case study examples for child protection

Case studies in child welfare

About this guide, child welfare case studies, real-life stories, and scenarios, social services and organizational case studies, other case studies, using case studies.

This guide is intended as a supplementary resource for staff at Children's Aid Societies and Indigenous Well-being Agencies. It is not intended as an authority on social work or legal practice, nor is it meant to be representative of all perspectives in child welfare. Staff are encouraged to think critically when reviewing publications and other materials, and to always confirm practice and policy at their agency.

Case studies and real-life stories can be a powerful tool for teaching and learning about child welfare issues and practice applications. This guide provides access to a variety of sources of social work case studies and scenarios, with a specific focus on child welfare and child welfare organizations.

• Real cases project Three case studies, drawn from the New York City Administration for Children's Services. Website also includes teaching guides
• Protective factors in practice vignettes These vignettes illustrate how multiple protective factors support and strengthen families who are experiencing stress. From the National Child Abuse Prevention Month website
• Child welfare case studies and competencies Each of these cases was developed, in partnership, by a faculty representative from an Alabama college or university social work education program and a social worker, with child welfare experience, from the Alabama Department of Human Resources

• Immigration in the child welfare system: Case studies Case studies related to immigrant children and families in the U.S. from the American Bar Association
• White privilege and racism in child welfare scenarios From the Center for Advanced Studies in Child Welfare more... less... https://web.archive.org/web/20190131213630/https://cascw.umn.edu/wp-content/uploads/2013/12/WhitePrivilegeScenarios.pdf
• You decide: Would you remove these children from their families? Interactive piece from the Australian Broadcasting Corporation featuring cases based on real-life situations
• A case study involving complex trauma This case study complements a series of blog posts dedicated to the topic of complex trauma and how children learn to cope with complex trauma
• Fostering and adoption: Case studies Four case studies from Research in Practice (UK)
• Troubled families case studies This document describes how different families in the UK were helped through family intervention projects
• Parenting case studies From of the Pennsylvania Child Welfare Resource Center's training entitled "Understanding Reactive Attachment Disorder"
• Children’s Social Work Matters: Case studies Collections of narratives and case studies

• Race for Results case studies Series of case studies from the Annie E. Casey Foundation looking at ways of addressing racial inequities and supporting better outcomes for racialized children and communities
• Systems of care implementation case studies This report presents case studies that synthesize the findings, strategies, and approaches used by two grant communities to develop a principle-guided approach to child welfare service delivery for children and families more... less... https://web.archive.org/web/20190108153624/https://www.childwelfare.gov/pubPDFs/ImplementationCaseStudies.pdf
• Child Outcomes Research Consortium: Case studies Case studies from the Child Outcomes Research Consortium, a membership organization in the UK that collects and uses evidence to improve children and young people’s mental health and well-being
• Social work practice with carers: Case studies
• Social Care Institute for Excellence: Case studies
• Learning to address implicit bias towards LGBTQ patients: Case scenarios [2018] more... less... https://web.archive.org/web/20190212165359/https://www.lgbthealtheducation.org/wp-content/uploads/2018/10/Implicit-Bias-Guide-2018_Final.pdf
• Using case studies to teach
• Last Updated: Aug 12, 2022 11:21 AM
• URL: https://oacas.libguides.com/case-studies

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Child care and protection: 3 real life case studies.

In New South Wales, the law puts the safety, welfare and wellbeing of the children above all else. Government departments such as Family and Community Services (FACS) do not interfere in people’s lives unless children are believed to be at risk of significant harm. If children are removed from your care because they are deemed to be at risk of significant harm, they can be placed with family or emergency carers until the situation has been resolved. If the situation is not resolved, then the children may need to remain in that placement. Parents and guardians have the right to legal aid and will be able to appear in the Children’s Court to work towards having the children restored to their care. The following examples are real case studies from Australia (with names and identifying details changed) to demonstrate how complex child care and protection cases can be.

Case study 1: Thomas & Charlotte A single mother of two children moved in with a partner who has a long criminal history, which included offences against children . There were reports made that the partner was abusing the children. The mother refused to accept that her partner was a risk to the children and prioritised him over the safety, welfare and wellbeing of the children. The children's father was contacted and said he was willing to take care of the children, but he has had little contact with them since the separation.

Response: Concerned about the risk of harm to the children, FACS removed the children and placed them into care and made an application to the Children’s Court to have interim parental responsibility for the children. The mother worked with FACS to address the concerns and was able to have the children restored to her care.

