Abstract

SUMMARY It is known that the extreme consequence of child abuse is a dead child. Attempts to determine the success of services to prevent child abuse and subsequent deaths confront the problems inherent in trying to prove a negative. The use of an epidemiological approach resolves some of the methodological problems by measuring 'failure' to protect in an examination of children's homicides rates over time. Between 1973 and 1988 it was found that there was a substantial reduction in baby homicides in England and Wales, equivalent to a fall of 61 per cent and a 57 per cent reduction in Scotland. In a comparison with the other fifteen Western European countries, England and Wales topped the league of improvements in children's homicide, and Scotland was fourth. Such improvements suggest advances by the child protection servi ces. Explanations for the positive British results are considered.

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