Child abuse and neglect in Saudi Arabia: journey of recognition to implementation of national prevention strategies.
OBJECTIVE
To describe increased child abuse and neglect (CAN) reporting and the characteristics of the reports in the context of the development of a system of intervention for one of the hospital-based child protection centers in Riyadh, Saudi Arabia aligned with the United Nations Convention on the Rights of the Child (CRC) Article 19.


METHODS
A retroprospective collection of data on all children evaluated by the Suspected Child Abuse and Neglect (SCAN) team in King Abdulaziz Medical City for the National Guard from 2000 to 2008. The cases were further divided into 3 subgroups corresponding to the years 2000-2004, 2005-2006, and 2007-2008 parallel to the stages of development of the national child protection system.


RESULTS
During the study period, there were a total of 188 referrals to the SCAN team. Of these 133 (70.7%) were further investigated as CAN cases. The total number of referred cases increased 10-fold from 6.4 cases per year in the first period to 61.5 cases per year in the third period. The mean age was 5 years, evenly represented by males and females. Physical abuse was the most common form of abuse in the first (2000-2004) period at 61% and second (2005-2006) period at 76%, which changed to neglect (41.6%) as the most common form of maltreatment in the third (2007-2008) period. Parents were the perpetrators in 48.9% of cases throughout the 3 periods. Overall fatality rates were 4.4%, 14.3%, and 7.9% in the first, second, and third periods respectively.


CONCLUSIONS
Recognition of CAN is expanding in Saudi Arabia. This is due to the successful adoption of a system of intervention consisting of child protection centers in the medical facilities, in conjunction with mandatory reporting and data collection strategies. In addition, the changes in public attitudes towards a better understanding of CAN enhanced further recognition and reporting of neglect and milder forms of abuse. We believe that the number of reported CAN cases in Saudi Arabia will continue to rise, hence adequate multi-sectoral services for the abuse victims require further development and improvements throughout the country.
Al Eissa
Majid
M
National Family Safety Program, King Abdulaziz Medical City for the National Guard, Riyadh, Saudi Arabia.
Almuneef
Maha
M
D015984:Causality; D002648:Child; D002649:Child Abuse / Q000331:legislation & jurisprudence* / Q000401:mortality / Q000517:prevention & control* / Q000706:statistics & numerical data; D002650:Child Abuse, Sexual / Q000331:legislation & jurisprudence / Q000401:mortality / Q000517:prevention & control / Q000706:statistics & numerical data; D002651:Child Advocacy / Q000331:legislation & jurisprudence*; D002669:Child Welfare / Q000331:legislation & jurisprudence*; D002675:Child, Preschool; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006801:Humans; D008297:Male; D019221:Mandatory Reporting; D012017:Referral and Consultation / Q000331:legislation & jurisprudence; D012189:Retrospective Studies; D012529:Saudi Arabia; D015996:Survival Rate; D014480:United Nations; D014947:Wounds and Injuries / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control