This project involves the piloting of child death review teams as a mechanism to improve the identification and criminal justice outcomes of fatal child abuse. In addition, the project will monitor the effectiveness of the teams through the use of standardised indicators to improve case identification. The overall goal is to prevent child deaths through the identification of gaps and barriers in the child protection system.
Child death reviews (CDR) have been implemented in high income countries to address the poor identification of child deaths from maltreatment and to develop policy and interventions to prevent such deaths. CDR teams are multidisciplinary and are made up of a pathologist, investigating officer, child protection worker (social worker), prosecutor and paediatrician as the core team who meet regularly to share case-specific information on the circumstances surrounding the death of a child.
The National Child Homicide Study, conducted by the Medical Research Council (MRC) in 2012, provided evidence on gaps in the reporting and management of fatal child abuse. The study pointed to an urgent need to strengthen reporting systems between mortuaries operated by the provincial Departments of Health and provincial police services, but also to include other stakeholders.
Therefore, the child death reviews study tests CDR teams’ efficiency in improving the identification and outcomes of fatal child abuse by identifying gaps in the child protection system.
Child death review teams were set up at two selected sites based on the location and availability of a multidisciplinary team – one in Cape Town, and one in Durban. The pilot was implementation in partnership with the Departments of Health and Social Development and the police services. Expertise and collaboration are drawn from the Red Cross Children’s Hospital and child protection organisations such as Childline.
The CDR teams review unnatural deaths of children under the age of 18 on a monthly basis at the selected mortuary sites. Cases are selected based on manner and cause of death, and the reviews follow a process to identify risk factors, gaps in the system and recommendations for possible changes in practice in each case.
Should the pilot evaluation show that CDR teams are effective locally, government will be engaged and lobbied to roll out a national CDR mechanism with a proposal for one of the departments to take the co-ordination role.
This project is a partnership with UCT's Gender & Health Research Unit and Forensic Medicine and Toxicology division; the Medical Research Council; Departments of Health Western Cape and KwaZulu-Natal; as well as Childline South Africa. The project is funded by the DG Murray Trust and the Open Society Foundation for South Africa.
Project team members: Associate Prof Shanaaz Mathews and Zulpah Albertyn (Children’s Institute); Prof Lorna Martins, (Forensic Medicine and Toxicology, UCT); Prof Naeema Abrahams (Gender and Health Research Unit, MRC); Dr Neil McKerrow (Department of Health, KwaZulu-Natal); and Ms Joan van Niekerk (formerly Childline SA).
Child death reviews in the context of child abuse fatalities – learning from international practice
Mathews S, Abrahams N & Martin LJ 2013
Joint briefing paper of the Children’s Institute, University of Cape Town, and the Medical Research Council.