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Ending violence against children: a call to action
by The Lancet, End Violence Aganst Children
Global Partnership to End Violence Against Children, agencies
Violence in all forms is ubiquitous, increasingly visible, and recognised as a public health problem worldwide. Violence against children is a human rights violation and places huge costs on individuals and society.
The magnitude and devastating burden of such violence globally is immense; violence affects more than 1 billion children every year, and occurs in every country and community.
In 2006, the UN published a report on violence against children, and in 2011 the UN Committee on the Rights of the Child published general comment 13 on the “right of the child to freedom from all forms of violence”; however, many issues related to the implementation of violence prevention programmes have not been addressed.
Data from high-income countries show that the burden and long-lasting consequences (including intergenerational effects) of violence against children are considerable both to children themselves and to society at large, and are likely to be greatly amplified in low-income and middle-income countries.
Evidence over the past 30 years—from neuroscience, developmental psychology, epigenetics, social science, and epidemiology—shows that violence against children contributes to social, emotional, physical, and cognitive impairments and high-risk behaviours leading to disease, disability, social problems, and premature mortality.
Recognising an ethical, public health, and human rights imperative to respond to this pressing issue, a coalition comprising the International Society for Social Pediatrics and Child Health (ISSOP), the International Society for the Prevention of Child Abuse and Neglect (ISPCAN), and the International Pediatric Association (IPA) produced a position statement—Violence against children of the world: burden, consequences and recommendations for action. The statement, a call to action to policy makers and practitioners, was launched in Lahore, Pakistan, in November, 2017, at the inaugural South Asia Conference on Child Rights.
The past 2 years have seen the international community align around the issue of violence against children, its scale, the immense burden in terms of pain and suffering, and the urgency for collective action.
Our main objective with this statement is to broaden the narrow perspective of violence against children. The focus of peoples understanding of violence should be shifted to make practitioners and policy makers think about the wide context of violence against children and families and to recognise and respond to the myriad forms of violence affecting children across the world.
We redefine the agenda on violence against children with a focus on child rights and highlight the need to move from evidence to policy.
We acknowledge the primary importance of structural violence and describe typologies of violence specifically pertinent to children and young people globally, including child maltreatment; bullying, cyber violence, and corporal punishment; domestic and family violence; institutional violence; child labour; armed conflict; and harmful cultural and traditional practices.
Children are disproportionately affected by widespread conflict, which is possibly the most visible form of violence globally as images of conflict frequently include images of children.
We address the intersectionality between different types of violence, for example, children exposed to armed conflict, whether directly or remotely; the intersections between violence against women and violence against children; and the gender dimensions of violence against children.
In 2016, ten major international organisations and campaigns launched INSPIRE, an evidence-based resource package of strategies to end violence against children.
The strategies include implementation and enforcement of laws; norms and values; safe environments; parent and caregiver support; income and economic strengthening; response and support services; and education and life-skills.
The Know Violence report, Ending violence in childhood, gathered the best available evidence, mostly from low-income and middle-income countries, of the burden and scale of violence against children.
The report highlighted the importance of prevention as the only feasible response on a global scale. Building on this previous work, we are calling for a child rights-based response to violence against children that requires multisectoral action and involves not only prevention, but also treatment and rehabilitation of the effects of such violence.
A rights-based response involves all children, everywhere, with their voices heard and taken seriously. A child''s right to survival, health, wellbeing, and development to the fullest potential is paramount and must be fulfilled.
Although the role of the health sector, along with those in justice, welfare, and education, are essential in achieving this goal, the sustainable development goals are explicit in calling for multisectoral policies and intersectoral collaboration. Efforts should be coordinated and prioritised effectively.
Priorities for ending violence against children
Recognise armed conflict as a major form of violence against children and address the needs of children living in humanitarian contexts
Adopt a public health model incorporating population-based studies and improved monitoring and surveillance of violence
Integrate the common concerns of violence against women and children into policy and community programmes for broader outreach and support for those affected
Train all professionals working in child protection, as part of preservice and ongoing professional development, and link such training to awarding credentials to professionals through inter-agency partnerships
Highlight the role of hospitals, health-care facilities, and schools as settings for prevention, early identification, and intervention, in programmes and systems through inter-disciplinary collaborations and outreach
Generate relevant public policies with intersectoral action and effective child and youth participation, to support large-scale interventions
The time has come to end violence against children and we are calling for action to achieve this globally and within a single generation, recognising that the benefits will continue to accrue across several generations.
