Developing a Child Protection System Indian Experience

Introduction

The Constitution of India guarantees equality before the law to all citizens, and pledged special protections for children.  In 1992, India accepted the obligations of the UN Convention on the Rights of the Child (CRC). When countries ratify the CRC, its articles are integrated into national constitutions and legislation.

Children’s Rights and Protection (CR) are fundamental to our pediatric practice. The pediatricians, and allied multidisciplinary professionals must be aware all steps their government has taken to protect children’s rights. We must always acknowledge, respect and protect CR. The purpose of the present paper is to understand the development of a Child Protection System in LMIC, especially in Indian settings, and to become effective advocates for child protection.

Every pediatrician can and should have adequate knowledge of rights of every child in the area of child survival, identity, development, protection and participation. They should understand the broader social determinants of child health, become trained in the use of UN CRC, align themselves with CR organization in advocacy efforts and lobby their local, state and national elected representatives to advance child rights, health and protection

The 2030 Agenda for Sustainable Development Goals (SDG)

The United Nations General Assembly formally adopted the 2030 Agenda for

Sustainable Development Goals (SDG) in September 2015. The SDG’s are for universal, integrated and transformative vision for a better world.  SDG are composed of 17 goals and 169 targets to wipe out poverty, fight inequality and tackle climate change over the next 15 years.

India’s Approach to Promotion & Protection of Child Rights

The National Commission for Protection of Child Rights (NCPCR) provides for setting up State level commissions, meant for protection and promotion of child rights.  Several policies, laws and programs have been introduced:

National Policy for Children (2013).  The Government adopted this policy to reiterate its commitment to rights-based approach to children. 

National Plan of Action for Children (NPAC) (2016). Based on the National Policy for Children, NPAC provides a road map that links the policy objectives to actionable programs.

Integrated Child Protection Scheme (ICPS) (2009) recognize that child protection is a primary responsibility of the family, supported by community, government and civil society.

Laws to Protect Rights of Children in India

• Juvenile Justice ( Care & Protection) Act 2015
• The Protection of Children from Sexual Offences (POCSO) Act, 2012

• The Right to Education Act (RTE) (2009)
• The Child Labour (Prohibition & Regulation) Act (CLPR Act) 1986
• The Prohibition of Child Marriage Act, 2006
• Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994.

CHILDLINE 1098: This is an emergency telephonic help line, which helps link children in situations of abuse/neglect with rehabilitation services. 

Child Protection

Child Protection is the safeguarding of children from abuse, neglect, violence and  exploitation. The WHO defines ‘‘Child Abuse”  as forms of physical and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment, commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power’’.

Major types of child abuse by caregiver or other adults include (a) Physical abuse – acts of commission by a caregiver that cause actual physical  harm or have the potential for harm;(b) Sexual abuse is defined as those acts where a caregiver uses a child for sexual gratification;(c) Emotional abuse– the failure of a caregiver to provide an appropriate and supportive environment, and includes acts that have an adverse effect on the emotional health and development , (d) Neglect refers to the failure of a parent/ guardian to provide for the development of the child – where the parent is in a position to do so – in one or more of the following areas: health, education, emotional development, nutrition, shelter and safe living conditions. Neglect is thus distinguished from circumstances of poverty in that neglect can occur only in cases where reasonable resources are available to the family or caregiver. The Government of India (2007) study on child abuse clearly highlights the high prevalence of all forms of child abuse in our country. The major finding of this study revealed two thirds of children are physically abused; half are sexually and emotionally abused.

Short- and Long-term consequences of Child Abuse

Child abuse can lead to development of   both short term and long-term adverse health consequences for the victim (WHO, 2019). The short and long-term effects on children may include regressive behaviors that interfere with developmental milestones (such as a return to thumb-sucking or bed-wetting), sleep disturbances, eating problems, performance problems at school, sexualized behavior. There exist lifelong consequences of child abuse including mental and physical health, reproductive health, academic performance, and social functioning. A well designed epidemiologic, Adverse Childhood Experiences (ACEs) Study (Felitti et al), revealed a high risk of heart disease in adult survivors of abused children. The  adverse health effects in adult life, including development of adulthood high-risk health behaviors include smoking, alcohol and drug abuse, promiscuity, and severe obesity, and also correlate with ill-health including depression, heart disease, cancer, chronic lung disease and shortened lifespan.

Role of Pediatricians in Realizing Child Rights

The status and condition of children is the clearest indicator of whether nations and societies understand and respect human rights. Survival, early childhood care including health care, nutrition, education, growth and   development are most crucial child rights and must be prioritized. Prevention and response to child abuse, neglect, protection and exploitation (street children, child labour, trafficking, child marriage) must be integrated in the training of medical students and residents. Pediatricians need to be familiar with relevant laws and the basic legal procedures to ensure good health and protection of all children.  When parents are illiterate or ignorant, they must be made aware of child rights; must demand and fight to obtain them.

 Right to Education (RTE) Act is now the law of the land.  All educated people need to ensure that all are educated. The Government must provide the necessary infrastructure, but the community needs to oversee that the schools function, the teachers teach and the learners learn.  A rights-based rather than a welfare approach is needed to realize child rights, of which education and health are crucial. As Pediatricians from the LMICs, we should join hands with committed groups of multidisciplinary professionals, NGOs, media and allied partners in order to work together and monitor the government efforts in promotion and protection of various aspects of child rights and protection.

Recommended Readings

Convention on the Rights of the Child (with optional protocols), available from www.unicef.org/crc, accessed June 2022.

Srivastava RN. Right to health for children. Indian Pediatr 2015 Jan;52(1):15-8

Seth R. Child Abuse and Neglect in India. Indian J Pediatr. 2015;82:707-14

SustainableDevelopmentalGoals(SDG),available www.un.org/sustainabledevelopment/sustainable-development-goals, accessed June 2022.

Felitti VJ . The Relation Between Adverse Childhood Experiences and Adult Health: Turning Gold into Lead. Perm J. 2002 Winter; 6(1): 44–47.

DR RAJEEV SETH

MD (AIIMS), DNBE, FIAP, FAAP (USA)

Managing Trustee

Bal Umang Drishya Sanstha (BUDS) India

Email rajeevseth@budsngo.org