Case study 2: William A child care worker raised concerns about a toddler's late development. The child's mother was contacted and she admitted that she often struggles with her parental duties and relies on stimulants and anti-anxiety medication, but sometimes finds it hard even to get out of bed. Upon further investigation, it was found that the mother was using methamphetamine daily and often leaving the child unsupervised whilst she slept. Response: Her son was temporarily placed into care, but the mother was open to receiving help. She began attending parenting classes and she engaged with drug and alcohol counselling. She also completed random drug screens for FACS to show that she was no longer using illicit substances. She also spoke to her Doctor and obtained assistance for her anxiety. Her son was eventually returned to her care. Case study 3: James A school contacted child protection services when it was concerned about a pupil's poor attendance record, falling asleep in class, arriving without lunch and hygiene issues. When officers visited the child's home, they found that his mother suffered from a number of health problems that made it difficult for her to provide the daily care her son needed. Response: With no close family members available to help out, government support services were contacted to offer financial and emotional support. Care proceedings were not required. Are you worried about your children? If you or a loved one have been separated from your children, you have the right to representation in Children's Court if you can prove that your home is now a safe and caring environment. To find out more about child care and protection in New South Wales and how family lawyers can help you, click the image below to download our free ebook : Care and Protection: Know Your Rights and Where to Get Support.

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Child Protection Forum | Community

Community Child Protection Exchange

Resguardos de Paz – Módulos del proyecto. Guardia Indígena

Published: no date author: war child colombia.

Una historia de resistencia y protección Guardia Indígena. Acciones para la protección comunitaria, defensa de los derechos humanos y construcción de memoria histórica en comunidades indigenas en los departamentos de Choco y Antioquia, Colombia.

A SCHOOL FOR EVERY CHILD! Story of a community-led Initiative against school absenteeism in Jharkhand

Published: 2021 author: the inter-agency core group cini, chetna vikas, child resilience alliance, plan india, & praxis.

A short, illustrated story of a community-led initiative against school absenteeism in Khunti, Jharkhand, India.

Artbooks as witness of everyday resistance: Using art with displaced children living in Johannesburg, South Africa

Published: 2021 author: glynis clacherty.

Artbooks, which are a combined form of picture and story book created using mixed media, can be a simple yet powerful way of supporting children affected by war and displacement to tell their stories. They allow children to work through the creative arts, which protects them from being overwhelmed by difficult memories.

Ficha de situación – Chocó: Quibdó

Published: 2020 author: mire–mecanismo intersectorial de respuesta a emergencias.

Ficha de situación – Chocó: Quibdó. Comunidades de Villa nueva, Wounaan Phoboor y Wounaan la Paz.

Protecting children through village-based Family Support Groups in a post-conflict and refugee setting, Northern Uganda: A Case Study

Published: 2018 author: written by glynis clacherty, edited by lucy hillier, with contributions from mike wessells for the interagency learning initiative (ili).

This case study tells the story of a child protection programme developed by a community-based organisation called Children of the World that works in villages in northern Uganda. The Children of the World programme was chosen for this set of case studies because of its focus on the importance of a personal psychological process for real sustainable child protection.

Truck drivers stand for child protection – The story of the Regional Association of Truck Drivers Against Exploitation of Children, Uganda, Kampala/Mombasa trucking route: A Case Study

This case study tells the story of a regional association set up by truckers to protect children, in particular to stop truck drivers from picking up girls under 18 in the towns along the Uganda section of the Kampala-Mombasa trucking route. It tells the story of some of the truckers who took a stand against sexual exploitation of under-age girls as individuals and how they approached the Uganda Reproductive Health Bureau (URHB) to help them with technical information.

The Tatu Tano child-led organisation – Building child capacity and protective relationships through a child-led organisation, North-western Tanzania

Published: 2018 author: written by glynis clacherty, edited by lucy hillier, with contributions from mike wessells. photographs by james clacherty..

A case study collaboration between the Interagency Learning Initiative (ILI) on community-based child protection mechanisms, the Community Child Protection Exchange, and Kwa Wazee, Tanzania.

The story of the Vutamdogo Clubs, Mwanza, Tanzania. Youth clubs run livelihood projects and a literacy programme that provides protection for young children

A case study collaboration between the Interagency Learning Initiative (ILI) on community-based child protection mechanisms, the Community Child Protection Exchange, and Tanzanian Home Economics Association (TAHEA).

Weaving the web: documenting community-based development and child protection in Kolwezi, DRC

Published: 2018 author: mark canavera et al. with good shepherd international foundation.

The goal of this document – and the research process that underpins it – is to articulate the model that the Good Shepherd Sisters (GSS) have been implementing in Kolwezi in the Democratic Republic of Congo (DRC). By consulting with stakeholders from multiple levels – the Good Shepherd Sisters and their staff, participants in their programmes, community members who are not involved in the programme, government and non-government partners, and mining company representatives – we aimed to document what the Good Shepherd Sisters have been doing in Kolwezi over the past five years with an eye to provide constructive recommendations about the future of the programme, which is currently under review for possible replication in areas around Kolwezi.