All violence against children is preventable and no violence against any child is justifiable. In 2015 the global community committed to ending such violence by 2030 in Sustainable Development Goal 16. Public health approaches are crucial to address all causes and consequences of violence against children, whether the violence occurs in the home, community, or society.
The mantle of a shared agenda to end violence against children should be taken up as an imperative in promoting and protecting children''s rights and benefiting generations to come.

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Putting Children First: Taking action to tackle poverty and inequality in Africa
by Dr. Agnes Akosua Aidoo
African Child Policy Forum, agencies
The heavy burden of child poverty in Africa is enormous and unacceptable. Yet we cannot deny that the burden of poverty and particularly child poverty in Africa is heavy and unacceptable.
According to the 2017 report of the UN General Secretary on the SDGs, there was a reduction in the global rate of extreme poverty from 28 per cent in 1999 to 11 per cent in 2013-which is the good news. The bad news is that half of the world’s poor, most of them children, live in Africa where 42 percent of the population subsisted in conditions of extreme poverty.
Substandard living conditions and the lack of basic services hit children and youth the hardest, diminishing their prospects for good health and education, creating potentially lifelong consequences for their physical, cognitive and social development as well as their active engagement in the development of their countries as agents of change.
In 2014-2016, Southern Asia and Africa accounted for 63 per cent of undernourished people worldwide. Almost two thirds of people suffering from hunger also live in these two regions. Slums are most pervasive in Africa, where more than half (56 per cent) of urban dwellers live in slum conditions with their children.
While the situation is improving globally, Africa still has the highest incidence of child labour involving more than one in five children or 59 million children according to the ILO in 2017.
Africa’s Agenda for Children 2040 acknowledges that poverty and violence affect certain categories of children in Africa including children with disabilities, orphans, children without parental or family care, children heading households, children surviving on the streets, children of marginalized or stigmatized ethnic or other minority communities more acutely than other children. These children in very vulnerable situations bear a heavy burden of chronic poverty. Climate change is also having severe impacts on children.
For example, the 2015/16 El Niño phenomenon which led to severe drought across Eastern and Southern Africa affected millions of families and children and strained traditional systems of social support. It affected the hard earned achievements in expanding primary education and forced large numbers of children to drop out of school. When children drop out of school and receive no help to move forward, they drop into debilitating poverty.
Child poverty linked to fragility, conflict, instability and insecurity
Children living in countries that are extremely poor, fragile with weak institutions, or in a state of conflict and instability are extremely vulnerable to poverty, and are more likely to experience multiple violations of their human rights. Young children and adolescents are profoundly affected by unstable economies and livelihoods, gaps and disruptions in service delivery and the effects of stress driven by conflict and insecurity.
Africa has been, and still continues, experiencing protracted conflicts and crisis situations which have devastating effects on children. According to the most recent study by the African Committee on the Rights and Welfare of the Child on the impact of conflict and crises on children, it is estimated that children are twenty-four times more likely to die during armed conflict due to illness and injury than in peacetime.
Conflict in Africa accounts for a 50 per cent increase in infant deaths and a 15 per cent increase in undernutrition. Conflict and crisis situations particularly increase the risk of girls being trafficked and experiencing sexual and gender-based violence.
So are there solutions to Africa’s child poverty challenge?
Solutions for ending child poverty are available and affordable. Child-sensitive approaches to social protection and the equitable provision of basic services to reach every child have now been widely tested and proven by African countries. However, we need to learn more about what works and innovative solutions for children in poverty especially in places where there is instability, conflict and weak institutional capacity to deliver services.
As the African Child Policy Forum advocated in its 6th International Policy Conference on the African Child in 2014, we must strive to expand the scope of social protection beyond protection and relief from deprivation, to a comprehensive agenda that includes transformative change for the beneficiaries and participants. This must be aimed at redressing the social and power inequalities, discrimination and marginalization in African societies which undermine children’s rights and their ability to reach their full human potential.
