Paediatric approaches to child maltreatment are subject to wide organisational variations across Europe.
OBJECTIVE
Little is known about the organisation of child maltreatment practice in Europe. We therefore explored medical child protection systems and training across Europe.


METHODS
An online survey was completed by physicians working in child maltreatment, identified through professional organisations in 28 member countries of the European Union, Iceland, Norway and Switzerland in 2012-2013. Respondents were questioned regarding management of suspected child maltreatment, mandatory reporting, professional training, patient referral and physician roles in multidisciplinary investigations. Responses underwent a narrative synthesis and descriptive enumerations.


RESULTS
The survey was completed by 88 individuals, unevenly distributed in 22 of 31 countries. Physicians were mandated to report child maltreatment in 16 of 22 countries. All of 88 responding physicians described multidisciplinary involvement in the clinical and forensic management of suspected child maltreatment. Practitioners involved in physical examinations included general physicians, paediatricians, forensic medical examiners, gynaecologists and paediatric surgeons. Paediatricians were required to undergo child protection training according to 30 of 86 respondents in 14 of 22 countries.


CONCLUSIONS
This survey demonstrates that there were wide variations in the organisation of child maltreatment paediatrics in Europe. The differing legislative frameworks and models of care are pertinent to consider when comparing epidemiology of maltreatment reported from across European countries.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Gabriel
G
Otterman
Karolinska University Hospital, Solna, Sweden.
Marie
M
Jalsenius
Institute of Primary Care & Public Health, Cardiff University School of Medicine, Cardiff, UK.
Sabine
S
Maguire
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Anna
A
Sarkadi
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Staffan
S
Janson
D002648:Child; D002649:Child Abuse / Q000331:legislation & jurisprudence*; D000068216:Child Protective Services / Q000458:organization & administration; D005060:Europe; D006801:Humans; D019221:Mandatory Reporting; D010372:Pediatrics / Q000331:legislation & jurisprudence / Q000458:organization & administration*
Child death review; Child health services; Child maltreatment; Mandatory reporting