All children have the right to live in an environment free from abuse and neglect. The safety of children is the paramount concern that must guide child protection efforts. It is in this context that reference of this paper will be made to The Child Act 2001, the key outcome of Malaysia’s ratification of the Convention on the Rights of the Child (CRC) which forms part of the protective legal environment for children in the country. Initiatives have been introduced under this Act to safeguard children from abuse, neglect and violence such as incest which has been criminalized by the Penal Code and the Domestic Violence Act which protects the child against violence within family. This Act was introduced to consolidate and amend the laws relating to the care, protection and rehabilitation of children. With the Act beforehand, numbers of child abuse cases are still alarming. Therefore, this article is an attempt to give an overview of care and protection provided under the Child Act 2001 towards children who are being the victims of abuse. The main purpose of this article is to evaluate the extent of the protection and care given under the Act to safeguard the children in the social justice system in Malaysia. At the end of the paper some areas are identified for further improvement and future amendment.

The tragic deaths of Victoria Climbie and Peter Connelly (Baby P) and the ensuing moral panics have driven the world of child protection into a spiral of defensiveness, posturing, and bureaucratic box-ticking that is now threatening to engulf general practice – to the detriment of both doctors and any children who might need safeguarding.1 Over the past month I have received requests from local child protection authorities for reports on 18 children. These follow a standard form, opening with a request for ‘specific medical history’ and proceeding to solicit further information under a number of headings: the ‘developmental needs of the child’ (with five subheadings); the ‘capacities of parent/carer to respond appropriately to those …

In the aftermath of well–publicised child abuse cases such as the United Kingdom examples of Baby P and Victoria Climbie governments, communities and professions have begun to question their role in the protection and safeguarding of children and young people. Safeguarding, protection, abuse, neglect and need are all distinctly separate terms within their own right and yet jointly play a part in the safety assurance of children and young people. This article reviews the current literature and investigates a paramedics' role in safeguarding and protecting children and young people. It introduces future research possibilities and raises questions as to the education paramedics currently have in such an emphatic and emotive area of practice.

Child protection has become a very poignant subject in the UK. The Laming report into the death of Victoria Climbié led to the implementation of multidisciplinary safeguarding policies and training for healthcare professionals, social services staff and police. However, many dental practitioners, as well as other healthcare professionals, have little confidence when reporting their concerns and reducing the 'gap' between suspicion and reporting (Laming in The victoria climbie inquiry: report of an inquiry by Lord Laming, 2003. https://www.gov.uk/government/publications/the-victoria-climbie-inquiry-report-of-an-inquiry-by-lord-laming ). Our audit aimed to identify and address the barriers of reporting safeguarding concerns amongst the hospital team. Questionnaires were distributed to staff at Surrey and Sussex Healthcare National Health Service Trust with a valid Safeguarding Children Level 3 certificate in order to assess their knowledge of safeguarding children. Changes to traditional safeguarding training (Group 1) were implemented to include a broader range of speakers, each speaking for shorter times with more personal and focused presentations (Groups 2 and 3). Three cohorts of participants were assessed including healthcare assistants, nurses, dentists, and doctors. Group 1 (n = 100) reported 64% experience of reporting compared with group 2 (n = 100) 43% and group 3 (n = 76) 51%. Confidence was higher in those with more experience in child protection. The most common barrier was the uncertainty of diagnosis. More barriers to reporting existed in the new style of training in groups 2 and 3. The scenarios were answered with appropriate concern and reporting by groups 1 and 2, however, less for group 3. Experienced and trained practitioners are more likely to refer children to child protection teams when they have concerns of abuse or neglect. Personalising training was shown to be less effective and the focus should be more on diagnosis and local protocols. Early training from undergraduate level was a unanimous request. Focused training on diagnosis and local protocols, accompanied by bespoke teaching for specific specialties would be the most constructive tool for safeguarding children. Exploring modern methods such as simulation-based training could be effective. Structured forms and local policies that are familiar to clinicians prevent omissions and encourage professional awareness.

The purpose of this article was to examine the potential impact of child welfare services on the risk for fatal child maltreatment. This was conducted using a subsample of children who were identified as "prior victims" in the National Child Abuse and Neglect Data System from 2008 to 2012. At the multivariate level, the analyses show that case management services act to protect children from death as do family support services, family preservation services, and foster care, but that the results vary by type of maltreatment experienced. The author recommends that before strong conclusions are drawn, additional research in this area is warranted.