Solutions to ending child poverty must also embrace the voices and views of the children themselves. We need to learn and do more about listening to the perspectives of children. The necessary mechanisms must be put in place to engage children in order to enhance the effectiveness of the interventions meant to address their needs. This will also demonstrate that the future indeed belongs to children and they can be agents of change in that future.
There is a need for aligning Africa’s development agenda with the fulfilment of human rights-including children’s rights. Poverty reduction strategies must be realigned more closely with the fulfilment of children’s rights to non-discrimination, inclusion, protection from harm and exploitation as well as ensuring their access to basic services.
Respect for the social and economic rights of poor children and their families must be strengthened by adopting a rights-based framework for development. Such a framework can help to address the structural causes of poverty and ensure inclusiveness.
The need for enhancing implementation and improving performance
When all the policies, strategies and plans on poverty have been adopted, governments must ensure their effective implementation. Ending child poverty is about unwavering commitment to pursue a coordinated effort to implement all children’s rights and the SDGs. It is also about intensifying efforts to improve performance through, among other things, enhancing the capacity of both government and independent institutions responsible for oversight and holding the executive branches of government to account.
We must not only ask for more education and more healthcare for children, critical as they are, but we must also look at the efficiency of how the services are provided and whom they reach.
What attitudes and influences affect the delivery of basic services in African countries?
If the attitudes are those that look down on the poor, will the services reach children suffering from multiple dimensions of poverty? When health services and school supplies in primary and middle schools are free for children but the delivery system is tainted with corruption will the services reach poor children?
Education may be made available but must we not ask what kind and what quality of education? If, for example, whole classes in different schools in different geographic areas of a country such as mine, Ghana, fail all the subjects at national Basic Education Certificate Examinations (BECE) after nine years of primary and junior high school education, will most of these children not slip into poverty with all the attendant frustrations that failure brings them and their families?
Ghana is not the only country where poor basic services are rather aggravating child poverty. So we must act now and hold the authorities accountable. I would also suggest that we try to look beyond the child-related social sectors and seek linkages with other sectors for solutions. Child poverty may be greatly reduced by policy reforms in the tax systems, access to credit and improvements in agricultural productivity.
Can improvements in agricultural productivity, not just in the cash crop sector of cocoa, coffee, cashews etc., but in the food crops sector dominated by families often living on the verge of poverty help to change their situation and that of their children?
The question may also be asked about tackling child poverty by improving conditions in pastoral communities and small scale fishing communities and enhancing the economic value of the millions of women and men selling in the traditional markets usually accompanied by their poor children in the absence of affordable early childhood development programmes.
Can we invest some time and space to look at policy simulations and propose policy actions in different sectors that we know will have positive impacts on children?
The need for political engagement
My last suggestion, is that the Coalition and all the national partners in Africa find the best ways to engage politicians and policy makers on poverty eradication by putting children first. With the wonderful research and advocacy going on, can we get politicians and policy makers in general to use the right terminology as this can be a powerful path to change?
Politicians and policy makers can use the data and poverty measurements that come out of the research, be more firmly guided by the vision and mission that come out of the children’s rights instruments, national, regional and global, and use the impetus of the SDGs and Africa’s Agenda 2063 and Africa’s Agenda for Children 2040 as well as the powerful examples of success to make progress.
The fight to end child poverty in Africa must be an ongoing national commitment not subject to partisan campaign interpretations or delivery only in four or five year terms of political office only for the priority to change after the next elections.
We need consistent commitment to this priority. I would like to conclude by reiterating that poverty affects children in lifelong ways, from malnutrition, poor health, lack of success in school, harmful labour and an overall poor quality of life. Not only is this extremely damaging for children and their families, but it has a lasting and detrimental impact on the prosperity and the wellbeing of their countries.
Child poverty is everyone’s problem, and national governments should make addressing it their absolute priority. Given the gravity and intensity of the situation in Africa, the governments are urged to focus and accelerate all efforts, for the children living in poverty cannot wait any longer.
* Keynote Speech by Dr. Agnes Akosua Aidoo - International Board of Trustees, African Child Policy Forum; former Vice-Chairperson, UN Committee on the Rights of the Child to the international conference held Addis Ababa, Ethiopia: "Putting Children First: Identifying Solutions and Taking Action to Tackle Poverty and Inequality in Africa":

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