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Data needs in child maltreatment response

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Solving the problem begins with accurately measuring its occurrence

In a recent supplement to the American Journal of Preventive Medicine on approaches to measuring the incidence of the leading cause of fatal child maltreatment — inflicted brain injury — a staff member of the World Health Organization asserted that the major element missing from the global response to child maltreatment was “epidemiologically informed methods for monitoring its occurrence”.1 This view was reinforced when, in the year after its 2009 series on child maltreatment, The Lancet asked leading professionals in child health and welfare what question they most needed to be answered by the scientific published work. Their response was “Are trends in child maltreatment decreasing?”2

The difficulties of relying on reporting or notification and substantiation data from statutory child protection agencies to monitor child maltreatment are well known. These data are not good measures of the true prevalence of child abuse and neglect, because they are subject to changes in legislation and reporting policies and practices.3 This is nowhere more evident than in the impact of the recent change to the reporting threshold in New South Wales, changed by legislation after the Wood Inquiry in 2008, from “harm”…