International guidelines for the prevention of sexual violence: A systematic review and perspective of WHO, UN Women, UNESCO, and UNICEF's publications.

BACKGROUND: Sexual violence is a major public health issue worldwide, with a high prevalence and extensive human and financial costs. Implementing prevention programs is complex, requiring not only evidence-based practices and high ethical standards, but also close collaboration with local governments and non-governmental organizations. In order to guide and support all stakeholders necessary to achieve large-scale prevention (e.g., politicians, decision-makers, in-field professionals), it is essential to establish international benchmarks for the prevention of sexual violence. OBJECTIVE: The main goal of this collaborative study was to conduct a systematic review of the frameworks adopted by WHO, UN Women, UNESCO, and UNICEF to help prevent sexual violence worldwide, according to the PRISMA methodology. A secondary objective was to highlight the levels of prevention and determinants of health targeted by these organizations. RESULTS: Overall, 1008 references were identified, of which 50 met the inclusion criteria. All international guidelines were limited to primary or tertiary prevention, and they were not specifically dedicated to sexual violence. In addition, each organization had developed idiosyncratic prevention strategies. Common primary prevention determinants of health were still found across organizations, including education, socio-economic inequalities, and life skills training. Tertiary prevention was poorly developed and polarized between victims and perpetrators. Secondary prevention was never addressed, however, despite the effectiveness of approaches such as helplines for people sexually attracted to children. DISCUSSION: Given these results, an international French-speaking consortium of professional teams, all involved in the secondary prevention of sexual violence, was recently formed with a ratified charter presented here.

Multi-sectoral response to child maltreatment in Switzerland for different age groups: Varying rates of reported incidents and gaps in identification.

BACKGROUND: As many countries lack (multi-sectoral) data on the epidemiology of agency responses to child maltreatment, they do not know if children in different regions of the country have equal chances to receive help and protection. The Optimus Study, the first nationally representative Swiss study on multi-sectoral responses to child maltreatment, examines gaps in identifying children in need and reveals opportunities for improved support and protection. METHODS: A stratified sample of 351 agencies (participation rate 81 %) in the social and health sector, public child protection, and the penal sector provided data on new cases between September 1 and November 30, 2016. The resulting study data on 7651 cases included information on the maltreatment incident, specifics of the report/referral, and child characteristics. The weighting procedure to produce national estimates was based on inverse sampling probabilities and inverse response rates. RESULTS: In the 3-month period, an estimated 10,335 cases were referred/reported to agencies in multiple sectors of the child protection system in Switzerland. This corresponded to 66 cases per 10,000 children. Rates were highest for adolescents (aged 13+), with 69 cases per 10,000 children. Lower rates for school-aged children coincided with a relatively low percentage of reports/referrals from the schools (8 %). Regional variance was extensive, with rates more than quadrupling from a low of 26 cases to a high of 107 cases per 10,000 children. Types of child maltreatment handled by agencies in the different sectors varied. Gender distribution was lopsided for sexual abuse, with many more girls experiencing incidents of sexual abuse, and unequal for incidents of neglect and psychological maltreatment. CONCLUSIONS: There are gaps in the identification of maltreated preschoolers. Promoting health checkups for this age group is a potential solution. However, school-aged children up to age 11 are underreported as well, as the schools contribute only marginally to child maltreatment reporting. The findings of the study are being used to initiate the implementation of continuous and multi-sectoral child maltreatment surveillance in Switzerland.