Preventing violence against children 2020: report for the WHO South-East Asia Region

PREVENTING VIOLENCE AGAINST CHILDREN 2020: REPORT FOR THE WHO SOUTH-EAST ASIA REGION 9 789290 228660 Preventing violence against children 2020: rePort for the Who south-east asia region Adopted from the Global Status Report for preventing violence against children 2020 Preventing violence against children 2020: report for the WHO South-East Asia Region ISBN: 978-92-9022-866-0 © World Health Organization 2021 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial- ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. 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Cover photo credits: WHO Bangladesh WHO Thailand WHO SEARO WHO SEARO/Christine McNab Marcus Perkins WHO Maldives WHO Timor-Leste Background and method 1 Key findings 5 Child homicide rates 11 Opportunities and moving forward 13 Global recommendations 17 Acknowledgements 18 Annexures 19 Bangladesh 20 Bhutan 21 India 22 Indonesia 23 Maldives 24 Nepal 25 Sri Lanka 26 Thailand 27 Timor-Leste 28 Report for the WHO South-East Asia Region iii PREvEntinG viOlEncE AGAinSt cHildREn 2020 contents Report for the WHO South-East Asia Regioniv Preventing violence against children 2020 © iStock.com/pixelfusion3d Report for the WHO South-East Asia Region 1 Preventing violence against children 2020 Background and method Violence affects the lives of up to 1 billion children globally, with long-lasting and costly health, emotional, social and economic consequences.1 In South-East Asia, the Regional report of the Global status report for violence prevention published in 2014 revealed that victims of child maltreatment incur higher health-care costs, make more visits to health-care providers over their lifetime and have more hospital stays than those who have not experienced violence.2 In the East Asia and Pacific region, child maltreatment costs a total of US$ 151 billion or 1.9% of the region’s gross domestic product (GDP).3 Violence against children can be prevented. Evidence-based guidance on what works to prevent and respond to violence against children is readily accessible in the seven INSPIRE strategies (Box 1). Evidence shows that a 20–50% decrease in prevalence has been achieved by well-designed programmes, many of which are implemented in low- and middle-income countries.4 Rapid reductions in violence are clearly possible if there is political will and strong leadership, evidence-based policies and interventions, and adequate finances. Governments have committed to ending violence against children through their adoption of: „ the 2030 Agenda for Sustainable Development, Target 16.2 on ending all forms of violence against children, and other targets that cover reducing deaths due to all forms of violence, ending violence against girls, and ensuring safe, non-violent educational settings; „ the WHO Global plan of action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children,5 as endorsed by World Health Assembly Resolution 69.5 of 2016; and 1 Hillis S, Mercy J, Amobi A Kress H. Global prevalence of past-year violence against children: a systematic review and minimum estimates. Pediatrics. 2016;137(3):e20154079 2 Fact sheet: Violence prevention in the South-East Asia Region. New Delhi: WHO Regional Office for South- East Asia; 2015 (https://apps.who.int/iris/bitstream/handle/10665/164334/Fact%20Sheets%20on%20 Violence%20in%20SEAR,%202015.pdf;sequence=1, accessed 23 June 2021). 3 Ending violence in childhood: global report 2017. Geneva: WHO; 2017 (https://resourcecentre. savethechildren.net/library/ending-violence-childhood-global-report-2017, accessed 23 June 2021). 4 INSPIRE: seven strategies for ending violence against children. Geneva: World Health Organization; 2016. Geneva: WHO; 2016 (https://www.who.int/publications/i/item/inspire-seven-strategies-for-ending-violence- against-children, accessed 23 June 2021). 5 Global plan of action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children. Geneva: WHO; 2016 (https://www.who.int/publications/i/item/9789241511537, accessed 23 June 2021). Report for the WHO South-East Asia Region2 Preventing violence against children 2020 „ the WHO Thirteenth General Programme of Work (GPW13), target to reduce violence against children by 20% by 2023. The Global status report on preventing violence against children 2020,6 developed in consultation with Member States, measures the extent to which governments around the world are taking evidence-based actions in line with the INSPIRE strategies (see Box 1) to achieve the Sustainable Development Goal (SDG) targets on ending violence against children. The report provides a baseline against which governments can monitor their progress over the course of 2020–2030, which the United Nations has declared as the Decade of Action to deliver the global goals for sustainable development. It focuses on interpersonal violence, which accounts for most acts of violence against children, and includes child maltreatment, bullying and other types of youth violence, and adolescent intimate partner/teen dating violence. Based on the findings of the Global status report,6 the regional report focuses on the WHO South-East Asia (SEA) Region. Of the 11 Member States, nine participated 6 Global status report on preventing violence against children 2020. Geneva: WHO; 2020 (https://www.who. int/teams/social-determinants-of-health/violence-prevention/global-status-report-on-violence-against- children-2020, accessed 23 June 2021). Box 1. INSPIRE strategies, approaches and cross-cutting activities for preventing and responding to violence against children INSPIRE is a set of seven evidence-based strategies for countries and communities working to eliminate violence against children. Launched in 2016, INSPIRE serves as a technical package and handbook for selecting, implementing and monitoring effective policies, programmes and services to prevent and respond to violence against children. It comprises seven strategies that provide an overarching approach for ending violence against children: „ specific interventions, including programmes, practices and policies to implement the strategies; „ evidence to support these strategies and interventions; „ links to related SDG targets. INSPIRE is an acronym, with each letter representing a strategy: I for the implementation and enforcement of laws; N for norms and values; S for safe environments; P for parent and caregiver support; I for income and economic strengthening; R for response and support services; and E for education and life skills. There are also two cross-cutting activities (multisectoral action and coordination, and monitoring and evaluation) that connect the seven strategies and monitor the extent of their implementation and impact on the problem. Report for the WHO South-East Asia Region 3 Preventing violence against children 2020 in a self-administered survey filled in by officials from different government sectors in each country. They then discussed and reached agreement on the responses. Countries reported on the status of their national action plans, indicators, laws and data collection mechanisms, and about programmes and services along the lines of those given as examples under each of the INSPIRE strategies. The final responses were officially cleared by the relevant government ministry, underlying the report’s unique value as being the first time ever that governments self- reported on their work to specifically address violence