BackgroundFew studies have examined the effects of the Child Protection Act on child maltreatment in Taiwan. ObjectiveThis study estimated the secular trends in the incidence rate of physical abuse of children requiring hospitalization between 1996 and 2013, and the subsequent in-hospital death proportion before and after implementation of the Act in 2003. Participants and settingThe cases were children younger than 12 years old who were hospitalized due to child abuse, shaken-baby syndrome, neglect, or homicide between 1996 and 2013. A comparison group consisted of children requiring hospitalization for other reasons. We used the National Health Insurance database to identify patients. MethodsThe Joinpoint Regression Program was used to estimate temporal trends in the standardized incidence rates. ResultsBetween 1996 and 2013, 2050 children required hospitalization for physical abuse. Before 2005, the annual percent change increased by 9.40 [95% confidence interval (CI), 4.98–14.00] per year, and after 2005 the annual percent change was –4.80 (95% CI, –9.53–0.17) per year. Among the 2050 physically abused children requiring hospitalization, 83 (4%) died in hospital. The in-hospital death proportion was 2.62% before 2003 and 4.90% after 2003, and the ratio of these two proportions was 1.43 (95% CI, 0.80–2.58). ConclusionsThe trend in the incidence of hospitalization of children due to physical-abuse-related injuries started to decline 2 years after implementation of the Child Protection Act. However, the proportion of children who died in hospital as a result of physical abuse requiring hospitalization did not change.

Research in child fatalities because of abuse and neglect has continued to increase, yet the mechanisms of the death incident and risk factors for these deaths remain unclear. The purpose of this study was to systematically examine the types of neglect that resulted in children's deaths as determined by child welfare and a child death review board. This case review study reviewed 22 years of data (n=372) of child fatalities attributed solely to neglect taken from a larger sample (N=754) of abuse and neglect death cases spanning the years 1987–2008. The file information reviewed was provided by the Oklahoma Child Death Review Board (CDRB) and the Oklahoma Department of Human Services (DHS) Division of Children and Family Services. Variables of interest were child age, ethnicity, and birth order; parental age and ethnicity; cause of death as determined by child protective services (CPS); and involvement with DHS at the time of the fatal event. Three categories of fatal neglect – supervisory neglect, deprivation of needs, and medical neglect – were identified and analyzed. Results found an overwhelming presence of supervisory neglect in child neglect fatalities and indicated no significant differences between children living in rural and urban settings. Young children and male children comprised the majority of fatalities, and African American and Native American children were over-represented in the sample when compared to the state population. This study underscores the critical need for prevention and educational programming related to appropriate adult supervision and adequate safety measures to prevent a child's death because of neglect.

Background and aims: Following the tragic death of an 8 year old girl called Victoria Climbie in 2000 due to child abuse, the British Government ordered a public inquiry to be chaired by Lord Laming into the circumstances surrounding her contact with each of the agencies and “the gross failure of the system to protect her”. The report was published in January 2003. This report had 108 recommendations. Recommendations 64-90 were healthcare related. We aimed to measure compliance with the Laming recommendations in a tertiary hospital in the United Kingdom (UK) and to compare the results with a previous similar audit. Methods: Retrospective study of case notes. All child protection referrals to social services over a period of 4 months were reviewed and 17 relevant case notes were selected for final analysis. Out of the 27 health care related recommendations, 81-90 were not within our clinical remit. 79 and 80 were considered not auditable from the case notes. The remaining 15 recommendations were audited. Results: See Image 1 Conclusions:

Amendments made to the Child Abuse Prevention and Treatment Act in 2003 and the Individuals with Disabilities Education Improvement Act in 2004 opened the door to a promising partnership between child welfare services and early intervention (EI) agencies by requiring a referral to EI services for all children under age 3 involved in a substantiated case of child abuse, neglect, or illegal drug exposure. However, little research has been conducted to assess the implications of these policies. Using data drawn from a nationally representative study conducted in 2008-2009, we observed less than a fifth of all children in substantiated cases to receive a referral to developmental services (18.2%) approximately 5 years after the passage of the amendments. Of children in contact with the U.S. child welfare system, Hispanic children of immigrants demonstrated the greatest developmental need yet were among the least likely to receive EI services by the end of the study period. Implications for policy and practice are discussed.

The recent report regarding the death of children due to child abuse brought on an implementation of an Act on special cases concerning the punishment, etc. of crimes of child abuse in September 2014. According to the report in 2013 by the National Child Protectin Agency, there were 10,000 suspected child abuse cases, with about 6,000 confirmed cases. While health care providers are obligated to report suspected child abuse, the rate of report was only less than 1%. Several studies suggest that the ease of screening process for child abuse in hospitals could increase the insight and reporting rate. With regard to the improvement in the perception for child abuse by health care providers in Korea, the authors reviewed the health care provider's roles for the protection of child abuse victims, various kinds of screening tools for child abuse in hospitals, and clinical processes for the evaluation of child abuse by a child protection team. Key Words: Child Abuse; Early Diagnosis; Hospitals; Health Personnel; Child Welfare