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Regional Committee for Europe EUR/RC63/TD/1
Sixty-third session 131535
Çeşme Izmir, Turkey, 16–19 September 2013 2 September 2013 ORIGINAL: ENGLISH
Technical discussion, Tuesday, 17 September 2013
Preventing maltreatment and other adverse childhood experiences
Background
Child maltreatment is one of the hidden forms of violence, and evidence shows that its prevalence is high both in the European Region of the World Health Organization (WHO) and worldwide. The World report on violence and health1 defines child maltreatment as physical, sexual or emotional abuse and/or deprivation and neglect. Child abuse when severe can be fatal, leading to the death each year of some 850 children aged under 15 years, equivalent to 67 000 person-years of life lost. Deaths, however, are just the tip of the iceberg. The European report on preventing child maltreatment2 estimates that the prevalence of child maltreatment is much higher: 22.9% for physical abuse, 13.4% for sexual abuse in girls and 5.7% in boys, and 29.1%
for emotional abuse. Conservative estimates from the European Region suggest that 18 million children under 18 years suffer from maltreatment during the course of their childhood.
Safe, stable and nurturing relationships with parents and carers are central to a child’s healthy development. Early relationships are thought to affect neurodevelopmental changes in the brain and, in turn, the emotional, cognitive and behavioural development of a child. Child maltreatment is one of the more serious forms of adverse childhood experiences (ACE).3 It is more likely to occur where there is socioeconomic deprivation and household dysfunction (substance misuse and/or mental illness among family members, violence towards the mother, separation or divorce of parents, or imprisonment of a family member). ACE may lead to toxic stress, which affects the developing brain and may lead to cognitive impairment and behavioural problems. This can lead to risk-taking types of behaviour such as smoking, alcohol misuse, risky sexual behaviour and self-harm. These in turn may lead to impaired mental, reproductive
1 Krug EG et al., eds. World report on violence and health. Geveva, World Health Organization, 2002.
2 Sethi D et al. European report on preventing child maltreatment. Copenhagen, WHO Regional Office for Europe (forthcoming 2013).
3 Adverse childhood experiences (ACE) may be one or more of the following: emotional, physical and/or sexual abuse; physical and/or emotional neglect; substance misuse and/or mental illness among family members; violent treatment of the mother; separation or divorce of parents; imprisonment of a family member.
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and physical health, poorer educational attainment, difficulties at work or in relationships, and becoming a victim or perpetrator of violence. In view of the far-reaching health and developmental consequences, child maltreatment per se will worsen health inequity and social injustice.
The European report on preventing child maltreatment outlines the burden, causes, consequences and the cost–effectiveness of prevention programmes. These make compelling arguments for increased investment in prevention and in mainstreaming prevention objectives into other areas of health and social policy. This is in keeping with the whole-of-society approach and requires intersectoral working and coordination through national policy. Tackling child maltreatment is therefore key to achieving the Health 2020 strategic objective of reducing health inequalities, and prioritizing this area would reap benefits throughout the life-course by reducing the burden of ill health.
Objectives
The purpose of this session for Regional Committee participants is to debate the problem of preventing child maltreatment and other adverse experiences, a heath policy topic of growing interest and concern in the Region. The specific objectives of the session are:
• to present the findings of the European report on preventing child maltreatment on the burden, causes and consequences of child maltreatment and on cost-effective interventions for prevention;
• to debate areas for policy action in the WHO European Region; and
• to promote and facilitate information exchange by Member States on country experiences.
The session will be structured around presentations by experts from Member States and from the WHO Secretariat. These presentations will be followed by invited statements and comments.
A general discussion will then be held among all present.
Invited experts from Member States are Professor Mark Bellis, United Kingdom; Dr Bjørn Guldvog, Director-General for Health and Chief Medical Officer, Norway; Dr Lars-Erik Holm, Chief Medical Officer, Sweden; Ms Kathryn Tyson, Director, International Health and Public Health delivery, Department of Health, United Kingdom; and representatives of the Ministry of Health, Turkey.
Background documentation provided by the Regional Office comprises:
1. the European report on preventing child maltreatment;
2. Regional Committee resolution EUR/RC55/R9 on the prevention of injuries in the WHO European Region;
3. policy briefing on preventing child maltreatment;
4. Regional Committee resolution EUR/RC62/R4 on Health 2020 – the European policy framework for health and well-being; and
5. World Health Assembly resolution WHA56.24 on implementing the recommendations of the World report on violence and health.
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Provisional agenda
Co-chairpersons: Dr Lars-Erik Holm, Chief Medical Officer, Sweden; and Dr Omer Faruk Kocak, Governer, Elazig, Turkey.
Time Topic/speaker
13:00 Introduction with highlights from the European report on preventing child maltreatment
Dr Dinesh Sethi, Programme Manager, Violence and Injury Prevention, WHO Regional Office for Europe
13:10
13:25
Results from the Multi-nation study of adverse childhood experiences in Eastern Europe: modelling and meta-analysis of impacts on health harming behaviours in young adults by Bellis MA et al.
Professor Mark Bellis, Director School of Public Health, Liverpool John Moores University, Liverpool, United Kingdom
Policy response in Norway
Dr Bjørn Guldvog, Director-General for Health and Chief Medical Officer, Norway
Policy response in the United Kingdom
Ms Kathryn Tyson, Director, International Health and Public Health Deliverty, Department of Health England, United Kingdom
Dr Omer Frauk Kocak, Governor, Elzaig, Turkey 13:40 Discussion on the way forward
Moderator: Dr Gauden Galea, Director, Division of Noncommunicable Diseases and Life-Course, WHO Regional Office for Europe
The working languages of the session will be English and Russian.