against children. In addition, as part of this project, new homicide estimates were produced by using information supplied by the countries on the number and proportions of homicide victims aged 0–17 years and subsequent consultation before finalizing the estimates that replace the existing WHO estimates. Report for the WHO South-East Asia Region4 Preventing violence against children 2020 © iStock.com/A.J. Rich Report for the WHO South-East Asia Region 5 Preventing violence against children 2020 Key findings all countries reported that there is formal collaboration between the different ministries for preventing violence against children Seven of the nine participating countries reported having formal collaboration among multiple stakeholders in addressing violence against children (14% of which had a single collaborative mechanism and 86% had multiple mechanisms). All countries listed nongovernmental organizations (NGOs) as members of the collaborations, 71% of countries listed United Nations (UN) agencies, and 57% listed other international agencies, academia and/or the private sector. All countries reported that there is formal collaboration between the different ministries, such as women and child health, social welfare, police/home affairs departments and education for preventing violence against children. In many countries (71–86%), there is collaboration between the health sector and police/ home affairs. Collaboration is in multiple areas of function, like designing and delivering prevention and response interventions for violence against children, data management, legislation, national plans. all countries in the region have national action plans to prevent violence against children, most of which are fully funded All countries in the Region have a national plan to prevent child maltreatment, sexual, school-based and gender-based violence, and 89% of countries have national plans for youth violence. These plans are fully funded in 78% of countries. The national plans of four countries in the Region make explicit reference to/are consistent with the WHO Global plan of action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children5 (Indonesia, Sri Lanka, Thailand and Timor-Leste). Three countries (Indonesia, Sri Lanka and Thailand) reported that their national action plans are consistent with the INSPIRE strategies. Report for the WHO South-East Asia Region6 Preventing violence against children 2020 In the Region, the national plans of Bangladesh and Indonesia explicitly recognize that violence is a risk factor for the development of health risk behaviours, such as the harmful use of alcohol, drug abuse, cigarette smoking, physical inactivity, overeating (leading to obesity) and risky sexual behaviour. Some of the subnational plans in Nepal and Sri Lanka also recognize violence as a risk factor for the development of health risk behaviours but others do not. few countries with nationally representative prevalence data are using these to set prevention baselines and targets Despite many countries having nationally representative prevalence data, only Indonesia and Nepal (two out of the nine respondent countries) have a prevalence indicator with baseline and target values contained in their national action plans. Such targets are important as they provide a focus for national authorities, and research shows that long-term goals and interim targets lead to increased political will and stakeholder accountability, closer management of strategies and programmes, better and more effective programmes, improved use of public resources and increased stakeholder motivation.7 7 Quantitative road safety targets. Brussels: European Commission, Directorate General for Transport; 2018 (https://ec.europa.eu/transport/road_safety/sites/default/files/specialist/knowledge/pdf/quantitative_road_ safety_targets.pdf, accessed 23 June 2021). Box 2. Availability of nationally representative prevalence data Data on the prevalence of violence against children are essential to understand the scale and distribution of the problem, set priorities and target resources, and monitor if and how policy, legal and programmatic prevention efforts are making a difference. The survey revealed that many countries do not have adequate administrative data systems for reporting child homicides to official sources. Fifty-six per cent of countries reported homicides from police records and only Nepal and Thailand provided data from civil or vital registration. Self-reports ascertained via nationally representative surveys are considered the more reliable standard for measuring the magnitude of the problem, identifying vulnerable groups and measuring progress. In South-East Asia, all participating countries have data on violence against children available from at least one internationally comparable nationally representative survey, including the Global School-based Student Health Survey (89% of countries), Demographic and Health Surveys (78% of countries), and United Nations Children’s Fund (UNICEF) Multiple Indicator Cluster Surveys (56% of countries). Report for the WHO South-East Asia Region 7 Preventing violence against children 2020 there are marked differences in the level of government support in line with the insPire strategy Countries reported on whether they had legislation to reduce violence against children (INSPIRE strategy on implementation and enforcement of laws) and whether there were government mechanisms to support implementation of activities consistent with the other six INSPIRE strategies. The frequency with which they reported providing any kind of support (e.g. funding, tools or training, irrespective of reach) for national-level implementation of the laws and activities is shown in Fig. 1. Overall, 60% of countries provide support for the INSPIRE strategies, but this varied considerably by strategy. Implementation and enforcement of laws are the most frequently supported strategies (by 89% of countries), followed by norms and values (by 82% of countries). Safe environments are the least supported strategy (by 29% of countries). Fig. 1. Percentage of countries in the South-East Asia Region reporting any support for INSPIRE strategies, 2018 (n=9 reporting countries) 100 80 60 40 20 0 Implementation and enforcement of laws Education and life skills Norms and values Response and support services Safe environments Income and economic strengthening Parent and caregiver support South-East Asia (N=9) Report for the WHO South-East Asia Region8 Preventing violence against children 2020 laws against violence that affect children are widely enacted but often inadequately enforced To assess the existence of laws and the extent of their enforcement, government respondents were asked to indicate whether a law existed (and to provide a copy of the legislative text) and, if so, to provide their best estimate of the likelihood that a person who breaks the law will be sanctioned (i.e. arrested, convicted, penalized or given a formal warning by a law enforcement agency).8 Of the laws examined, 100% of countries reported that they have laws in place against sexual violence (rape, contact sexual violence without rape, non-contact sexual violence), while 89% report having laws regulating civilian access to firearms. For the laws on firearms, 67% of countries require a minimum age and time- limited licensing period, 56% require a criminal history and health requirements and restrictions on certain types of firearms, while 44% of countries