Background A billion children are estimated to suffer violence each year. To support country efforts to end violence against children, WHO and partners developed INSPIRE - a technical package including seven evidence-based strategies to prevent and respond to violence against children. Whilst many of these strategies focus on individual and interpersonal risk factors, risks of violence are also affected by wider social determinants of health, such as social protection, education, employment, food security and social inclusion. However, less is known about social determinants-based approaches that can prevent violence against children and the legislative and policy frameworks that support them.

Objective Using the social determinants framework, support INSPIRE implementation by identifying policy and legislative approaches that prevent violence against children or influence intermediary determinants.

Methods A systematic review of academic and grey literature to identify evidence for policy and legislative approaches that support prevention of violence against children. Search strategies were based on preliminary work to identify relevant approaches and intermediary determinants of violence against children. Searches identified review-level evidence for each approach and aimed to fill gaps through study-level evidence. Articles (>18,000) were screened and data from relevant articles (127 reviews, 17 reports, 171 studies) were extracted and synthesised.

Results The review identified a set of seven policy and legislative strategies affecting social determinants of health that can support prevention of violence against children. Each strategy includes multiple approaches that were categorised based on available evidence of effectiveness in reducing violence against children or positively influencing intermediary determinants. Across the seven strategies, approaches with stronger levels of evidence include: social protection policies; tax credits for families with children; compulsory/free education and minimum school leaving age; financial support for low-income students; urban renewal and regeneration policies; legislation prohibiting violent behaviour; national-level parenting programmes; policies to reduce population-level access to alcohol and alcohol sales to minors; firearm control legislation; and data sharing policies.

Conclusions This framework supports governments, policymakers and all those working in, or advocating for, prevention of violence against children. Policies and legislation that address the social determinants of violence against children provide the essential foundations for ending such violence.