Child abuse and neglect affects millions worldwide, and the issues surrounding this social problem are remarkably similar regardless of economic resources or political structure. However, although this tragic social issue exists in most countries, the kinds of abuse and neglect and the ways they are defined, prevented, and treated vary significantly from country to country. Many countries appear to be in a state of flux regarding this issue, striving to create definitions of abuse and neglect within their cultural contexts, while seeking adequate distinctions between acceptable discipline and child rearing practices and inappropriate practices that should be defined as maltreatment. In addition to these crucial definitional issues, experts in many countries note their frustration with the lack of resources available to tackle the problem of child abuse and neglect (Schwartz- Kenney, McCauley, and Epstein 2001).
I. The United Nations Convention on the Rights of the Child
II. Global Unifromity Not Yet Achieved
III. ISPCAN Surveys
IV. Prevalence of Definitional Diversity
V. Global Variations in Available Services
VI. Awareness at the Public and Governmental Levels
The United Nations Convention on the Rights of the Child
The Convention on the Rights of the Child (CRC), one of the many United Nations Agreements on Human Rights, seeks to provide a common definitional understanding of child abuse and neglect and an organized and consistent framework for protecting children around the world regardless of sex, religion, social origin, or country of residence. The CRC was developed over a ten-year period and was opened for signature and ratification in 1989 (United Nations Children’s Fund [UNICEF] 1989). It bans discrimination against children and provides for special protection and rights appropriate to minors. Governments that have ratified the CRC state that they have a clear commitment to protecting and ensuring the human rights of children, as defined in the convention. By signing, each country also becomes accountable to the international community to follow the set of standards and obligations described in detail within the document. Specifically, the convention states that children have the right to survival; to develop to their fullest; to be protected from harm, including abuse and exploitation; and to participate fully in family, cultural, and social life. In addition, the convention includes guidelines governing health care, education, and legal, civil, and social services. Finally, countries may choose to ratify two optional protocols governing the involvement of children in armed conflict and child sexual exploitation through the sale of children, child prostitution, and child pornography.
The CRC is one of the most successful of the United Nations’ human rights initiatives. One hundred and ninety-two countries have ratified the convention. Only two members of the United Nations—the United States and Somalia—have yet to ratify the CRC, although both countries have indicated their intent to do so by formally signing the convention. Somalia has been unable to ratify this document because it lacks a recognized government, and an extensive examination is currently under way in the United States to determine whether the CRC is consistent with existing state and federal laws and practices. The CRC has proven effective worldwide, prompting changes in legislation and policy in numerous countries. However, despite near-global acceptance of the CRC, it has not yet created uniform global legal reforms.
Global Uniformity Not Yet Achieved
Consider, for example, the issue of child testimony. In cases of child abuse and neglect, children must provide testimony in court because the child is often the sole witness to the crime. The need for testimony creates a countervailing difficulty, in that forcing the child to recount his or her experiences may prove traumatic to the child, and having the child testify in the presence of the alleged abuser may prove frightening to the child, resulting in further trauma or inaccurate testimony. Countries vary greatly in their approaches to these problems (see Bottoms and Goodman 1996, which provides an international perspective on child abuse and the use of children’s testimony within legal systems). In Canada, children are allowed to testify via closed-circuit television, or behind a screen in the courtroom, if the judge believes that the child witness cannot testify as accurately under the standard courtroom conditions. A similar accommodation is available in thirty-six of the seventy-two courts in England and Wales, in which the child can testify in an adjacent room accompanied by a supportive adult (see Bull and Davies, in Bottoms and Goodman 1996). Live link television is also available to child witnesses in New Zealand, Scotland, and Australia. These accommodations are freely available when a country’s legal system does not guarantee a defendant the right to cross-examine witnesses or confront his or her accusers.
