Child abuse has become a major public health problem worldwide, according to the World Health Organization (WHO). A recent estimate from WHO shows that 40'000'000 children aged 0-14 around the world suffer from abuse and neglect and require health and social care.

A number of different international studies conducted in 19 countries (i.e. South Africa, Sweden, Dominican Republic) have reported prevalence rates for sexual abuse ranging from 7% to 34% among girls and from 3% to 29% among boys.

The burden of ill health caused by injury is staggering in terms of cost and socio-economic development. One study from the United states, for example, shows that the costs for 2 million child abuse victims is US$12.4 billion for one year.

"Abused children suffer a wide variety of physical, emotional and developmental problems which can hamper their ability to live healthy and productive lives. In addition to health consequences, abused children have difficulty in school, problems with substance abuse and problems with the law. It is a public health issue of vital importance for WHO, and it represents a challenge for the next millennium" said Dr Bjorn Thylefors, Director of WHO's Division on Disability, Injury Prevention and Rehabilitation.

At a recent meeting at WHO headquarters in Geneva, experts from all the world's regions presented findings and case studies which showed how child abuse is a problem that needs to be addressed in both developed and developing countries. The 24 experts came from disciplines as diverse as violence and injury prevention, medicine, social science, public health, psychiatry, psychology and law.

Programmes undertaken in some countries have shown that it is possible to reduce the prevalence of child abuse when parents are provided training in parenting skills before and after birth in a supportive environment by nursing personnel and/or community health workers. These programmes work best if they are child-centred, family-focused and community-based.

Major initiatives which the experts recommended be undertaken by the international community include:

1.The development of worldwide data collection on child abuse and estimates of the public health impact and related costs.

2.Sharing of interventions and best practices which are successful in the prevention of child abuse and neglect.

3.Continuing evaluation and research on child abuse prevention.

4. Development of national programmes for the prevention of child abuse, as well as for programmes that provide social support to victims and families.

The positive strengths and characteristics of cultures must be used in all approaches to the problem.

For further information, journalists can contact Gregory Hartl, Office of Press and Public Relations, WHO, Geneva. Telephone (41 22) 791 44 58. Fax (41 22) 791 48 58. E-Mail: hartlg@who.int