Health programmes: Integrating child protection

Health-1

During crises, children are even more vulnerable to infections, diseases and other risks to their health and lives. Not only have living conditions deteriorated, but immunisation programmes are also interrupted. The risks are even higher for unaccompanied and separated children. A concerted child-focused response is required.

Standard: Child protection concerns are reflected in the assessment, design, monitoring and evaluation of health programmes. Girls and boys have access to quality health services delivered in a protective way that takes into account their age and developmental needs. (CPMS, 2012)

Download a printable risk assessment summarising the guidelines below

Integrate

  • Disseminate agreed child protection messages through the work of health workers and in health centres, such as:
    • information on obtaining birth certificates
    • information on available services and what to do in cases of sexual violence
  • Use routine health services to identify child neglect, abuse and exploitation and work with child protection services to develop referral systems
  • Promote the recruitment of social workers and child psychologists

Keep children safe and avoid causing harm

Understand the context

  • Which child protection issues are affecting children in the community?
  • Identify current and pre-existing barriers to access to healthcare services
  • Find out what current coping strategies are:
    • Where do people go when they get sick? What kind of treatments can they expect?
    • Are they placing their safety and dignity at risk?
    • What distances will people travel for services other than primary health care (e.g. emergency obstetrics care)?

Reduce risks of harm within projects

  • As far as possible, ensure that health services are delivered in safe locations without threat of physical danger
  • Respect confidentiality and privacy by making sure that examination rooms are separated from public spaces, and personal data is stored securely
  • Provide separate lockable toilets for men and women, boys and girls
  • Orient staff and volunteers on how to offer psychological first aid
  • Ensure that staff have signed up to and been trained in a code of conduct, and are trained in child protection issues including prevention of separation

Reduce risk of exacerbating existing protection risks 

  • Consider installing lights near health centers
  • Do not accidentally cause family separation by taking a child or parent into hospital or health clinics without ensuring that children are cared for and a record of their family is taken
  • If inequitable access to health care is causing tension or conflict, consider also providing services to the local/host community

Ensure children’s access to assistance 

Make sure the most at-risk children are accessing services

  • Ensure that staff members who have knowledge and skills relevant to working with children are available at the health facility or can be contacted immediately
  • Develop child-friendly procedures for admitting, treating and discharging unaccompanied children
  • Put in place specific child survival health strategies for children under 5, both at health facility and community level (for example, vaccination campaigns, treatment of diarrhoea, promotion of exclusive breastfeeding)
  • Consider establishing support groups for mothers of young children

Adapt programming to remove barriers to access

  • Adapt health services to ensure accessibility for children, and especially children with disabilities (e.g. through adapting facilities and through the provision of community and home-based care)
  • Ensure a balance of male and female healthcare workers fluent in local and patient languages
  • Pregnant and breastfeeding women should be provided with adequate waiting spaces

Include feedback and participation

  • Regularly consult with patients to make sure that health centre access procedures are not too complex
  • Set up an accessible and confidential complaints and feedback mechanism

Respond effectively and appropriately to incidents of abuse

  • Health staff should be trained in recognising different forms of abuse, carrying out child-sensitive examinations, and child-friendly communication
  • Put in place child-friendly, safe, accessible and confidential services to respond to incidents of abuse, including referrals to relevant services (e.g. HIV testing and reproductive health services, counselling and psychological support)

Strengthen systems and help children to claim their rights

  • Staff are able to signpost other services, including legal services to respond to incidents of abuse, and to mental health and psychosocial support services
  • All unaccompanied children should be referred to a protection agency
  • Link parents of newborns to birth registration services

Monitor and evaluate

Include the safety of the affected population as a sub-objective of each health intervention. Ensure project indicators are disaggregated by age, gender, and location or specific group.

Sample objectives and indicators:

  • % of health staff that has received training on identifying and referring children affected by violence
  • % of health staff familiar with procedures to prevent children being separated from their families
  • % of health facilities that have a direct link with birth registration facilities and staff

Key references, standards and guidelines

These guidelines are based on:

And additional guidelines and resources listed here


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