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Every year over 5,000 children and young people in the UK die. Previous research suggests that 20-25% of these deaths may be preventable, and in comparison to many other European countries, the UK has higher child mortality rates. Child Death Review processes, introduced in the USA in the 1970s have been proposed as a means of learning from child deaths and driving prevention initiatives. Prior to 2008, the UK had no national system for reviewing and learning from children's deaths.
From 2006 to 2007, a team from Warwick Medical School led by Dr Peter Sidebotham undertook government-funded research examining a number of Local Authorities across England who had set up pilot Child Death Overview Panels (CDOPs). The findings from this research were instrumental in developing national policy and procedures for child death reviews. The Warwick research emphasised the importance of a multi-agency approach to reviewing all child deaths, with a strong public health focus on learning lessons for prevention, and robust systems for notification and gathering information. This, together with other research by Warwick Medical School on fatal child maltreatment published between 2009 and 2011, has contributed to updated national policy and interagency practice to safeguard children.
Although it is too early in the process to demonstrate any impact on the ultimate goal of reducing preventable child deaths, CDOPs have now been established in every Local Authority in England, as well as an all-Wales panel, and current work in Scotland and Northern Ireland is considering how best to implement such reviews. These panels are reviewing all child deaths in England, resulting in local prevention initiatives, and national returns enabling a clearer picture of the nature of preventable child deaths.
Since 2006 the University of East Anglia (UEA) has led a series of Government commissioned studies of all Serious Case Reviews of child death and serious injury in England. This work has provided the largest national database of analyses of child deaths and serious injury where abuse or neglect are known or suspected.
Since 2008, the findings have informed public understanding, practitioner thinking, multi-agency child protection practice, policy and law - in the UK, and internationally. Both key child protection policy and practice reviews commissioned by the UK Government 2008-13, the Laming report (2009) and the Munro Review of Child Protection (2011), drew on this research.
UNICEF estimate that over 3,500 children die annually from abuse and neglect in economically developed countries, including 100 in the UK of whom around 4 are from Northern Ireland. Although the number of deaths appears to be falling in the UK, the rate of decline is slowing. This case study describes the impact of three related pieces of research undertaken for the Northern Ireland Executive and the Northern Ireland Commissioner for Children and Young People. The aim was to identify the things that policy makers and practitioners could do differently in order to protect children better, and has led to significant improvements into how reviews are undertaken, and in the child protection policies and practices in Northern Ireland. As a result children have been better protected by child welfare professionals.
The Unit's work has had a direct impact on the child protection system in England. In 2010, the Secretary of State for Education invited Eileen Munro to review the child protection system, giving her a wide remit enabling her to address systemic factors (such as the inspection framework, statutory guidance and performance management systems) as well as front line practice. All 15 recommendations of her final 2011 report [B] have been accepted and are being implemented. Munro's research has had significant reach: she has given evidence to two state government reviews of child protection in Australia; and in Queensland a charity is running a campaign to persuade the state government to learn from her work.
Our work on children's agency in research has had three impacts:
This approach has been replicated in Australia, Turkey, New Zealand, Norway and Qatar. The CRC website hosts 150 successful projects by children and young people, and through the Diana Award more than 1500 children were supported in their research on cyberbullying.
Impact: Health and welfare; raised awareness of childhood pneumonia as the largest single cause of global childhood mortality, which has led to increased investment and action. Global deaths have reduced from 2.01M (in 2002) to 1.58M (2008) and 1.26M (2011).
Significance: Global child pneumonia mortality (2008-2013) showed about 1M deaths fewer than if 2008 levels had persisted throughout this period.
Attribution: Campbell and Rudan (UoE) derived global pneumonia incidence and mortality estimates as the pneumonia technical experts for the WHO / UNICEF Child Health Epidemiology Reference Group.
Beneficiaries: Young children and families, international agencies, Ministries of Health.
Reach: Global (>170 countries on all continents, especially low- and middle-income countries).
LSHTM research led to the development of a computer-based tool known as the Lives Saved Tool (LiST), which has been made available to international organisations, governments and NGOs free of charge. It allows policy-makers and programme managers in the 75 countries with the highest number of child deaths to identify which policy and programme choices are likely to have the greatest impact in cutting neonatal and child mortality. Since its 2008 launch, LiST has been used widely by international agencies, foundations, bilateral agencies, large NGOs and individual countries to determine investment priorities and programme choices.
Research by the University of Huddersfield's Centre for Applied Childhood Studies (CACS) carried out between 2008-2009 has played a major role in tackling the problem of child sex abuse in the Caribbean. A study we have undertaken which UNICEF described as a "landmark" in the field has led to government acknowledgement of the problem, growing public awareness of its effects, new policies, legislative reform, innovative child protection programmes and improvements in the capabilities of professionals and agencies. The research is also helping to shape responses to child sexual abuse in other parts of the world.
Vincent's research comprises a UK comparison of child death review policy, development of a Scottish evidence base and a comparative study of child death review across six countries. The research has had an impact on public policy to protect children. It has stimulated international, national and local policy debate and changed policy. It has also had an impact on practitioners and services. Professionals from a range of disciplines have used the research findings in conducting their work and it has had an influence on inter-agency child protection guidelines and on multi agency training.
Research conducted by the Centre for the Study of Poverty and Social Justice (CSPSJ) led to a new way of assessing child poverty in developing countries. This novel method (termed the Bristol Approach) resulted in the United Nations General Assembly's adoption, for the first time, of an international definition of child poverty (2006). It also underpinned UNICEFs Global Study on Child Poverty and Disparities (2008-10), which was run in over 50 countries. In the last ten years, the CSPSJ's work has put child poverty at the centre of international social and public policy debates. Its researchers have advised governments and international agencies on devising anti-poverty strategies and programmes that specifically meet the needs of children, and have significantly influenced the way child poverty is studied around the world. The Centre has developed academic and professional training courses for organisations like UNICEF on the issues of children's rights and child-poverty. Our work has also spurred NGOs such as Save the Children to develop their own child-development indices, and so has had a direct and profound impact on the lives of poor children around the planet.