associated with disclosure and health seeking;Understand reasons why children did not seek help. Using nationally representative data from six countries, the study analyzed reports from children aged 13 to 17 who experienced any physical and/or sexual violence in their lifetimes. These samples of child survivors of violence represented a high percentage of total children across countries: physical violence among children ranged from 50 to 84%, while that for sexual violence ranged from 6 to 36%. What did we learn in terms of disclosure and reporting? Most children have never told anyone about the violence they experience: Across countries the percentage of children who ever told someone informally about their experience was low—23% in Cambodia and 32% in Kenya, to 42% in Tanzania and 54% in Malawi. These estimates show that children may be telling survey interviewers about violence for the very first time and confirms that violence is largely under-acknowledged and “hidden in plain sight.” It also means that children’s existing social networks—including family, friends, and neighbors are often a first source of disclosure and possible support system for children survivors. Formal services are rarely accessed or utilized by child survivors: The percentage of children who reported to formal sources was low—ranging from under 1% in Cambodia to 25% in Tanzania (formal disclosure)—and the percentage who received help was even smaller (1% in Nigeria to 11% in Tanzania, this outcome was not measured in Cambodia or Haiti). These statistics confirm that only a fraction of children attempt to contact health, social or legal services and even fewer receive any support, highlighting the importance of expanding accessibility and reach of assistance. Factors encouraging disclosure, help-seeking and reporting varied by country: Identifying factors that encourage these behaviors could help target services or develop secondary prevention programming. However, few factors were consistently positively correlated with help-seeking behaviors—including factors that are hypothesized to help, like household wealth and residing in urban settings. This lack of pattern underscores the importance of context and the challenges in targeting services using observable characteristics of child survivors. Self-blame, apathy and not needing or wanting services were top factors deterring children from disclosure: Across countries, common reasons cited for not seeking help were responses like “I felt it was my fault (self blame)”, “I did not think it was a problem (apathy)” or “I don’t want or need services.” For example, in Cambodia, the most common reason for not seeking help for physical violence was self-blame, mentioned by 56% of children, while the most common reason in Kenya, Malawi and Nigeria was apathy (25%-39%). Fewer children reported fear of repercussions or helplessness, while lack of access and financial constraints were rarely mentioned. These reasons highlight the role of shame and how the normalization of VAC is pervasive. Better data and methodological innovation is urgently needed: This study underscores the need for innovation in research methodologies to accurately estimate prevalence of sensitive topics. Improvements might include methods allowing self-administration of questions and those which allow for greater confidentiality. In addition, future surveys should include a wider range of household and community level indicators to understand underlying dynamics surrounding the child’s environment—for example, parental (mental health, parenting, time use), household (social and economic vulnerability factors), and community (gender norms, service availability) characteristics. What should we take away from these results? One concrete implication is that statistics based on violence against children reporting to formal sources such as data from health systems, police, or NGO reporting are likely to underestimate the total prevalence ranging from 4 to 940-fold depending on the country. This has implications for the analysis of such data during COVID-19, where there have been fears that children are even less able to access services—and that many cases of violence are uncounted. Our results show this is a huge issue and must be accounted for when interpreting the dynamics stemming from administrative data.Other implications relate to how to improve use of services for survivors. One strategy is to address barriers including social norms that normalize violence, and how these manifest in different contexts. Another is to improve linkages and raise awareness of child protection services and common touchpoints  for children, such as those within the education, health and community-based structures, which are likely to interact with children on an informal, daily basis. These trusted individuals in children’s lives are important entry points for formal services.It is also important to strengthen the capacities of professionals working in health, education and social sectors to be able to identify risks and respond using a survivor centered approach. Given the wide under-reporting and pervasive nature of violence against children, services which are targeted to only one setting or population are unlikely to result in broad uptake of services and assistance. Multi-sectoral responses and well-networked referral systems are necessary.Much more research is needed to unpack the dynamics around help-seeking and secondary prevention for survivors. We hope this analysis will serve as a starting point to advance research and practice to end violence against children and the long-lasting negative effects experienced by children over their lifetimes.***Special thanks to Alessandra Guedes, Alina Potts and Mary Shawa for helpful comments.Amber Peterman, Ph.D. joined UNICEF Office of Research – Innocenti in 2015 as a Social Policy Specialist and now works as a consultant with joint affiliation as an Associate Adjunct Professor at UNC Chapel Hill. Amber focuses on gender, violence and adolescent wellbeing and safe transitions to adulthood with the Transfer Project evaluations of social protection and cash transfers in Africa.Audrey Pereira is a Doctoral Student in Public Policy at The University of North Carolina at Chapel Hill.Tia Palermo is Associate Professor of Epidemiology and Environmental Health at the University at Buffalo (State University of New York) and an Affiliated Researcher with the Transfer Project. Full citation: Pereira A, Peterman A, Neijhoft AN, Buluma R, Kaloga IF, Harvey R, Islam A, Kheam T, Kitembe M, Lund-Henriksen B, Maksud N, Maternowska MC, Potts A, Rottanak C, Shawa M, T Palermo (2020). Disclosure, reporting and help-seeking among child survivors of violence: A cross-country analysis. BMC Public Health 20(1051).