Pediatric Care Program

1st Nationwide Campaign for the Prevention of Cruelty to Children in Greece

 The 1st Nationwide Campaign for the Prevention of Cruelty to Children in Greece was launched in 2016 as part of ELIZA’s overall mission for the prevention and elimination of incidents of child abuse and neglect. The campaign commenced with the implementation of two national programs.

Both programs owe their smooth operation to the cooperation of distinguished organizations, such as the YALE and IOWA medical schools in the USA, The New York Society for the Prevention of Cruelty to Children (NYSPCC) and the Medical School of the University in Athens, as well as to numerous other important educational institutions such as the American College of Greece (ACG), and social services in Greece.  ELIZA is deeply indebted to the major donors who ensured the financial support of this endeavor.

During the first year of the campaign, through the “Safe Τouches” program for the prevention of sexual abuse, which operates with the cooperation of The New York Society for the Prevention of Cruelty to Children (NYSPCC), 700 children, 200 parents and 100 teachers have been trained. This program is exclusively financed by the  Stavros Niarchos Foundation.

The second part of the campaign for the Prevention of Cruelty to Children is the “1st National Pediatric Care Program for the Prevention and Management of Child Physical Abuse”. The program is the result of the collaboration of ELIZA and the 2nd  Pediatric Department of the National and Kapodistrian University of Athens, “P. & A. Kyriakou” Children’s Hospital, under the guidance of the Department’s Chair, Professor of Pediatrics-Pulmonology, M. Tsolia, and is implemented on 5 strategic pillars:

  1. Creation of a network of physician-trainers throughout Greece
  2. Training first-line health care professionals
  3. Retrospective research on child physical abuse
  4. Protocol for the recognition and management of suspected child physical abuse
  5. Innovative Child Safety Care Unit
Creation of a network of physician-trainers throughout Greece

Twenty selected physicians from all over Greece attended an intensive “Train the trainer” course in Athens. They were trained by experts on the prevention and treatment of abuse, namely, American Professors of Pediatrics, Dr. John Leventhal and Dr. Resmiye Oral, in collaboration with Dr. Alexandra Soldatou, Assistant Professor of Pediatrics at the University of Athens Medical School and the Executive Director of ELIZA, Aphrodite Stathi.

Training first-line health care professionals

Within 7 months, 8 educational, fully-funded workshops took place in Athens (2), Thessaloniki, Alexandroupoli, Ioannina, Larisa, Patras and Heraklion; over 1.220 health care professionals, mostly physicians (medical students, residents and specialists in all areas of pediatric care), attended these workshops.

A 20-item pre- and post-training questionnaire was created to objectively assess the knowledge of attendees. The questionnaire proved to be reliable and showed statistically significant improvement of knowledge across all cities and categories of health care professionals

Retrospective research on child physical abuse

A key element of this initiative was a retrospective study focusing on children hospitalized at the “P. & A. Kyriakou” Children’s Hospital during a 2-year period (2014 & 2015). Among 35.273 admissions, the medical records of 161 children with social problems and/or an acute serious injury were selected and analysed.

Main findings

  • The average age of children with possible physical abuse was 7.7 years, in contrast to U.S. child abuse data, where the majority of reported cases of physical abuse are under the age of 3 years. Furthermore, the average length of hospital stay was 26 days. However, it is noteworthy that 6 out of 10 children were successfully relocated
  • In this sample, infants were at greater risk of physical abuse, consistent with existing international literature that highlight the vulnerability of infants to physical abuse
  • The history of trauma provided by parents or caregivers in nearly 20% of children hospitalized for burns and 35% of children hospitalized for fractures was not consistent with patient’s medical findings and /or developmental stage; these findings were in accordance with international data and statistics
  • 1 in 3 cases of burns could have been prevented with improved parent/caregiver education and child supervision
Protocol for the recognition and management of suspected child physical abuse

In the context of the program, a Protocol i.e. a user-friendly standardized procedure was developed for the assessment of suspected physical abuse, adapted for implementation at hospitals in Greece. This Protocol could contribute in:

  • Increasing the index of suspicion and timely detection of child physical abuse among health care professionals
  • Optimizing and standardizing the laboratory workup and management of suspected physical abuse with prompt notification of child protection services
  • Empowering physicians to recognize abuse prior to irreversible physical and emotional trauma
  • Supporting and preserving families at the same time with avoiding the institutionalization of children
Innovative Child Safety Care Unit

Both the National and Kapodistrian University of Athens Medical School and the Children’s Hospital of Athens “P. & A. Kyriakou” have approved the establishment of an Innovative Child Safety Care Unit at the “P. & A. Kyriakou” Children’s Hospital.

The program’s imprint

The program is an initiative with a strong nationwide imprint

  • Training of 1,220 health care professionals, mostly physicians, throughout Greece; Significant improvement of knowledge in child physical abuse post-training , based on a novel assessment tool, created by Greek and American scientists
  • Study of a sample of hospitalized children with serious injuries in Greece suggests the presence of medical findings incompatible with developmental stage and/or  history of trauma and a high risk of physical abuse among infants. These findings are consistent with existing data from other countries
  • 1 in 3 cases of burns could have been prevented with improved parent/caregiver education and child supervision
  •  Greek and American scientists developed a user-friendly, standardized procedure, for the recognition and management of child physical abuse at hospitals in Greece
  • Establishment of an Innovative Child Safety Care Unit at the “P. & A. Kyriakou” Children’s Hospital in order to enhance interdisciplinary  management of child abuse and collaboration of all professionals involved
Reinforcement of the protection wall for minors/children

This national program comprises a series of important actions aimed at a safer future for children in Greece. However, in order to reinforce the child safeguarding at a national level, it is essential:

  • To adopt the Protocol/User-friendly Standardized Procedure for the recognition and management of child physical abuse at all hospitals
  • To implement the national registry of child abuse and neglect, already developed by the Institute of Child Health
  • To implement an interdisciplinary approach for the management of child abuse through dedicated hospital teams
  • To establish short and long-term follow up of hospitalized cases of physical abuse
  • To create safe and developmentally appropriate transitional housing for children with possible abuse under investigation
  • To develop national educational curricula adapted for all professional categories involved in the care and protection of pediatric abuse victims, such as paramedics, nurses, psychologists, social workers, police officers
  • To incorporate educational courses on the prevention, recognition and management of all forms of child abuse at the graduate and post-graduate levels and ensure continuing medical education of physicians caring for children