INSPIRE: A comprehensive package to reduce violence against children and provide a safe and nurturing environment

Dear Editor,

Child maltreatment refers to the neglect and different forms of abuse directed to children less than 18 years of age, which poses a potential risk to their health, survival, or development.^[1] It has been acknowledged as a global problem, with 25% of adults with a positive history of being physically abused, while one in every five women and one in 13 men have been sexually abused during their childhood phase.^[1] Further, most of these numbers underestimates the actual magnitude of the problem, as often they are not reported or incorrectly attributed to other reasons.^[2] In addition, the estimates significantly increase in cases of humanitarian emergencies, under which many girls are extremely vulnerable to exploitation.^[1],[2]

Moreover, such maltreatment enhances the risk for behavioral, physical, and mental health problems, augments the burden on the health system, increases financial expenditure, and can eventually reduce the pace of a nation’s economic and social growth.^[2],[3] Further, a wide range of factors related to different stakeholders, such as child (viz. being unwanted, or does not meet parents’ expectations, having special needs, etc.), parent or caregiver (like poor bonding, history of themselves being abused, impractical expectations, financial crisis, etc.), family (viz. any health problem in one of the family members, marital or family disharmony, no support for the rearing of the child), and community and societal factors (like gender and social inequality, absence of basic welfare measures, poverty, unemployment, easy access to alcohol and drugs, absence of targeted policies or their poor implementation), has been attributed to the increase in the incidence of this global problem.^[1],[2],[3]

It is very important to understand that preventing such violence or maltreatment against children is very much possible, even before it begins, provided all stakeholders are actively involved.^[1],[2] Also, the earlier interventions are implemented in children’s lives, better it is both for the child as well as for the society.^[4] Though, different strategies can be tried upon, nevertheless the effective ones will be those which support parents and teach them positive parenting skills through arranging home-visits by nursing staff to support parents and children through education and information, organizing sessions for a group of parents to orient them about child-rearing skills or expected development pattern of a child, targeted strategies to prevent abusive head trauma (through hospital-based initiatives by making parents aware about the dangers or way to deal with persistent crying) or sexual abuse. In addition, early recognition of such cases by the health workers can reduce the risk of its recurrence or it’s after effects.^[1],[2],[4]

Infact, in order to significantly minimize the instance of violence against children, the World Health Organization in collaboration with its different stakeholders has launched a new package “INSPIRE”, comprising of seven strategies.^[5] These include implementation and enforcement of laws, bringing about an alteration in the norms and values about the role assigned to gender, enabling the development of a safe environment, measures to support parents and caregivers, strategies to ensure income generation and financial strengthening, building a framework for response and support services, and encouraging the education and training of life skills to children.^[1],[5] The ultimate aim is to keep all the stakeholders on the same plane as the strategies are developed in such a way that they reinforce each other and deliver best outcomes if implemented in combination.^[5]

To conclude, the evidence about violence against children and its consequences is growing, and it is high time to utilize this information and act collectively to ensure provision of a safe and nurturing environment for the healthy growth and development of children.

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Conflicts of interest

There are no conflicts of interest.

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.213161