Tisser la Toile: documenter l’approche au développement communautaire et protection de l’enfance à Kolwezi, RDC

Published: 2018 author: mark canavera et al. avec good shepherd international foundation.

Le but de ce document et le processus de recherche qui le sous-tend est d’articuler le modèle que les Soeurs du Bon Pasteur (GSS) ont mis en place à Kolwezi en République Démocratique du Congo (RDC). En consultant des intervenants de multiples niveaux les Soeurs du Bon Pasteur et leur personnel, les participants de leurs programmes, les membres de la communauté qui ne participent pas au programme, les partenaires gouvernementaux et non gouvernementaux et les représentants des sociétés minières, nous avons cherché à documenter ce que les Soeurs du Bon Pasteur ont réalisées à Kolwezi au cours des cinq dernières années dans le but de fournir des recommandations constructives sur l’avenir du programme, qui est actuellement en cours de révision pour une réplication possible dans les zones situées autour de Kolwezi.

Community Management of Child Friendly Spaces Kiryandongo Refugee Settlement, Uganda. A case study.

Published: 2018 author: clacherty, g. published by the interagency learning intitative on community based child protection, the community child protection exchange and tpo uganda.

A case study collaboration between the Interagency Learning Initiative (ILI) on community-based child protection mechanisms, the Community Child Protection Exchange, and TPO Uganda.

Supporting Communities’ Disaster Resilience

Published: 2018 author: global communities.

A cross-sector example from the humanitarian response to disaster affected populations. Global Communities partners with communities to recover after natural disasters by addressing long-term needs and rebuilding climate-resilient infrastructure. It works with communities to strengthen their environmental resilience through climate change adaptation planning and disaster risk mitigation. The approach seeks to empower communities to identify, prioritise and find solutions to their most pressing needs. Haiti, Colombia, Nicaragua, Puerto Rico.

Building cross-sector collaboration using participatory action research to improve community health in an urban slum in Accra, Ghana

Published: 2018 author: jessica kritz.

A cross sector case study. Every urban slum creates challenges too complex for governments to resolve when working alone. Old Fadama, the largest slum in in Accra, Ghana, is home to over 100 000 people. Old Fadama has virtually no water or sanitation infrastructure, contributing to diminished quality of health and frequent cholera outbreaks when the nearby river floods. Our research introduces a model for cross-sector collaboration, supporting stakeholders who wanted to improve community health by installing latrines.

Community-based alternative care as a strategy for protecting Burundian refugee girls and boys: a case study from Mahama camp, Rwanda

Published: 2017 author: plan international.

A case study which describes the community-based child protection programme implemented between 2015 and 2016 with Burundian girls, boys and adults in Mahama refugee camp in Rwanda.

Barefoot Guide 5 – Mission Inclusion

Published: 2017 author: the fifth barefoot guide writer’s collective.

Many organisations, large and small, are tackling the deep challenges of exclusion and coming up with creative, innovative and workable solutions that are putting into practice the policies and strategies that everyone is talking about. This Barefoot Guide, written by 34 practitioners from 16 different countries on all continents makes many of these successful approaches and solutions more visible.

From the ground up: developing a national case management system for highly vulnerable children – An experience in Zimbabwe

Published: 2017 author: n. beth bradford.

A case study from Zimbabwe on how a national case management system for orphans and vulnerable children was built based on a community based care model.

How collaboration, early engagement and collective ownership increase research impact: Strengthening community-based child protection mechanisms in Sierra Leone

Published: 2017 author: michael wessells, david lamin, marie manyeh, dora king, lindsay stark, sarah lilley and kathleen kostelny.

Chapter 5 of the publication “The Social Realities of Knowledge for Development: Sharing Lessons of Improving Development Processes with Evidence” published by the International Development Institute, 2017. Using Interagency Learning Initiative (ILI) action research in Sierra Leone, this chapter from a DfiD provides a case study on how a highly collaborative approach can enable child protection research to achieve a significant national impact. The chapter describes how the inter-agency research facilitated a community-driven approach to addressing teenage pregnancy.

Presentation by Eddy Walakira – Kampala workshop, 17-18 August, 2016

Published: 2016 author: eddy walakira.

This presentation looks at the results of a War Child Holland initiative in Northern Uganda around prevention of violence against children in a post war setting.

Presentation by Patrick Onyango – Kampala workshop, 17-18 August, 2016

Published: 2016 author: patrick onyango.

A presentation on girl mothers in armed forces and groups and their children in Northern Uganda, Liberia and Sierra Leone – Participatory Action Research to assess and improve their situations.

Community engagement to strengthen social cohesion and child protection in Chad and Burundi – “Bottom Up” participatory monitoring, planning and action

Published: 2016 author: international institute for child rights and development (iicrd), dr. philip cook, michele cook, natasha blanchet cohen, armel oguniyi & jean sewanou.

