Research in Child Protection Against Abuse and Neglect: at the crossroads of analysis, strategy, and policy

Guest Editorial

Abstract

This special issue on Child Abuse and Neglect celebrates the 25th anniversary of the PGH-Child Protection Unit (CPU) and Child Protection Network and reinforces the latter’s nationwide intersectoral approach to child health. It stands as a testament to the pivotal role of research as one of the five pillars in the Care Continuum for Child Maltreatment; the other pillars being 1) integrated clinical care for the abused child, 2) prevention of child abuse at three levels, 3) training in all sectors, and 4) governance. These articles summarize evidence critical for evaluating, reviewing, and advancing policies.1

Operational analyses of existing infrastructure suggest practice guidelines that can help others establish the same.

• Qualitative analysis of operational deliverables ofthe PGH-Child Protection Unit and Child Protection Network in advancing the Care Continuum for Child Maltreatment – a roadmap for operational evaluation and set-up sheds light on key elements, intricacies, and variables of infrastructure and operations as a basis for plans on what, how, and where best to improve.
• The National Baseline Study dives into the prevalence of child physical and sexual abuse in the Philippines.
• DNA detection in cases of sexual abuse has revolutionized the investigation and prosecution of these cases, as explored by A Retrospective Look on the Use of DNA Evidence in a Sexual Assault Investigation in the Philippines.
• The Development of a Local Sexual Assault Investigation Kit:The Philippine Experience identifies key elements important for training modules on caring for child victims and handling evidence.

The following studies focus on the human element: victims’ and perpetrators’ characteristics are summarized and analyzed.

• Child victims are studied in Comparison ofthe ClinicalProfile ofPrepubertal versusPubertal Female Child Sexual Abuse in a Tertiary Hospital.
• Obstetric and Perinatal Outcomes and the Factors Associatedwith It Among PregnantTeen/Adolescent Filipino 13-19 years old in a Tertiary Institution focuses on this special subgroup.
• Prevalence and Risk Factors of Suicidal Ideation Among Victims of Child Sexual Abuse highlights a key consequence.
• Juvenile perpetrators are studied in The Demographics of Minor Perpetrators of Sexually Assaulted Pediatric Patients from PGH from January 2013 to December 2018.
• Female perpetrators of child abuse are studied in The Demographic Profile of the Female Assailant: A Ten-Year Background Review of Female Perpetrators Committing Abuse Seen at the UP-Philippine General Hospital Child Protection Unit from January 2008 to December 2018.

These articles review potential risk factors that come in the form of cultural practices.

• Research on normal behavior and acceptable cultural practice is characterized in EmicPerceptions ofAge-Appropriate Parent-Child Intimate Behaviors Related to Hygiene, Affection, and Privacy.
• Research on analysis of cultural perspectives on discipline and when disciplinary measures are inappropriate and qualify as abusive in Socio-cultural Perspectives on Child Discipline, and Child Abuse in the Philippines give insight into prevention initiatives in the community.
• Research on child protection advocacy through safe schools is reported in An Outcomes-based Evaluation of the Mindfulness for Safe Schools giving insight into policy and program design.

These papers lay the groundwork for Clinical Practice Guidelines as mandated by the Philippines Department of Health (DOH),3 catalyzing research here and abroad,4-6 and advancing Child protection in the Philippines.

Child protection in the Philippines grew from a few hospital-based CPUs to an organized Child Protection Network of 114 CPUs in 58 provinces and 10 independent cities, reaching 90% of the children in the Philippines. This speaks to intersectoral collaborations, generosity, professionalism, motivation for excellence, and commitment to children. This also speaks to the value of integrated medical care, governance and policy-making, training of current and future specialists, and research.

After 25 years, we stand at the crossroads of analysis, strategy, and policy for child protection against abuse and neglect.

Victoria L.M. Herrera, MD
Department of Medicine
Boston University School of Medicine
United States of America

Heather S. Spader, MD
Pediatric Neurosurgery
University of New Mexico
United States of America

Marilyn J. Kaufhold, MD
Child Abuse Pediatrics
Chadwick Center for Children and Families,
Rady Children’s Hospital
San Diego, California, United States of America

REFERENCES

1. Dubowitz H. Child abuse pediatrics: research, policy and practice. Acad Pediatr. 2011 Nov-Dec; 11(6):439-41. doi: 10.1016/j.acap. 2011.09.005. PMID: 22078838.
2. National Unified Health Research Agenda 2017-2022. Manila: Philippine Council for Health Research and Development [Internet] 2022. [cited 2022 July] Available from https://doh.gov.ph/publication/National-Unified-Health-Research-Agenda-2017-2022.
3. Republic of the Philippines. 2019. Republic Act 11223. An Act Instituting Universal Health Care for All Filipinos, Prescribing Reforms in the Health Care System, and Appropriating Funds Thereof.
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