require a waiting period for firearm possession and safe storage. Laws banning corporal punishment are present in 78% of countries, but only in only Nepal and Timor- Leste do these laws cover all settings, while 67% of countries have laws against weapons on the school premises. However, the proportion of countries where the perceived enforcement level was considered sufficient to ensure a high likelihood of sanction for people breaking the laws ranges from 44% for bans on corporal punishment to 67% for laws on rape, contact sexual violence without rape and weapons on the school premises (Fig. 2). Respondents were asked about the legal service laws in terms of legislation on providing compensation for victims of violence and legislation on providing victims of violence with free/State-funded legal representation in criminal courts. Eighty- nine per cent of countries have laws providing legal representation to the victim and 78% of countries have laws providing victim compensation. Findings about laws restricting access to alcohol were taken from the WHO Global status report on alcohol and health 2018,9 which revealed that 44% of the participating countries have a minimum age for alcohol sales, one country has a total ban, while the rest do not have a minimum age at the national level. In India, a minimum age for alcohol sales exists at the subnational level. 8 Perceived enforcement was assessed using a rating scale ranging from 1 where it was considered highly unlikely that someone breaking the law would be sanctioned, to 10 where respondents considered it highly likely that someone would be sanctioned for breaking the law. The median of the respondents’ scores was calculated and assessed according to three levels of enforcement: low enforcement for ratings up to 3.3; medium enforcement for ratings from 3.4 to 6.7 and wide enforcement for ratings from 6.8 to 10. 9 Global status report on alcohol and health 2018. Geneva: World Health Organization; 2018 (https://www. who.int/publications/i/item/9789241565639, accessed 23 June 2021). Report for the WHO South-East Asia Region 9 Preventing violence against children 2020 While countries are investing in prevention, decision-makers in every country accept that they need to scale up their efforts The INSPIRE strategy on implementing and enforcing laws is complemented by the remaining six strategies covering prevention programmes and services for victims and perpetrators. The six strategies encompass 23 different approaches. To assess how far these approaches are reaching all their intended beneficiaries, government respondents were asked to provide their best estimate of the extent to which approaches receiving national-level support are reaching all or nearly all those who need them8. For the most part, response approaches were more frequently rated as having a wide reach compared to prevention approaches (see Fig. 3). Only three prevention approaches were rated as having a wide reach by 50% or more of countries (school enrolment, bystanders’ intervention and life skills training). Except for perpetrator identification, and referral and mental health services, response approaches were rated as having a wide reach by 50% of countries. Fig. 2. Proportion of countries with national laws to prevent violence and enforcement (likelihood of sanction), 2018 (n=9 reporting countries) 100 100 89 100 78 67 67 56 56 67 44 67 - 10 20 30 40 50 60 70 80 90 100 Against rape Against non- contact sexual violence Regulating civilian access to firearms Against contact sexual violence without rape Banning corporal punishment Against weapons on school premises Law exists Perceived high likelihood of sanction Report for the WHO South-East Asia Region10 Preventing violence against children 2020 Fig. 3. Percentage of countries where support for INSPIRE prevention and response approaches was considered adequate to reach all or nearly all in need, 2018 (n=9 reporting countries) School enrolment (E) Bystander intervention (N) Life skills training (E) Training to recognize abusive situations (E) Anti-bullying (E) Violence by school staff (E) Cash transfer (I) Gender and social norms (N) Community mobilization (N) Spatial modification (S) Microfinance with gender norm training (I) Centre-based parenting (P) Home visiting (P) Hotspot interventions (S) Interrupting the spread of violence (S) Dating violence prevention (E) Group savings and loan (I) Child protection services (R) Clinical services for sexual violence victims (R) Victim identification and referral (R) Victim mental health services (R) Perpetrator identification and referral (R) Perpetrator mental health services (R) Prevention approaches Percent of countries 0 20 40 60 63 63 50 38 38 38 38 25 25 25 25 13 13 13 13 13 13 13 50 50 50 50 25 80 100 Response approaches Key: E=education and life skills; N=norms and values; I=income and economic strengthening; S=safe environments; P=parent and caregiver support; R=response and support services Report for the WHO South-East Asia Region 11 Preventing violence against children 2020 child homicide rates the south-east asia region has the fourth-highest child homicide rate globally In 2017, an estimated 16% of homicides among those aged 0–17 years (out of 40 150 homicides globally) occurred in the South-East Asia Region. The estimated child homicide rate in the Region is 1 per 100 000 children, which represents the fourth-highest rate in the world, after the Americas (5.8 per 100 000), African (2.1 per 100 000) and Eastern Mediterranean (1.5/100 000) regions. The regional child homicide rate is the fourth highest for both sexes, with the homicide rate for males (1.1 per 100 000) is somewhat higher than that for females (0.8 per 100 000). © iStock.com/Joanna Jablonska Report for the WHO South-East Asia Region12 Preventing violence against children 2020 Fig. 4 reveals that Indonesia, Thailand and Timor-Leste have a higher child homicide rate for both sexes combined and for males than the regional rate, and that Nepal’s male child homicide rate is higher than the regional rate. Indonesia is the only country in the Region were female child homicide rate is higher than the regional rate (Fig. 4). Fig. 4. Estimated homicide rates per 100 000 population in children aged 0–17 years by country and sex, South-East Asia Region, 2017 1.4 1.4 1.2 1 0.9 0.9 0.8 0.6 0.52 0.4 1 1.9 2.3 1.2 1.1 1.1 1.2 1.1 0.7 0.58 0.5 1.1 0.8 0.4 1.1 0.8 0.8 0.5 0.6 0.4 0.45 0.3 0.8 0 0.5 1 1.5 2 2.5 Tim or -L es te Th ail an d Ind on es ia Ind ia Ind ia Ne pa l Ba ng lad es h M ald ive s Bh ut an Sr i L an ka SE AR O All sexes Male Female Report for the WHO South-East Asia Region 13 Preventing violence against children 2020 opportunities and moving forward The current report is based on the Global status report for preventing violence against children 2020,6 the first ever report to measure the extent to which governments are implementing evidence-based actions to achieve the SDG targets on ending violence against children. This report can be used by governments as a baseline to monitor their progress in preventing violence against children. The survey revealed that much effort has been undertaken by countries in the South-East Asia Region to prevent violence against children, including institutional management, development of national action plans, implementing the INSPIRE strategies, and monitoring and evaluation. The baseline findings of the report show that more national support is needed to fill in the gaps within