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Preventing and Responding to Child Sexual Abuse and Exploitation: Evidence Review

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Preventing and Responding to Child Sexual Abuse and Exploitation: Evidence Review Preventing and Responding to Child Sexual Abuse and Exploitation: Evidence review Lorraine Radford, Debra Allnock and Patricia Hynes About the authors Lorraine Radford is Professor of Social Policy and Social Work at the University of Central Lancashire, UK; Debbie Allnock is Senior Research Fellow at the International Centre: Researching child sexual exploitation, trafficking and violence at the University of Bedfordshire, UK; and Patricia Hynes is a Principal Research Fellow within the School of Applied Social Studies, University of Bedfordshire. Cover Photo [NAMES CHANGED] On 22 March 2016, (left-right) Elisa, 13, and Gina, 12, walk along the beach on the island of Nosy Be, off the northwest coast of Madagascar. Both girls were befriended and sexually exploited by a 59-year-old Frenchman, who police believe is part of a larger network of criminals involved in the production and distribution of child sexual abuse material. The mother of one of the girls, who was employed for him as a domestic worker, introduced the man to the girls, and they began to spend evenings with him at his home. Elisa testified that the man, who took nude photographs of both girls for online distribution of child sexual abuse material, sexually assaulted her. He is now in prison, awaiting extradition to France. © UNICEF/UN015612/Prinsloo i Acknowledgements This evidence review was commissioned by UNICEF to support the work of the Child Protection Section, Programme Division, UNICEF Headquarters in New York. Special thanks go to Clara Sommarin, Child Protection Specialist for her expert guidance and advice throughout the course of the work. Theresa Kilbane, Senior Advisor, and Regina Reza, UNICEF consultant, also gave valuable feedback and reviewed and commented on drafts of the report. Regina Reza also completed a scoping report and compiled a bibliography which provided a helpful foundation for the wider searches required for this evidence review. Valuable feedback and inputs were provided by a number of research and practice experts. These include: Cecilia Anicama (Office of the UN Special Representative of the Secretary-General on Violence against Children), Gary Barker (IMAGES Research), Manuel Contreras (George Washington University, USA), David Finklehor (University of New Hampshire, USA), Dora Giusti (UNICEF), Karin Heissler (UNICEF), Neha Kapil (UNICEF), Lena Karlsson (Save the Children Alliance), Kathryn Leslie (Office of the UN Special Representative of the Secretary-General on Violence against Children), Harriet MacMillan (McMaster University, Canada), Bernadette Madrid (University of the Philippines /Philippine General Hospital), Nankali Maksud (UNICEF), Jim Mercy (the US Centers for Disease Control and Prevention), Jenny Pearce (University of Bedfordshire, United Kingdom), Ethel Quayle (Cork University, Ireland).Sophie Read Hamilton (consultant UNICEF), Lauren Rumble (UNICEF), and Jo Spangaro (University of New South Wales, Australia). ii Contents List of tables and figures ......................................................................................................................... v Acronyms and abbreviations ................................................................................................................. vi Glossary/definitions .............................................................................................................................. vii Executive Summary ................................................................................................................................. 1 1. Introduction ........................................................................................................................................ 8 1.1 Methodology ................................................................................................................................. 9 1.2 Report structure .......................................................................................................................... 12 1.3 Definitions ................................................................................................................................... 12 2. What is Known about Child Sexual Abuse and Exploitation and its Consequences ......................... 16 2.1. The nature and extent of the problem ...................................................................................... 16 2.2 Causes, risks and vulnerabilities ................................................................................................. 22 2.3 Consequences ............................................................................................................................. 34 2.4 Protective factors ........................................................................................................................ 37 3. Review of What Has Been Done ....................................................................................................... 39 3.1 Measuring change ....................................................................................................................... 39 3.2 Evidence of progress in implementing children’s rights ............................................................. 40 3.3 What is good evidence? .............................................................................................................. 42 3.4 National responses...................................................................................................................... 42 3.5 Prevention ................................................................................................................................... 48 3.6. Identification and protection ..................................................................................................... 65 3.7 Recovery and reintegration ........................................................................................................ 80 4. Implications for Policy ....................................................................................................................... 90 4.1 Understanding the problem........................................................................................................ 90 4.2 identifying potentially effective responses ................................................................................. 93 4.3 Existing guidance on child sexual abuse and exploitation .......................................................... 97 4.4 General recommendations ....................................................................................................... 100 4.5 Recommendations for consolidated guidance ......................................................................... 102 References .......................................................................................................................................... 103 Appendix A. Search Strategy ........................................................................................................... 139 Appendix B. Table of guidance assessed and included a ................................................................. 144 Appendix C. Guidance rating framework ........................................................................................ 152 Appendix D. Prevalence of Child Abuse in Selected Regions .......................................................... 157 iii Appendix E. World Health Organization (WHO) typology of violence ............................................ 158 iv List of tables and figures Table 1. Prevalence of child sexual abuse by region from two meta-analyses, Andrews et al. 2004 and Stoltenborgh et al. 2011 (percentages) Table 2. Risks of child sexual abuse and exploitation Table 3. The impacts of child sexual abuse and exploitation Table 4. Common protective factors for child maltreatment Table 5. Framework for presenting findings on the evidence Table 6. Summary of evidence on prevention Table 7. Summary of evidence on identification and protection Table 8. Summary of evidence on recovery and reintegration response Table A1. Databases searched Table A2. Search strings used Figure A. Summary of evidence ratings Figure 1. The different dimensions of child sexual abuse and exploitation in context Figure 2. Risks for sexual violence against children v Acronyms and abbreviations ASEAN Association of South East Asian Nations CBT cognitive behavioural therapy CDC Centers for Disease Control and Prevention CEDAW Convention on the Elimination of All forms of Discrimination against Women CRC Convention on the Rights of the Child ECPAT End Child Prostitution, Child Pornography and the Trafficking of Children for Sexual Purposes EMDR eye movement desensitization and processing FGM/C female genital mutilation/cutting GBV gender-based violence HIC high-income country ICT information and communication technology ILO International Labour Organization IRC International Rescue Committee LMICs low- and middle-income countries NAP national action plan NGO non-governmental organization OPSC Optional Protocol to the Convention on the Rights of the Child on the sale of children, child prostitution and child pornography RAP regional action plan RCT randomized controlled trial STI sexually transmitted infection TF-CBT trauma-focused cognitive behavioural therapy UNFPA United Nations Population Fund UNHCR United Nations High Commissioner for Refugees UNICEF United Nations Children’s Fund UNSVAC United Nations Study on Violence against Children VAWG violence against
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