A systems approach to addressing child maltreatment in China: China needs a formalized child protection system

The relationship between child maltreatment and psychological distress among adolescents has been well-established, but its underlying mechanism is rarely explored. Based on the biological embedding model of early adversity and interpersonal theory of psychopathology, this study examines whether the four main dimensions of social relationships–those of family, teacher-student, peers and classmates mediate the association between child maltreatment and adolescent psychological distress. Data are collected from a random sample of 971 students from middle and high schools in some rural areas in Shaanxi province, mainland China. Structural equation modeling is used to test the theoretical framework and results show a good model fit. The experience of child maltreatment not only has direct and significant influence on adolescent psychological distress, but also an indirect influence through family and teacher-student relationships. Relationships with peers and classmates do not mediate the association between child maltreatment and adolescent psychological distress. This study expands our understanding of the underlying mechanisms of how child maltreatment affects adolescent psychological distress. In addition, findings provide practical implications for the policies and social work services to reduce the psychological distress of adolescents in China.

Hospital-stranded children are defined as children who are left by parents in medical settings for over six months. These children, who legally are not classified as orphans, are excluded from existing permanent placement policies in China. Yet, little is known about this vulnerable population of children.

This study explores the experiences of hospital-stranded children and the causes for their plight, and examines the strengths and weaknesses of existing child protection practices in medical settings.

Using a multiple-case design, 20 hospital-stranded children from three children's hospitals in a first-tier Chinese city were included in this study. Sixteen hospital personnel participated in semi-structured interviews. Interview findings, case records, and field observations were analyzed using a thematic analysis approach. Current child protection practices were analyzed through a child protection system model.

The children in this study were well cared for by the hospitals, but their rights to provision, participation, and protection were violated due to the lack of a national child protection system. Three key weaknesses of child protection practices were identified: underreporting of suspected cases, delayed action after reporting, and inadequate follow-up services. The ineffectiveness of the national child welfare system and the family-oriented cultural values in China also created barriers to the protection of hospital-stranded children.

The findings suggest an urgent need for a national child protection system. Professional child protection training for healthcare workers and collaboration among departments within and outside hospitals are also necessary to offer a systematic protective network for hospital-stranded children.

Currently, gender disparities in domestic child maltreatment (DCM) have become an important and highly controversial issue worldwide. This study aims to provide panoramic evidence from China on this issue.

Data were derived from a survey of 4,308 children (M_age = 12.13, 48.7% were boys) conducted in seven provinces in rural China from June to December 2019. This study used multistage cluster sampling to select respondents, and modified versions of the JVQ Scale and the DSM-5 Scale (11–17 years old) were adopted.

This study reached three significant conclusions. First, the gender disparities in DCM vary among different maltreatment subtypes. Compared with girls, boys are more likely to experience physical abuse. A higher prevalence of neglect is observed among girls than among boys. Second, although DCM significantly increased the likelihood of posttraumatic depression for all children, its negative effect was more severe for girls than for boys. Third, gender heterogeneity is less evident than gender homogeneity in the risk factors for DCM. In rural China, children’s problematic behaviours, family structure, parents’ experiences of childhood violence and family relationships are common predictors of maltreatment for all children.

This paper highlights gender differences in the risk of DCM among children in rural China, reveals the Confucian culture behind DCM and gender, and provides Chinese evidence for building an international dialogue.

Globally, progress to improve data on child protection outcomes has been slower than efforts to improve data on child nutrition, vaccination and development outcomes in the under-five age group. The Sustainable Development Goals included several child protection targets further necessitating the need to track progress on child protection, but few studies have examined the varied data landscape for child protection within countries.

This mixed-methods study aims to examine (1) the prevalence of child protection outcomes in Nepal, (2) the types of data the child protection sector uses, and (3) recommendations to improve the collection, analysis and use of child protection data.

We used: (a) secondary data from the nationally-representative 2014 Nepal MICS which surveyed over 13,000 households to measure the national prevalence of child labor, child marriage, and violent discipline, and (b) primary data from 18 qualitative key informant interviews with organizations in Nepal’s child protection sector.

We conducted descriptive quantitative analyses of the secondary data and thematic inductive and deductive qualitative analyses of transcripts of key informant interviews.

The burden of violent discipline (82%), child labor (37%), child marriage (12%), and their co-occurrence is high in Nepal. Respondents described using a range of data sources which included: large-scale surveys, case data from the police, court system, newspapers, community consultations, and child participation. Recommendations to improve data included developing a national child protection information system, ensuring the definitions of child protection outcomes were comparable across data sources, and improving the dissemination of data.

Increasing evidence has suggested that childhood maltreatment might mediate the association between physical disability or chronic illness and depression among adolescents. We sought to identify whether childhood maltreatment mediated the relationship between physical disability or long-term health problems and depression in Chinese adolescents.

A total of 5726 middle and high school students aged 12–18 years old were chosen to participant in this study. Participants completed the self-reported questionnaire on childhood physical or long-term health problems, childhood maltreatment and depression.

The results showed that there were significant differences of childhood maltreatment, depression between adolescents with childhood physical disability or long-term health problems and those without. Physical abuse, sexual abuse, emotional abuse, physical neglect and emotional neglect mediated the association between childhood physical disability or long-term health problems and depression accounting for 8.7%, 20.6%, 14.5%, 16.3% and 14.7% of the total effect of physical disability or long-term health problems on depression in each single mediator model respectively, whereas the indirect effect of emotional abuse and sexual abuse in the association between physical disability or long-term health problems and depression explained 15.6% and 8.0% of the total effect in a multiple mediation model respectively.

Childhood physical disability or long-term health problems was associated with the increased risk for depression, and the associations between childhood physical disability and long-term health problems and depression were partially mediated by childhood maltreatment experiences. Childhood maltreatment exposure should be considered to prevent depression among adolescents with childhood physical disability or long-term health problems.

This article documents how a community approach was used as part of developing a child protection service in China. In order to demonstrate the potential of the community approach, it is first argued that the fragmented institutional arrangements and weakening family care in China have resulted in an incomplete system that leaves vulnerable children with insufficient support. However, as the current literature indicates, the community approach can be considered to provide an effective solution by mobilising community resources in the Chinese context. A pilot project which was set within a child protection service and delivered by a non-governmental organisation is presented as a case study. Five key elements that define the Chinese practice of the community approach can be summarised: (1) a belief in the important role of the community in the child protection system; (2) targeting those vulnerable children experiencing child maltreatment issues but with little family care; (3) the importance of involving the community in reporting, referral and intervention systems; (4) highlighting the protective role that the community can play; (5) collaborating with government to ensure the support of statutory resources. Lastly, this article discusses both the potential and challenges of using the community approach in this context.