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Table 3 Physical and sexual violence definitions used in GSS baseline survey to set response criteria for referring childrena

From: “I never expected that it would happen, coming to ask me such questions”:Ethical aspects of asking children about violence in resource poor settings

Child discloses

Referral level

Indicated by positive answer to any of below discrete violent acts or injuries by any person

Responseb

Time frame for appropriate response from lead response agency

Forced sexual intercourse within the past week, or obvious untreated physical injuries

1

In past week: threatened or pressured into sex; physically forced sexual intercourse or doing sexual things; suffered cuts, loss of consciousness; dislocated, sprained, fractured or broken bones; untreated injuries or severe injuries (requiring medical attention) reported as a result of physical or sexual violence; signs of acute malnutrition /neglect

Community Development Officer, leads referral, partner NGO child protection officer leads monitoring

Same or next day

(defined as ‘urgent action needed’)

Severe physical violence within the past week, or less severe sexual violence within the past week, or minor injuries observed

2

In past week: burnt; choked; cut with a sharp object; severely beaten; had genitals, breasts, or buttocks touched; exposed to pornographic imagery; forced undressing; exposed to nudity; forced to touch sb else’s genitals, breasts, or buttocks; involved in making of sexual photos or videos; forced kissing; suffered bruising; swelling; bleeding; difficulty sitting or walking; had to seek medical attention; and disclosures do not meet same urgency or severity criteria as for level 1 (e.g. forced sex or in need of urgent medical attention

As for referral 2

As soon as possible but up to four weeks since day child was interviewed and referred

(defined as ‘less urgent but serious notification’)

Severe physical violence within the past year or sexual violence within the past year, but no violence within the past week

3

As for referral 2, but past year; and disclosures do not meet same urgency or severity criteria as for level 2

Partner NGO child protection officer leads referral and reports to the probation office

Up to 12 weeks since day child was interviewed and referred

(defined as ‘non-urgent but serious notification’)

Severe physical violence, or any sexual violence before the past year

4

As for referral 2, but before past year; and disclosures do not meet same urgency or severity criteria as for level 2

As for referral 3

Up to 12 weeks since day child was interviewed and referred

(defined as ‘non-urgent but serious notification’)

No disclosure of specific violent acts in baseline survey but child says they wish to receive further help

0 (none)

 

As for referral 3

Up to 12 weeks since day child was interviewed and referred

(defined as ‘voluntary notification’)

All children offered counseling

N/A

Child requests counselling

Counsellor dispatched

No specified timeframe

  1. aRefer to Fig. 1.b Towards the end of data collection and following suspension of direct CDO notification, as part of alterations to the referral strategy, all referrals were directed to the partner NGO child protection officer and probation office for case management and monitoring