The South African Child Death Review Project - effective intersectoral collaboration
Child Death Reviews (CDRs) use an intersectoral approach to understand and prevent child deaths.1 This project has been implemented by the Children’s Institute in collaboration with the Division of Forensic Medicine, University of Cape Town for the Western Cape and the Forensic Pathology Services, KwaZulu-Natal Department of Health for Kwa-zulu Natal. The CDR teams facilitate a coordinated response between the police, forensic pathology services, prosecution authorities, paediatricians, and social services in the management of child deaths. The efficacy of the model in the South African setting was tested through a process evaluation in 2014 at two sites, Salt River Mortuary in the Western Cape and Phoenix Mortuary in Kwa-zulu Natal, with a focus on establishing the effectiveness of the teams to strengthen the health and child protection response systems.2 This multi-agency approach brings together evidence from medical records, autopsy reports, police and social services investigations, and enables more effective identification of child abuse and neglect. It helps identify systems failures within different departments and opportunities to strengthen communication and coordination between them.
The CDR pilot has demonstrated how a multi-agency approach can enhance reporting and enable a real-time response to ensure children are safer in their homes. The value of making joint decisions also took the burden off the forensic pathologist and police as investigating child deaths in the home is incredibly difficult, particularly when there is a suspicion of a non-accidental injury at the hands of someone close to the child. Social services investigations have also proved crucial in identifying families in distress who require ongoing support to prevent further negative outcomes.
The project has been adopted by the Department of Health in the Western Cape as a “best practice model” and is being expanded across the province.
For queries about this project contact: Prof Shanaaz Mathews – shanaaz.mathews@uct.ac.za
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Further reading
- Abrahams N, Mathews S, Martin LJ, Lombard C, Nannan N & Jewkes R (2016) Gender Differences in Homicide of Neonates, Infants, and Children under 5 y in South Africa: Results from the Cross-Sectional 2009 National Child Homicide Study. PLoS Medicine, 13(4), e1002003.
- Dawson M, Mathews S, Abrahams N & Campbell J (2017) Death Reviews in the Context of Domestic Homicide in Low- to Middle-Income Countries: South Africa as a Case Study. In: Dawson M. (eds) Domestic Homicides and Death Reviews. Palgrave Macmillan, London.
- Mathews S, Abrahams N, Jewkes R, Martin LJ, & Lombard C (2013) The epidemiology of child homicides in South Africa. Bulletin of the World Health Organization, 91(8), 562–568.
- Mathews S & Martin L (2016) Developing an understanding of fatal child abuse and neglect: Results from the South African child death review pilot study. South African Medical Journal, 106(12), 1160-1163.
- Mathews S, Martin L, Coetzee D, Scott C & Brijmohun, Y (2016) Child deaths in South Africa: Lessons from the child death review pilot. South African Medical Journal, 106(9), 851-852.
- Mathews, S., Martin, L., Scott, C., Coetzee, D., & Lake, L. (2015). Every child counts: Lessons learned from the South African Child Death Review pilot. A research brief.
Featured Publications
- BRIEFING PAPER
- RESEARCH REPORT
- RESEARCH REPORT
- LAW REVIEW
- EARLY CHILDHOOD REVIEW 2017
- HEALTH GUIDE
Shifting Attitudes and Behaviours Underpinning Physical Punishment of Children
The purpose of this briefing paper is to assist policy makers and practitioners to make informed decisions about interventions that could support the development and implementation of policies and programmes targeting physical punishment. This briefing paper presents evidence on largescale interventions that have been used to shift attitudes and behaviours underpinning physical punishment. In light of the paucity of evidence in relation to physical punishment, the briefing paper also presents evidence on the effectiveness of large-scale interventions targeting other forms of violence against children and intimate partner violence.Out of Harm's Way? Tracking Child Abuse Cases Through the Child Protection System at Five Selected Sites in SA
The study aims to document how the child protection system processes reported cases of child abuse, and make recommendations about how child protection services could be strengthened, to reduce the risk of trauma to children and breaking the inter-generational cycle of violence. In particular the study generates recommendations for the specific improvement of child protection services within the local setting.
Towards a More Comprehensive Understanding of the Direct and Indirect Determinants of Violence against Women and Children in South Africa with a View to Enhancing Violence Prevention.
The main objective of this report is to provide the Inter-Ministerial Committee (IMC) to Investigate the Root Causes of Violence Against Women and Children with a critical analysis of the risk and protective factors, or determinants, associated with violence (physical, sexual and emotional) against women and children in South Africa, as well as an indepth understanding of the relationship between the relevant variables, and to recommend practical violence reduction and prevention interventions.South Africa’s Progress in Realising Children’s Rights: A Law Review
South Africa’s 20-year anniversary of the start of democracy is a good moment to take stock of progress in realising children’s rights, and to flag challenges in need of attention. This review of South African laws aimed at realising children’s rights was done to assess whether these laws have been designed and are being implemented in compliance with international and constitutional law. It focuses on children’s rights to birth registration; basic nutrition; social assistance; basic education; special protection when in conflict with the law; protection from violence; and appropriate alternative care when removed from the family environment. Produced in partnership with Save the Children South Africa.South African Early Childhood Review 2017
Early childhood development (ECD) services are needed to support the development of young children. With commitment from government sectors to work together, an essential package of ECD services can be delivered to all South Africa’s young children. This review presents a set of indicators to support inter-sectoral planning, delivery and monitoring of an essential package of ECD services, from conception to the age of six.Children's Act Guide for Health Professionals
This guide is for people working in the health sector, and outlines the specific provisions of the Children’s Act that apply to health professionals. It explains the children's rights and principles that inform the Act and addresses difficult questions such as how to determine the best interests of the child, and whether consensual sex between adolescents should be reported. The guide also details the consent requirements for different health services, and explains what to do in an emergency, or in case of conflict between parents and the child. It informs health professionals of their mandatory obligations to report abuse and neglect and examines how to interpret these requirements in light of recent court judgements. This edition has been substantially updated and includes short cases from health professionals to assist with the interpretation of the Act.
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