these activities. Based on the findings of the survey, Table 1 summarizes the opportunities and recommendations for preventing violence against children. © iStock.com/Bartosz Hadyniak Report for the WHO South-East Asia Region14 Preventing violence against children 2020 Table.1. Key findings, focus areas and recommendations to strengthen actions toward ending violence against children in the South-East Asia Region Area Key findings Areas needing further focus What is recommended for governments Multisectoral collaboration • Multiple government sectors are involved in addressing violence against children. • Mechanisms exist to involve sectors beyond the government – UN and other international agencies, academia, NGOs and the private sector. • All countries have at least one plan to prevent violence against children. • While most of the institutional functions are addressed, there is a need to further strengthen the compilation and dissemination of national statistics and the design and delivery of interventions. • A lead agency is needed to coordinate multisectoral action to end violence against children with the necessary executive powers and budget. • An in-depth institutional assessment can be especially useful to identify opportunities toward strengthening the capacity of coordination, especially in the areas of dissemination of statistics and delivering interventions. The review needs to address the problems of inadequate funding. • INSPIRE strategies and approaches need to be integrated into national policies to ensure that economic, education, employment, health and social areas are addressed. Monitoring and evaluation • Homicide data reported are not available from police records and vital registration in all countries . • Most countries have data from internationally comparable nationally representative surveys. • Homicide data collected from vital/ civil registry are inadequate. • Few countries use these nationally representative prevalence data to monitor the progress of their national action plans. • Not all the plans are consistent with the WHO Global plan of action on strengthening the role of the health system to address interpersonal violence, the INSPIRE strategies or link violence to health risk behaviours. • Increase dissemination and use of data for national-level programming. • Increase participation in internationally comparable nationally representative surveys. • Strengthen routine data collection of homicide data, especially for police and civil/ vital registry. • Review/develop measurable targets in the national action plans against best practice standards to ensure that they are specific, measurable, answerable, relevant and time bound. Report for the WHO South-East Asia Region 15 Preventing violence against children 2020 Legislative framework • Many laws to prevent violence against children are available in the Region. • Despite the law’s availability, not all laws are highly enforced and perhaps not of high quality. • To optimize the effectiveness of legislative frameworks in helping to end violence against children, it is important that governments ensure that laws have universal legal protections for children, meet best practice standards and that there is a renewed commitment to the implementation and enforcement of laws. Prevention and service programming • There are ongoing national efforts to address the response services for victims, including child protection services, clinical services for sexual violence victims, victim identification and referral, and victim mental health services). • There is a need to strengthen preventive interventions, including a change in norms and values; safe environments; parental and caregiver support; income and economic strengthening; and education and life skills • Governments should draw upon the evidence-based solutions presented in the INSPIRE strategies that provide a collection of proven and promising approaches. • Assess the extent to which their existing support for violence prevention programming is consistent with the INSPIRE evidence- based solutions. • Use the INSPIRE technical guidance to revise their support to ensure it promotes actions aligned with those in INSPIRE. Report for the WHO South-East Asia Region16 Preventing violence against children 2020 © UN Photo/Helena Mulkerns Report for the WHO South-East Asia Region 17 Preventing violence against children 2020 global recommendations Ensure full use of international support mechanisms by countries. Governments are encouraged to join the End Violence partnership as pathfinder countries, and to participate in the closely linked INSPIRE Implementation Working Group, a technical network and community of practice dedicated to supporting the uptake and monitoring of INSPIRE. „ As part of the Decade of Action, pathfinder countries should be encouraged to submit plans for accelerated actions to end violence against children to the UN with the aim of demonstrating measurable change by the second SDG Summit in 2023. „ Countries should be encouraged and supported to agree on a set of voluntary performance targets to track the implementation, reach and impact of INSPIRE strategies and approaches. „ Further global status reports on preventing violence against children should be published in 2025 and 2030 to track changes in the uptake of and support for the INSPIRE strategies and approaches against the voluntary performance targets. „ Partnerships with actors working on other SDGs – especially health, education, social protection – should be strengthened. Increase funding for evidence-based prevention. Donor funding to support INSPIRE implementation in low- and middle-income countries must be increased, and mechanisms must be established to ensure that such funds are effectively implemented. Strengthen implementation research. Support for high-quality implementation research must be increased, and more of this research must be conducted in low- and middle-income countries. Implementation research should focus on: „ how to take the INSPIRE approaches to scale, including through the identification of light, low-cost delivery options; „ the role of INSPIRE and subsets of INSPIRE strategies and approaches to accelerate progress towards multiple SDG goals and targets; „ building links between preventing violence against women and children; „ building a case for investment for each INSPIRE strategy, identifying unit costs for implementation in low-, middle-, and high-income settings, and calculating the financing gap. Report for the WHO South-East Asia Region18 Preventing violence against children 2020 acknowledgements WHO thanks the Foundation Botnar and the United States Centers for Disease Control and Prevention for their generous financial support to the development and publication of the Global Status Report for preventing violence against children 2020. Report for the WHO South-East Asia Region 19 Preventing violence against children 2020 Annexures SEAR Country profiles prepared from the Global Status Report for preventing violence against children 2020 1. Bangladesh 2. Bhutan 3. India 4. Indonesia 5. Maldives 6. Nepal 7. Sri Lanka 8. Thailand 9. Timor-Leste Preventing violence against children 2020: report for the Who south-east asia region20 BANGLADESH Population: 161 376 713 Income group: Lower middle Parent and caregiver support Response and support services Safe environments Income and economic strengthening Education and life skills Norms and values Strengthening non-violent