In the United States, where the rights to cross-examine and confront one’s accusers is guaranteed by the U.S. Constitution, judges are required to protect these rights and cannot freely allow a child witness to testify outside of court from a less public location. However, in the United States, the rights to confront and cross-examine witnesses are not absolute, and U.S. judges do have the authority to accommodate child witnesses under certain circumstances. In those instances in which in-court testimony is required, it may be possible for the child witness to turn away from the defendant while testifying, while still allowing the defendant to see the witness. States vary as to the accommodations allowed to child witnesses, and the decision to allow such accommodations is frequently left to the discretion of the judge. As a result, the accommodations that can be obtained are often dependent on the presiding judge (Myers 1996).
The International Society for the Prevention of Child Abuse and Neglect (ISPCAN) has conducted numerous worldwide surveys to obtain a global perspective of the characteristics of and responses to child abuse. ISPCAN’s goal in conducting this research is to provide information from a global perspective, from which programmatic changes can be identified and implemented based on successes and problems in this area around the world. Its latest survey was released in 2004 (ISPCAN 2004). For most of its research, the Society’s response rate has been approximately 50–70 percent. In the 2004 survey, of the ninety-four countries invited, sixty-four countries provided information. The respondent countries represent a diverse group, including countries from Africa, the Americas, Asia, Europe, and Oceania. Because of this great diversity, the ISPCAN survey provides a truly global perspective of the problem of child abuse and neglect. Accordingly, the summary below is based primarily on the Society’s comprehensive survey research, as well as two other resources that provide information on the global view of child abuse (Bottoms and Goodman 1996; Schwartz-Kenney, McCauley, and Epstein 2001).
Prevalence of Definitional Diversity
To assess similarities and differences in definitions of child abuse and neglect, the ISPCAN researchers listed behaviors and conditions and asked responders to indicate whether the behaviors or conditions would be labeled abuse or neglect in his or her country. The survey reveals many similarities in definitions of abuse and neglect (ISPCAN 2004). For example, all of the responding countries agree on the illegality of sexual abuse, although how sexual abuse is defined differs from country to country. Most countries also included in their definition of abuse such behaviors and conditions as child prostitution, children living on the street, physical beating of a child by an adult, foster care abuse and neglect, and abandonment by caretakers. However, despite these similarities, the ISPCAN survey reveals wide variations in defining the problem of child abuse and neglect.
Regional differences in definitions of child abuse or neglect are particularly dependent upon differences in cultural and religious values. For instance, behaviors such as failure to secure medical care, female circumcision, and physical discipline are not labeled as child abuse or neglect in regions where these behaviors are included in cultural or religious practices. Asian and African countries were less likely to define female infanticide as abuse than countries in the Americas, Europe, or Oceania.
Among the diverse views of child abuse and neglect, physical discipline of children produced the most widely varied response. Only 46 percent of countries surveyed considered physical discipline of children to be an abusive act. In those countries where physical discipline is not considered abuse, parents and teachers impose corporal punishment that would readily be labeled as abuse elsewhere. For instance, in Sri Lanka, an education ordinance is still in effect from 1939 that permits caning of students in Government Schools.
Other variations in definitions of abuse and neglect seem to stem from economic status—whether a country is developed or developing. Many developed countries define a number of resource-based behaviors and conditions as abuse or neglect (e.g., lack of basic necessities such as food, clothing, or shelter; forcing a child to beg; abuse or neglect committed within a school, daycare center, or psychiatric center; parental substance abuse that affects the child; psychological neglect; parental mental illness), where many developing countries do not. Essentially, when countries are faced with extreme economic hardship, as many developing countries are, such resource-based behaviors are often unavoidable and, therefore, are not considered abusive. Bottoms and Goodman (1996) suggest that cross-cultural differences in definitions of abuse and neglect may be related to the different resources available to each country to deal with the problem and corresponding differences in the relative emphasis that each country places on the issue. For example, in India, many children are considered lucky simply to have a roof over their head and someone to take care of them, a situation which leads to a relative de-emphasis on the degree of kindness received from the caretaker. Accordingly, India has a significantly high population of street children, many of whom are exploited by adults through working, begging, and prostitution (see Segal in Schwartz-Kenney et al. 2001). By contrast, in the more affluent Sweden, it is illegal to spank a child.
