Active surveillance of child abuse fatalities

https://doi.org/10.1016/0145-2134(92)90003-AGet rights and content

Abstract

Monitoring abuse related deaths of infants and young children yields information necessary to the formulation of sound public policy. Birth and death certificates were correlated with information in the state Child Abuse and Neglect Registry on 104 abuse related fatalities. Significant findings include: very young age of parents at the first pregnancy; high rate of single parenthood; significantly lower educational achievement of victims' mothers; late, inadequate prenatal care; complications during pregnancy; and low birth weight among victims. The authors suggest Active Surveillance as a model for collecting information pertaining to child fatalities. Using Active Surveillance, a review team examines information from state agencies pertaining to children and families to review or determine cause of death and to collect demographic data on victims and perpetrators. Active Surveillance decreases the possibility of misidentifying abuse related deaths as accidental, and allows state agencies to follow abuse fatalities, collecting pertinent information and adjusting policy accordingly. The authors argue that, using Active Surveillance, states and nations may monitor success in preventing child abuse fatalities just as they now use infant mortality to monitor progress in public health, thus creating a stable and reliable standard for measuring progress in eliminating one type of child abuse.

Résumé

L'étude des cas de maltraitance fatale fournit des données importantes pour formuler des politiques sociales. Dans le Kansas, on a corélaté 104 certificats de naissance et de décès avec certaines données puisées dans le registre d'enfants maltraités. Il en ressort le tableau suivant: parents très jeunes lors de la première grossesse, familles monoparentales, faible scolarité de la mère, services prénataux inadéquats et prodigués trop tard. complications durant la grossesse et poids inférieur de l'enfant á sa naissance. Les auteurs recommandent un programme de surveillance active pour recueillir systématiquement des données sur la maltraitance fatale, afin d'accumuler des données démographiques sur les victimes et les agresseurs et de préciser la cause du décès. Ce modèle diminue les chances de méprendre ces fatalités pour des accidents et permet aux autorités de faire un suivi, tout en recueillant des données et modifiant les politiques sociales. Les auteurs sont d'avis qu'un tel programme de suveillance active permet de jauger le succès des mesures préventives, tout comme on se sert de taux de mortalité pour mesurer le progrès des programmes de santé publique. Ainsi, disposeraiton d'un baromètre fiable et permanent pout mesurer les progrès par rapport á la prévention des fatalités causées par la maltraitance.

Resumen

Estudiar cuidadosamente las muertes de infantes y niños pequeños relacionadas con abuso puede ofrecer información necesaria para la formulación de una buena política gubernamental. Se correlacionaron los certificados de nacimiento y defunción con información del Registro Estatal de Abuso y Negligencia a los Niños, sobre 104 muertes asociadas al abuso. Resultados significativos incluyen: edad muy joven de los padres en su primer embarazo: alta tasa de padres y madres solteros; las madres de las vítimas tenían logros significativamente más bajos; cuidado pre-natal tardío e inadecuado: complicaciones durante el embarazo y menor peso al nacer de las víctimas. Los autores sugieren Vigilancia Activa como un modelo para recoger información relacionada con las muertes infantiles. Usando la Vigilancia Activa, un equipo revisor examina la información de las agencias estatales asociadas con los niños y las familias para revisar o determinar la causa de la muerte, y para recoger datos demográficos sobre las víctimas y los perpetradores. La Vigilancia Activa disminuye la posibilidad de mal identificar las muertes relacionadas con abuso como accidentales, y le permite a las agencias estatales hacerle un seguimiento a las muertes por abuso, regociendo información pertinente y ajustando conjuntamente la política. Los autores defienden que, usando la Vigilancia Activa, los estados y las naciones pueden supervisar si tiene éxito la prevención de las muertes por abuso a los niños de la misma forma que ahora se usa la mortalidad infantil para supervisar el progreso de la salud pública creando así una medida estable y confiable para evaluar el progreso para eliminar un tipo de abuse a los niños.

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