norms National YES NO YES Community mobilization National YES NO YES Bystander interventions National YES YES YES Addressing violence “hotspots” None - - - - Interrupting the spread of violence None - - - - Improving the built environment None - - - - Home visiting None - - - - Centre-based parenting support None - - - - Cash transfers None - - - - Group savings and loans with gender equity training None - - - - Microfinance and gender equity training None - - - - Child protection services National YES YES YES Clinical services for sexual violence victims National YES YES YES Mental health services for victims National YES YES YES Mental health services for perpetrators None - - - - Identification and referral for victims National YES YES NO Identification and referral for perpetrators None - - - - Increasing school enrolment National YES NO YES Helping children protect themselves from sexual abuse National YES YES YES Life and social skills training None - - - - School-based anti-bullying None - - - - School-based dating violence prevention None - - - - Reducing violence by school staff None - - - - Implementation support Perceived reach Level Funds Tools Training Very few Nearly all VIOLENCE PREVALENCE FROM SELECTED MULTI-COUNTRY SURVEYSa Male% Female% Experiencing violent discipline in the past month, 1–14 year olds 89 89 Witnessing physical violence in the home prior to 18 years, 18–24 year olds - - Sexual victimization prior to 18 years, 18–24 year olds - - Bullying victimization in the past 30 days/few months, 11–15 year olds 27 17 Involvement in physical fighting in the past 12 months, 13–15 year olds 27 10 a Countries may have data available from several other surveys but in the interests of global comparability, indicators from the most widely available internationally comparable surveys have been selected Da ta c ol le ct ed b y m ul tis ec to ra l c on se ns us m ee tin g an d cl ea re d by D ire ct or at e Ge ne ra l o f H ea lth S er vic es GOVERNANCE AND MONITORING TO END VIOLENCE AGAINST CHILDREN 3 Government sectors with functions addressing violence against children, 3 of which have coordinating function Includes prevalence indicator/s: NO Funding Child maltreatment YES Full Youth violence YES Full Sexual violence YES Full Funding School-based violence YES Full Gender-based violence YES Full Other NO - National action plan/s IMPLEMENTATION OF INSPIRE STRATEGIES AND APPROACHES Implementation and enforcement of laws Perceived enforcement Low High Bans on corporal punishment in all settings NO Against statutory rape YES Against contact sexual violence excluding rape YES Against non-contact sexual violence YES Regulating civilian access to and use of firearms YES Perceived enforcement Low High Against weapons on school premises NO - Providing for victim compensation YES Not asked Providing for victim legal representation YES Not asked Minimum age for alcohol sales NO Not asked 85Global status report on preventing violence against children 2020RE E G O E E AGA S H RE R HO S E A R Preventing violence against children 2020: report for the Who south-east asia region 21 1 BHUTAN Population: 754 396 Income group: Lower middle Parent and caregiver support Response and support services Safe environments Income and economic strengthening Education and life skills Norms and values Strengthening non-violent norms National YES YES YES Community mobilization National NO YES NO Bystander interventions National NO NO YES Addressing violence “hotspots” Subnational - - - - Interrupting the spread of violence None - - - - Improving the built environment - - - - - Home visiting None - - - - Centre-based parenting support None - - - - Cash transfers National NO YES YES Group savings and loans with gender equity training National YES YES YES Microfinance and gender equity training National YES YES YES Child protection services National NO YES YES Clinical services for sexual violence victims National NO NO YES Mental health services for victims National YES YES YES Mental health services for perpetrators None - - - - Identification and referral for victims National NO YES YES Identification and referral for perpetrators None - - - - Increasing school enrolment National NO YES YES Helping children protect themselves from sexual abuse National YES YES YES Life and social skills training National NO YES YES School-based anti-bullying National NO YES YES School-based dating violence prevention National NO YES YES Reducing violence by school staff National NO YES YES Implementation support Perceived reach Level Funds Tools Training Very few Nearly all VIOLENCE PREVALENCE FROM SELECTED MULTI-COUNTRY SURVEYS Male% Female% Experiencing violent discipline in the past month, 1–14 year olds - - Witnessing physical violence in the home prior to 18 years, 18–24 year olds - - Sexual victimization prior to 18 years, 18–24 year olds - - Bullying victimization in the past 30 days/few months, 11–15 year olds 31 29 Involvement in physical fighting in the past 12 months, 13–15 year olds 52 34 Da ta c ol le ct ed b y m ul tis ec to ra l c on se ns us m ee tin g an d cl ea re d by M in is tr y of H ea lt h GOVERNANCE AND MONITORING TO END VIOLENCE AGAINST CHILDREN 1 Government sector with functions addressing violence against children, 1 of which has coordinating function Includes prevalence indicator/s: NO Funding Child maltreatment YES Partial Youth violence YES Partial Sexual violence YES Partial Funding School-based violence YES Partial Gender-based violence YES Partial Other NO - National action plan/s IMPLEMENTATION OF INSPIRE STRATEGIES AND APPROACHES Implementation and enforcement of laws Perceived enforcement Low High Bans on corporal punishment in all settings NO - Against statutory rape YES Against contact sexual violence excluding rape YES Against non-contact sexual violence YES Regulating civilian access to and use of firearms YES Perceived enforcement Low High Against weapons on school premises YES Providing for victim compensation NO Not asked Providing for victim legal representation YES Not asked Minimum age for alcohol sales 18 Not asked RE E G O E E AGA S H RE R HO S E A R Preventing violence against children 2020: report for the Who south-east asia region22 INDIA Population: 1 352 642 283 Income group: Lower middle Parent and caregiver support Response and support services Safe environments Income and economic strengthening Education and life skills Norms and values Strengthening non-violent norms National YES YES YES - Community mobilization National YES YES YES - Bystander interventions None - - - - Addressing violence “hotspots” National NO NO YES - Interrupting the spread of violence National NO NO YES - Improving the built environment National YES NO YES - Home visiting National NO NO YES - Centre-based parenting support National NO NO YES - Cash transfers National YES NO NO - Group savings and loans with gender equity training National YES YES YES - Microfinance and gender equity training National YES NO YES - Child protection services National NO YES YES - Clinical services for sexual violence victims Subnational - - - - Mental health services for victims None - - - - Mental health services for perpetrators National NO YES NO - Identification and referral for victims National YES YES NO - Identification and referral for perpetrators None - - - - Increasing school enrolment National YES YES YES - Helping children protect themselves from sexual abuse National YES YES YES - Life and social skills training