Accordingly, in more developed countries, definitions of abuse frequently have a broader scope than definitions in less developed countries. However, even in some developed countries, commonly accepted definitions may be of only recent vintage. In Spain, commonly used and agreed upon definitions of abuse were not developed until 1987. The legislative act outlined different situations that could be indicative of child abuse and lead to child protection intervention by government child protection agencies. The covered situations included inappropriate protection or maltreatment of children by guardians. Definitions of physical abuse included any non-accidental behavior by parents that leads to physical harm or placing a child at risk of physical abuse. After the legislative act, professional handbooks were developed to assist child protection agencies in classifying cases. Spain’s definitions are consistent with those used in many other European countries and America (see de Paul and Gonzalez in Schwartz-Kenney et al. 2001).
In England, physical abuse includes instances in which children are subject to actual injury, failure to prevent injury, or placing a child in a situation in which he or she is likely to experience injury. Neglect may be persistent or severe, as well as the failure to protect from exposure to danger. Sexual abuse is more loosely defined and includes instances of actual or likely sexual exploitation of children (see Stainton-Rogers and Roche in Schwartz-Kenney et al. 2001).
Global Variations in Available Services
The ISPCAN respondents reported great differences in services available to intervene when abuse was present. These differences were in the type of interventions available (e.g., services for children or services for parents). More developed countries (e.g., United States, Canada) provide a wider array of services compared with developing countries (e.g., India, Rwanda, South Africa). Looking at all responding countries as a whole, services were most often made available to children, rather than parents. When services were available for parents, European countries provided therapy and home visits, which were often not available in African countries. These differences therefore parallel those between economic statuses in terms of definitions: More developed countries are likely to cast a wider net around the issues, with respect to both scope and services, than less developed countries. Differences between developed and developing countries also emerged in connection with prevention strategies, with most differences arising in the areas of availability of services overall and greater access to health care and home-based strategies. ISPCAN respondents most often cited limited resources, decline in family support, and family privacy as factors that limited greater prevention of abuse and neglect. Many African nations cited the influence of poverty, availability of health services, and dependency on finances from other countries as reasons why prevention efforts were not more extensive.
In addition to the presence of services, ISPCAN researchers also assessed the adequacy of the services available. Regional differences again emerged, with those from Africa and the Americas reporting lower adequacy of service compared with Asian and European respondents. This difference is likely due in part to how ‘‘adequate’’ is defined in each responding country.
Differences based on developmental status also appear with respect to funding sources of services. When services were available, they were most often provided through non-governmental organizations (NGOs), private foundations, hospitals, and service agencies, rather than universities, religious organizations, or businesses. Only rarely were services provided by relief organizations such as the Red Cross. However, in developing countries, NGOs and international relief organizations provided more funding than in developed countries. Funding for developed countries more often came from national and local governments.
When preventative measures were available, the ISPCAN respondents most often reported strategies such as advocacy, professional training, media campaigns, and prosecution. However, even where these strategies were in place, many responding countries indicated that the strategies were not effectively reducing the occurrence of child abuse and neglect. When the available strategies are compared based on developmental status, developed countries were more likely to provide individuallevel preventative strategies, such as risk assessment, home-based services, and home visitation, as well as community-based strategies such as universal health care and preventative medical care. The lack of these strategies in less developed countries is most likely due to lack of resources or funds available to provide these services to all those in need.
With regard to investigations of suspected cases of abuse or neglect, wide variations exist even within individual countries. For instance, in the United States, investigation procedures differ from state to state. Australia was the first country to attempt to create a national strategy for approaching the problem of child abuse and neglect. There, child abuse and neglect is categorized under one of four categories: neglect or abandonment, physical abuse, emotional abuse, or sexual abuse. Once reported, independent committees are responsible for investigating all reports of suspected abuse (Schwartz- Kenney et al. 2001).
