Why health workers need to know the law

Research shows that children who have not experienced violence are less likely to act violently, both in childhood and when they become adults. More than 150 studies on the impact of corporal punishment, for example, show that it is associated with a wide range of negative outcomes, while no studies have found evidence of any benefits (Global Initiative to End All Corporal Punishment of Children, 2013).

Effective prohibition contributes to the prevention of domestic violence, mental illness and antisocial behaviour, and supports the well-being, education and positive developmental outcomes for children. Therefore preventing violence in one generation reduces its likelihood in the next.

However, a major challenge facing health workers in the region is the poor enforcement of the laws and policies, and the extent of mistreatment of the child within the family.

The introduction of legislation to provide protection is only the first step. There is also a need for policies to promote the implementation of the law, as well as mechanisms through which the law can be enforced. It is important to bear in mind the issues raised earlier concerning parental and children’s rights. The law does, for example, restrict parental rights to use harsh physical punishment to discipline their children. As a health worker, you will be a witness to the harm caused to children as a result of such punishment. You need to be clear about the right of children to protection from such harm, and your legal and ethical responsibility to protect them from further harm.

You also need to be familiar with the policy – the local mechanisms for reporting, referring, investigating and eventually treating. At the same time as addressing the right to protection from harm, you must also have a regard for the child’s right to express their views and to do so in private. The right to be heard and taken seriously can contribute significantly to the prevention of all forms of abuse in the home and the family.

Activity 2.4: Policies to protect children from violence

Consider the following questions. Discuss them with colleagues to explore how the issues are thought about in your community.

  1. What evidence of violence against children do you see in your health setting?
  2. Do you know what systems or structures are in place to provide protection for children within your community, and how effective they are?
  3. What strategies could be developed in health settings and in the community to help reinforce these laws and policies?
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  1. Do you see children coming to clinics who have been seriously beaten or harmed by their parents, or by other people they know? Do you routinely report these cases?

    How does the local community react to these cases? Are they taken seriously as a matter of concern?

    Discussing these issues will help you begin to build up a picture of both the prevalence and nature of violence against children, and whether law and policy are being followed.

  2. It is essential that you know where a child can report a case of violence or abuse. Would they go to the local magistrate? Or to the police? Is there a community-based child protection committee and, if so, who are the members? Do children know where to go for help and do they use those systems?

    You can share your knowledge of the law with others. Is the health worker mandated by the law to examine the victim and then present his/her findings to a court of law for purposes of prosecution of the offender? In Uganda, for instance, Article 17 of the Children Act states that it is the duty of every citizen, including health workers, to protect children against any form of abuse, harassment or ill treatment.

  3. There are a number of measures that you might have thought of that could be implemented locally, for example:
    • Training practitioners on child rights, the law and the role of professionals in protecting children
    • Drawing up clear guidelines for health professionals on how and where to report instances of abuse
    • Establishing local mechanisms to protect women and children against harmful traditional practices
    • Developing and supporting community-based child protection systems
    • Awareness raising to ensure that children know their rights and how to exercise them
    • Effective and transparent complaints, monitoring, investigation and redress mechanisms.

A serious commitment to ending violence against children requires comprehensive policies at all levels of society to ensure that any laws that have been introduced are actually implemented on the ground.

Activity 2.5: Reporting mechanisms

What is the reporting mechanism in your workplace, for you as a health practitioner, if you suspect a child is being abused by someone in their own family? Who do you tell and when?

If you do not know – find out – and record the procedure.

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Comprehensive Community Based Rehabilitation Hospital in Tanzania [CCBRT] has developed a child protection policy to ensure that when children seek health services there, they are treated with dignity and respect. It is a best practice that needs to be scaled up in Tanzania and replicated in other countries. CCBRT is guided by the UN Convention as the benchmark for upholding child rights. Integral to the CCBRT is the child protection policy that all staff members, consultants, visiting doctors, journalists and other people are required to sign up to. The code of conduct lays down clearly defined standards, rights and responsibilities for all CCBRT stakeholders in respect of child protection (CCBRT, n.d.)

2.5 The law and the child’s right to protection from violence and abuse

2.6 The law and the child’s right to information