National YES YES YES - School-based anti-bullying National NO YES YES - School-based dating violence prevention None - - - - Reducing violence by school staff None - - - - Implementation support Perceived reach Level Funds Tools Training Very few Nearly all VIOLENCE PREVALENCE FROM SELECTED MULTI-COUNTRY SURVEYSb Male% Female% Experiencing violent discipline in the past month, 1–14 year olds - - Witnessing physical violence in the home prior to 18 years, 18–24 year olds - - Sexual victimization prior to 18 years, 18–24 year olds - - Bullying victimization in the past 30 days/few months, 11–15 year olds - - Involvement in physical fighting in the past 12 months, 13–15 year olds - - a Subnational b Countries may have data available from several other surveys but in the interests of global comparability, indicators from the most widely available internationally comparable surveys have been selected B as ed o n da ta a nd in fo rm at io n av ai la bl e in p ub lic d om ai n. GOVERNANCE AND MONITORING TO END VIOLENCE AGAINST CHILDREN 3 Government sectors with functions addressing violence against children, 2 of which have coordinating function Includes prevalence indicator/s: NO Funding Child maltreatment YES Full Youth violence NO - Sexual violence YES Full Funding School-based violence YES Full Gender-based violence YES Full Other NO - National action plan/s IMPLEMENTATION OF INSPIRE STRATEGIES AND APPROACHES Implementation and enforcement of laws Perceived enforcement Low High Bans on corporal punishment in all settings NO - Against statutory rape YES - Against contact sexual violence excluding rape YES - Against non-contact sexual violence YES - Regulating civilian access to and use of firearms YES - Perceived enforcement Low High Against weapons on school premises NO - Providing for victim compensation YES Not asked Providing for victim legal representation YES Not asked Minimum age for alcohol sales a Not asked RE E G O E E AGA S H RE R HO S E A R Preventing violence against children 2020: report for the Who south-east asia region 23 INDONESIA Population: 267 670 549 Income group: Lower middle Parent and caregiver support Response and support services Safe environments Income and economic strengthening Education and life skills Norms and values Strengthening non-violent norms Subnational - - - - Community mobilization National YES YES YES Bystander interventions National YES YES NO Addressing violence “hotspots” None - - - - Interrupting the spread of violence None - - - - Improving the built environment National YES YES YES Home visiting None - - - - Centre-based parenting support National YES YES YES Cash transfers National YES NO NO Group savings and loans with gender equity training None - - - - Microfinance and gender equity training National YES YES YES Child protection services National YES YES YES Clinical services for sexual violence victims National YES YES YES Mental health services for victims National YES YES YES Mental health services for perpetrators None - - - - Identification and referral for victims National YES YES YES Identification and referral for perpetrators None - - - - Increasing school enrolment National YES YES YES Helping children protect themselves from sexual abuse National YES YES YES Life and social skills training National YES YES YES School-based anti-bullying National YES YES YES School-based dating violence prevention None - - - - Reducing violence by school staff National YES YES YES Implementation support Perceived reach Level Funds Tools Training Very few Nearly all VIOLENCE PREVALENCE FROM SELECTED MULTI-COUNTRY SURVEYSa Male% Female% Experiencing violent discipline in the past month, 1–14 year olds - - Witnessing physical violence in the home prior to 18 years, 18–24 year olds - - Sexual victimization prior to 18 years, 18–24 year olds - - Bullying victimization in the past 30 days/few months, 11–15 year olds 24 19 Involvement in physical fighting in the past 12 months, 13–15 year olds 36 13 a Countries may have data available from several other surveys but in the interests of global comparability, indicators from the most widely available internationally comparable surveys have been selected Da ta c ol le ct ed b y m ul tis ec to ra l c on se ns us m ee tin g an d cl ea re d by C en te r o f D at a an d In fo rm at io n GOVERNANCE AND MONITORING TO END VIOLENCE AGAINST CHILDREN 9 Government sectors with functions addressing violence against children, 9 of which have coordinating function Includes prevalence indicator/s: YES (Physical, sexual, emotional) Funding Child maltreatment YES Full Youth violence YES Full Sexual violence YES Full Funding School-based violence YES Full Gender-based violence YES Full Other YES Full National action plan/s IMPLEMENTATION OF INSPIRE STRATEGIES AND APPROACHES Implementation and enforcement of laws Perceived enforcement Low High Bans on corporal punishment in all settings NO Against statutory rape YES Against contact sexual violence excluding rape YES Against non-contact sexual violence YES Regulating civilian access to and use of firearms YES Perceived enforcement Low High Against weapons on school premises YES Providing for victim compensation YES Not asked Providing for victim legal representation YES Not asked Minimum age for alcohol sales 21 Not asked 132 Global status report on preventing violence against children 2020 RE E G O E E AGA S H RE R HO S E A R Preventing violence against children 2020: report for the Who south-east asia region24 MALDIVES Population: 515 704 Income group: Upper middle Parent and caregiver support Response and support services Safe environments Income and economic strengthening Education and life skills Norms and values Strengthening non-violent norms None - - - - Community mobilization National YES YES YES Bystander interventions None - - - - Addressing violence “hotspots” None - - - - Interrupting the spread of violence None - - - - Improving the built environment None - - - - Home visiting National YES YES YES Centre-based parenting support None - - - - Cash transfers Subnational - - - - Group savings and loans with gender equity training None - - - - Microfinance and gender equity training None - - - - Child protection services National YES YES YES Clinical services for sexual violence victims None - - - - Mental health services for victims None - - - - Mental health services for perpetrators None - - - - Identification and referral for victims None - - - - Identification and referral for perpetrators None - - - - Increasing school enrolment - - - - - Helping children protect themselves from sexual abuse None - - - - Life and social skills training - - - - - School-based anti-bullying National NO YES YES - School-based dating violence prevention - - - - - Reducing violence by school staff - - - - - Implementation support Perceived reach Level Funds Tools Training Very few Nearly all VIOLENCE PREVALENCE FROM SELECTED MULTI-COUNTRY SURVEYSb Male% Female% Experiencing violent discipline in the past month, 1–14 year olds - - Witnessing physical violence in the home prior to 18 years, 18–24 year olds - - Sexual victimization prior to 18 years, 18–24 year olds - - Bullying victimization in the past 30 days/few months, 11–15 year olds 30 30 Involvement in physical fighting in the past 12 months, 13–15 year olds 41 23 a Total ban b Countries may have data available from several other surveys but in the interests of global comparability, indicators from the most widely available internationally comparable