The ISPCAN researchers attempted to examine the prevalence of child abuse and neglect within countries indirectly, by attempting to measure the well-being of children from country to country. The well-being of individual children is related to child abuse and maltreatment because the wellbeing of a child is usually directly related to the willingness and ability of a caretaker to adequately meet a child’s basic needs. When those basic needs are not met, children suffer, and, in severe situations, the mortality rate of children will significantly increase. To this end, the ISPCAN survey measured adopted the same measure of well-being used by UNICEF in its State of the World’s Children Report (UNICEF 2004). The measure is called the Under-Five Mortality Rate (U5MR) and is used as a measure of child well-being because the death of a child often results due to a parent or guardian’s unwillingness or inability to meet a child’s basic needs, or due to a government’s failure to provide sufficient health care, or finally due to overall societal neglect. Results from the ISPCAN report indicate that poverty, children living on their own, inadequate health care systems, acceptance of corporal punishment, and the need for family privacy all significantly related to children’s overall well-being. The most important factor governing child well-being was whether a country had a reporting system of abuse in place and whether parental services were available when abuse was reported. Accordingly, most experts see general public awareness of abuse as one route to increased intervention and prevention. Fortunately, all countries but one indicated an increase in awareness of child abuse neglect during the ten years preceding ISPCAN’s 2004 survey.
Awareness at the Public and Governmental Levels
To increase awareness, some countries have implemented public awareness campaigns, which seemed effective in Africa, the Americas, and Asia. In Europe, awareness was increased more through professional education. The ISPCAN report also noted that awareness was also affected, though less often, by media profiles of child deaths and through the efforts of NGOs. These last types of awareness factors did not differ between developed and developing countries.
The ISPCAN survey asked respondents to indicate if and how their country maintained records of cases of child abuse and neglect as well as public awareness of the problem. They found that a significant number of countries (68 percent) conducted population surveys, many conducted public opinion polls (67 percent), with fewer monitoring an official count of cases (57 percent). Of the countries that did maintain specific information concerning the number of child abuse and neglect cases, most included physical, sexual, neglect, and psychological maltreatment within the database. Developmental status differences did emerge, with developing countries using public opinion polls more often than developed countries. These public opinion polls allow the developing countries to maintain information about awareness and how residents define abuse, but with much lower expense involved. All countries but one indicated an increase in public awareness of abuse and neglect over the last decade. Developed countries reported greater public awareness of ways to protect children from abuse and neglect than developing countries.
The history of legislative recognition of the problem within countries illustrates the global diversity in recognizing and addressing the problem. In Australia, the problem of child abuse and neglect was recognized over 100 years ago when the Offences against the Person Act was passed, creating harsh consequences for those who commit crimes against children (see Shrimpton, Oates, and Hayes, in Bottoms and Goodman 1996). In Canada, there was also little social or legal recognition of the needs of children until the end of the nineteenth century (Mia, Bala, and MacMillan 2001). The same time frame can be found in England and Ireland, where the National Society for the Prevention of Cruelty to Children began its work at the end of the nineteenth century (see Stainton-Rogers and Roche, in Schwartz-Kenney 2001). In contrast, in Hong Kong, statutory protection of children from abuse focused primarily on sexual exploitation against girls, until 1951, when the protection of Women and Juveniles Ordinance was enacted (see Ho in Bottoms and Goodman 1996).
ISPCAN’s 2004 survey reports that 81 percent of responding countries have an official governmental policy on child abuse and neglect. One-third of those policies were in place before 1980, and 41 percent were enacted between 1990 and 2000. The policies usually include criminal penalties for abusing a child and provisions for state response to abuse, such as removing a child from the abusive environment. Most policies also included information on mandatory and voluntary reporting laws. Countries reporting no national policy included Hong Kong, Saudi Arabia, Syria, Australia, and Romania. Only one-third of the official policies required intervention services for abusers, and two-thirds included resources for prevention services. The report indicates that the lack of focus on intervention is likely due to the increase in defining child abuse as a crime rather than a mental health problem and to the lower cost of prevention (e.g., parenting education and family support services) compared with intervention (e.g., ongoing therapy). Although most countries reported official policies for responding to reports of abuse and neglect, only one-third of all countries noted that these policies were implemented consistently. More than half of the countries also maintained a database for the number of cases of abuse, specifically physical, sexual, neglect, and psychological maltreatment. Regional differences emerged regarding reporting laws, with African and Asian countries less likely to have mandatory reporting laws. The lack of mandatory reporting is likely due, again, to the limited resources available in these regions.