The Behaviours and Perceptions of Paediatricians in Malta Relating to Child Protection Work: National and International Implications of a Mixed‐Methods Study

Abstract

Health professionals fulfil an essential role within the multiagency response to safeguarding concerns. This study explored the experiences, attitudes and perceptions of paediatricians relating to child protection (CP) work. A mixed‐methods approach was adopted, using the explanatory sequential design. The quantitative strand involved a population survey of paediatricians (N = 56). Data were analysed and used to inform a subsequent qualitative strand. Both strands indicated that CP work was perceived as complex, emotive and stressful. Paediatricians perceived themselves to be working within an unstructured system. Despite most reporting to have assessed CP cases, 77.4 per cent (n = 41) had never received training. The majority reported that response pathways and reporting procedures were unclear and that they were not involved in tasks beyond identification. These factors contributed to a lack of confidence and ambivalence towards CP, particularly child sexual abuse. Participants felt reassured by having a designated consultant, however, this role also enabled them to offload responsibility. Overall, CP work was not being fully owned. This study suggests that the lack of mandatory and statutory guidance results in significantly suboptimal practice. Investment in structured training and support systems is recommended to engage professionals. Designated professionals should complement, rather than minimise, the role and responsibility of other professionals.‘This study explored the experiences, attitudes and perceptions of paediatricians relating to child protection work’Key Practitioner Messages Child protection is the responsibility of every professional working with children. Developing child protection systems requires a strong national commitment reflected in legislation and statutory guidance in order to ensure that they are standardised, robust and sustainable. Engaging professionals in child protection work is essential and calls for structured training programmes, support systems and provisions in law that protect against legal liability. Designated professionals in child protection are essential, however, their role should complement, rather than minimise, the role and responsibility of other professionals. Child sexual abuse requires specialist input.