surveys have been selected Da ta c ol le ct ed b y m ul tis ec to ra l c on se ns us m ee tin g an d cl ea re d by M in is tr y of G en de r, Fa m ily a nd S oc ia l S er vic es GOVERNANCE AND MONITORING TO END VIOLENCE AGAINST CHILDREN 3 Government sectors with functions addressing violence against children, 3 of which have coordinating function Includes prevalence indicator/s: NO Funding Child maltreatment YES Full Youth violence YES Full Sexual violence YES Full Funding School-based violence YES Full Gender-based violence YES Full Other NO - National action plan/s IMPLEMENTATION OF INSPIRE STRATEGIES AND APPROACHES Implementation and enforcement of laws Perceived enforcement Low High Bans on corporal punishment in all settings NO - Against statutory rape YES Against contact sexual violence excluding rape YES Against non-contact sexual violence YES Regulating civilian access to and use of firearms YES Perceived enforcement Low High Against weapons on school premises YES Providing for victim compensation NO Not asked Providing for victim legal representation NO Not asked Minimum age for alcohol sales YESa Not asked 152 Global status report on pr venting violence against child en 2020RE E G O E E AGA S H RE R HO S E A R Preventing violence against children 2020: report for the Who south-east asia region 25 NEPAL Population: 28 095 712 Income group: Low Parent and caregiver support Response and support services Safe environments Income and economic strengthening Education and life skills Norms and values Strengthening non-violent norms National YES YES YES Community mobilization National YES YES YES Bystander interventions National YES YES YES Addressing violence “hotspots” None - - - - Interrupting the spread of violence None - - - - Improving the built environment None - - - - Home visiting None - - - - Centre-based parenting support None - - - - Cash transfers Subnational - - - - Group savings and loans with gender equity training None - - - - Microfinance and gender equity training None - - - - Child protection services National YES YES NO Clinical services for sexual violence victims National YES YES YES Mental health services for victims National YES YES YES Mental health services for perpetrators None - - - - Identification and referral for victims National YES YES YES Identification and referral for perpetrators None - - - - Increasing school enrolment National YES YES YES Helping children protect themselves from sexual abuse National YES YES YES Life and social skills training National YES YES YES School-based anti-bullying National YES YES YES School-based dating violence prevention None - - - - Reducing violence by school staff - - - - - Implementation support Perceived reach Level Funds Tools Training Very few Nearly all VIOLENCE PREVALENCE FROM SELECTED MULTI-COUNTRY SURVEYSa Male% Female% Experiencing violent discipline in the past month, 1–14 year olds 83 81 Witnessing physical violence in the home prior to 18 years, 18–24 year olds - - Sexual victimization prior to 18 years, 18–24 year olds - - Bullying victimization in the past 30 days/few months, 11–15 year olds 56 45 Involvement in physical fighting in the past 12 months, 13–15 year olds 45 35 a Countries may have data available from several other surveys but in the interests of global comparability, indicators from the most widely available internationally comparable surveys have been selected Da ta c ol le ct ed b y m ul tis ec to ra l c on se ns us m ee tin g an d cl ea re d by M in is tr y of H ea lth a nd P op ul at io n GOVERNANCE AND MONITORING TO END VIOLENCE AGAINST CHILDREN 5 Government sectors with functions addressing violence against children, 1 of which has coordinating function Includes prevalence indicator/s: YES (All types) Funding Child maltreatment YES Full Youth violence YES Full Sexual violence YES Full Funding School-based violence YES Full Gender-based violence YES Full Other NO - National action plan/s IMPLEMENTATION OF INSPIRE STRATEGIES AND APPROACHES Implementation and enforcement of laws Perceived enforcement Low High Bans on corporal punishment in all settings YES Against statutory rape YES Against contact sexual violence excluding rape YES Against non-contact sexual violence YES Regulating civilian access to and use of firearms YES Perceived enforcement Low High Against weapons on school premises NO - Providing for victim compensation YES Not asked Providing for victim legal representation YES Not asked Minimum age for alcohol sales - Not asked 164 Global status report on preventing violence against children 2020 RE E G O E E AGA S H RE R HO S E A R Preventing violence against children 2020: report for the Who south-east asia region26 SRI LANKA Population: 21 228 760 Income group: Upper middle Parent and caregiver support Response and support services Safe environments Income and economic strengthening Education and life skills Norms and values Strengthening non-violent norms National YES YES YES Community mobilization National YES YES YES Bystander interventions None - - - - Addressing violence “hotspots” National YES YES YES Interrupting the spread of violence National YES YES YES Improving the built environment National YES YES YES Home visiting National YES YES YES Centre-based parenting support National YES YES YES Cash transfers National YES YES YES Group savings and loans with gender equity training National YES YES YES Microfinance and gender equity training National YES YES YES Child protection services National YES YES YES Clinical services for sexual violence victims National YES YES YES Mental health services for victims National YES YES YES Mental health services for perpetrators National YES YES YES Identification and referral for victims National YES YES YES Identification and referral for perpetrators None - - - - Increasing school enrolment National YES YES YES Helping children protect themselves from sexual abuse National YES YES YES Life and social skills training National YES YES YES School-based anti-bullying National YES YES YES School-based dating violence prevention National YES YES YES Reducing violence by school staff National YES YES YES Implementation support Perceived reach Level Funds Tools Training Very few Nearly all VIOLENCE PREVALENCE FROM SELECTED MULTI-COUNTRY SURVEYSa Male% Female% Experiencing violent discipline in the past month, 1–14 year olds - - Witnessing physical violence in the home prior to 18 years, 18–24 year olds - - Sexual victimization prior to 18 years, 18–24 year olds - - Bullying victimization in the past 30 days/few months, 11–15 year olds 50 29 Involvement in physical fighting in the past 12 months, 13–15 year olds 57 36 a Countries may have data available from several other surveys but in the interests of global comparability, indicators from the most widely available internationally comparable surveys have been selected Da ta c ol le ct ed b y m ul tis ec to ra l c on se ns us m ee tin g an d cl ea re d by M in is tr y of H ea lth , N ut rit io n an d In di ge no us M ed ic in e GOVERNANCE AND MONITORING TO END VIOLENCE AGAINST CHILDREN 8 Government sectors with functions addressing violence against children, 6 of which have coordinating function Includes prevalence indicator/s: NO Funding Child maltreatment YES Partial Youth violence YES Partial Sexual violence YES Partial Funding School-based violence YES Partial Gender-based violence YES Partial Other NO - National action plan/s IMPLEMENTATION OF INSPIRE STRATEGIES AND APPROACHES Implementation and enforcement of laws Perceived enforcement Low High Bans on corporal punishment in all settings NO Against statutory rape YES Against contact sexual violence excluding rape YES Against non-contact sexual violence YES Regulating civilian access to and use of firearms YES Perceived enforcement Low High Against weapons on school premises YES Providing for victim compensation YES Not asked Providing for victim legal representation YES Not asked Minimum age for alcohol sales 21 Not asked 200 Global status report on pr venting violence against child en 2020RE E G O E E AGA S H RE R HO S E A R Preventing violence against children 2020: report for the Who south-east asia region 27 THAILAND Population: 69 428 454 Income group: Upper middle Parent and caregiver support Response and support services Safe environments Income and economic strengthening Education and life skills Norms and values Strengthening non-violent norms National YES YES YES Community mobilization National YES YES NO Bystander interventions National NO YES NO Addressing violence “hotspots” Subnational - - - - Interrupting the spread of violence None - - - - Improving the built environment National YES YES YES Home visiting National YES YES NO Centre-based parenting support National YES YES YES Cash transfers None - - - - Group savings and loans with gender equity training None - - - - Microfinance and gender equity training None - - - - Child protection services National YES YES YES Clinical services for sexual violence victims National YES YES YES Mental health services for victims National YES YES NO Mental health services for perpetrators None - - - - Identification and referral for victims National YES YES NO Identification and referral for perpetrators National YES YES NO Increasing school enrolment National YES YES YES Helping children protect themselves from sexual abuse National NO YES YES Life and social skills training National NO YES YES School-based anti-bullying National NO YES YES School-based dating violence prevention Subnational - - - - Reducing violence by school staff National NO YES YES Implementation support Perceived reach Level Funds Tools Training Very few Nearly all VIOLENCE PREVALENCE FROM SELECTED MULTI-COUNTRY SURVEYSa Male% Female% Experiencing violent discipline in the past month, 1–14 year olds 77 73 Witnessing physical violence in the home prior to 18 years, 18–24 year olds - - Sexual victimization prior to 18 years, 18–24 year olds - - Bullying victimization in the past 30 days/few months, 11–15 year olds 38 28 Involvement in physical fighting in the past 12 months, 13–15 year olds 37 21 a Countries may have data available from several other surveys but in the interests of global comparability, indicators from the most widely available internationally comparable surveys have been selected Da ta c ol le ct ed b y m ul tis ec to ra l c on se ns us m ee tin g an d cl ea re d by M in is tr y of P ub lic H ea lth GOVERNANCE AND MONITORING TO END VIOLENCE AGAINST CHILDREN 9 Government sectors with functions addressing violence against children, 5 of which have coordinating function Includes prevalence indicator/s: NO Funding Child maltreatment YES Full Youth violence YES Full Sexual violence YES Full Funding School-based violence YES Full Gender-based violence YES Full Other NO - National action plan/s IMPLEMENTATION OF INSPIRE STRATEGIES AND APPROACHES Implementation and enforcement of laws Perceived enforcement Low High Bans on corporal punishment in all settings NO Against statutory rape YES Against contact sexual violence excluding rape YES Against non-contact sexual violence YES Regulating civilian access to and use of firearms YES Perceived enforcement Low High Against weapons on school premises YES Providing for victim compensation YES Not asked Providing for victim legal representation YES Not asked Minimum age for alcohol sales 20 Not asked 207Global status report on preventing violence against children 2020 RE E G O E E AGA S H RE R HO S E A R Preventing violence against children 2020: report for the Who south-east asia region28 TIMOR-LESTE Population: 1 267 975 Income group: Lower middle Parent and caregiver support Response and support services Safe environments Income and economic strengthening Education and life skills Norms and values Strengthening non-violent norms National YES YES YES Community mobilization National YES YES YES Bystander interventions National YES YES YES Addressing violence “hotspots” None - - - - Interrupting the spread of violence None - - - - Improving the built environment Subnational - - - - Home visiting Subnational - - - - Centre-based parenting support Subnational - - - - Cash transfers National YES YES YES Group savings and loans with gender equity training None - - - - Microfinance and gender equity training National YES YES YES Child protection services National YES YES YES Clinical services for sexual violence victims National YES YES YES Mental health services for victims National YES YES YES Mental health services for perpetrators National YES YES YES Identification and referral for victims National YES YES YES Identification and referral for perpetrators National YES YES YES Increasing school enrolment National YES YES YES Helping children protect themselves from sexual abuse National NO NO YES Life and social skills training National NO YES YES School-based anti-bullying National NO NO YES School-based dating violence prevention National NO NO YES Reducing violence by school staff National NO NO YES Implementation support Perceived reach Level Funds Tools Training Very few Nearly all VIOLENCE PREVALENCE FROM SELECTED MULTI-COUNTRY SURVEYSa Male% Female% Experiencing violent discipline in the past month, 1–14 year olds - - Witnessing physical violence in the home prior to 18 years, 18–24 year olds - - Sexual victimization prior to 18 years, 18–24 year olds - - Bullying victimization in the past 30 days/few months, 11–15 year olds 39 25 Involvement in physical fighting in the past 12 months, 13–15 year olds 40 27 a Countries may have data available from several other surveys but in the interests of global comparability, indicators from the most widely available internationally comparable surveys have been selected Da ta c ol le ct ed b y m ul tis ec to ra l c on se ns us m ee tin g an d cl ea re d by M in is tr y of H ea lth GOVERNANCE AND MONITORING TO END VIOLENCE AGAINST CHILDREN 1 Government sector with functions addressing violence against children, 1 of which has coordinating function Includes prevalence indicator/s: NO Funding Child maltreatment YES Full Youth violence YES Full Sexual violence YES Full Funding School-based violence YES Full Gender-based violence YES Full Other NO - National action plan/s IMPLEMENTATION OF INSPIRE STRATEGIES AND APPROACHES Implementation and enforcement of laws Perceived enforcement Low High Bans on corporal punishment in all settings YES Against statutory rape YES Against contact sexual violence excluding rape YES Against non-contact sexual violence YES Regulating civilian access to and use of firearms NO - Perceived enforcement Low High Against weapons on school premises YES Providing for victim compensation YES Not asked Providing for victim legal representation YES Not asked Minimum age for alcohol sales NO Not asked 208 Global status report on pr venting violence against child en 2020RE E G O E E AGA S H RE R HO S E A R PREVENTING VIOLENCE AGAINST CHILDREN 2020: REPORT FOR THE WHO SOUTH-EAST ASIA REGION 9 789290 228660