A final report on action research which looked at how communities can help drive monitoring, planning and action around social cohesion strengthening and child protection in Chad and Burundi.

Tatu Tano – a portrait

Published: 2015 author: kurt madoerin. kwa wazee.

A background document on the Tatu Tano programme in Nshamba, Tanzania, Developed and implemented by Kwa Wazee.

Tatu Tano – a portrait

Published: 2015 author: kurt madoerin/kwa wazee.

An outline of the Tatu Tano programme and learning from 2015.

An Overview of the Community Driven Intervention To Reduce Teenage Pregnancy in Sierra Leone

Published: 2014 author: mike wessells, david lamin, & marie manyeh.

An overview of the Interagency Learning Initiative process of supporting community-driven action that addresses needs of vulnerable children in Bombali and Moyamba Districts of Sierra Leone.

National Child Protection Systems in the east Asia and Pacific region – a review and analysis of mappings and assessments

Published: 2014 author: ecpat international, plan international, save the children, unicef and world vision - ecpat international, bangkok.

A review of mappings and assessments of the child protection system in 14 countries was commissioned by the Inter-Agency Steering Committee (IASC), a subcommittee of the East Asia and Pacific Child Protection Working Group.

Etude sur les problématiques et les risques de protection de l’enfance – Etude de cas dans la région de Segou, Mali

Published: 2014 author: frédérique boursin-balkouma - sociologue - spécialiste en protection de l’enfant, ouagadougou, burkina faso. nouhoun sidibé - enseignant – chercheur - spécialiste en education, isfra, bamako, mali.

A travers un diagnostic participatif, l’étude commanditée par l’ONG Terre des hommes dans les districts sanitaires de Markala et Macina avait pour objectif d’identifier les problématiques et les risques de protection de l’enfance les plus répandus ; ainsi que de découvrir les pratiques endogènes de protection (PEP) existantes.

Study on the issues and risks for child protection in the Segou region in Mali

A participatory study sponsored by the Terre des Hommes NGO in the health districts of Markala and Macina which aimed to identify the most common risks for child protection as well as existing endogenous protection practices.

Research Brief: An Ethnographic Study of Community-Based Child Protection Mechanisms and their Linkages with the National Child Protection System of Sierra Leone

Published: 2012 author: inter-agency learning initiative on community-based child protection mechanisms and child protection systems.

This document serves as a seven-page summary of the longer report included among these research documents, “An Ethnographic Study of Community-Based Child Protection Mechanisms and their Linkages with the National Child Protection System of Sierra Leone.”

Kwa Wazee’s Impact assessment of Self Defense – the views of the participants

Published: 2011 author: kwa wazee.

A 2011 evaluation of the Kwa Wazee girl’s self-defence training initiative in Nshamba, Tanzania.

Tanzania: Linking community systems to a national model of child protection

Published: 2011 author: sian long, maestral international.

This report describes a child protection system strengthening initiative that was piloted in four districts in Tanzania. The aim of the initiative was to improve the delivery of social and protective services to all children, especially the most vulnerable, with a view towards building an evidence base for an effective child protection model that can be scaled up nationally.

Strengthening National Child Protection Systems in Emergencies through Community-Based Mechanisms: A Discussion Paper

Published: 2010 author: alyson eynon and sarah lilley for save the children uk on behalf of the child protection working group of the un protection cluster.

This discussion paper uses three case studies – Myanmar, the occupied Palestinian territories, and Timor Leste – to examine the state of evidence about strengthening national child protection systems through community-based mechanisms during emergencies.

Executive Summary: What are we learning about protecting children in the community?

Published: 2009 author: mike wessells, lead consultant, on behalf of an inter-agency working group.

This 20-page executive summary presents an overview of the key findings from a 2009 inter-agency review of the evidence on community-based child protection mechanisms. The full report is also available in this research section.

Sudan: An in-depth analysis of the social dynamics of abandonment of FGM/C

Published: 2009 author: samira ahmed, s. al hebshi and b. v. nylund for unicef innocenti research centre.

An Innocenti Working Paper Special Series on Social Norms and Harmful Practices.This paper examines the experience of Sudan by analysing the factors that promote and support the abandonment of female genital mutilation/cutting (FGM/C) and other harmful social practices. Despite the fact that FGM/C is still widely practiced in all regions of northern Sudan, women’s intention to circumcise their daughters has decreased significantly during the last 16 years. Attitudes are changing and today, actors are mobilizing across the country to end the practice. This paper examines these changes. It analyses programmes that support ending FGM/C in Sudan and highlights the key factors that promote collective abandonment of the practice, including the roles of community dialogue, human rights deliberation, community-led activities, and the powerful force of local rewards and punishment.

A Common Responsibility: The role of community-based groups in protection children from sexual abuse and exploitation – a discussion paper

Published: 2008 author: sarah lilley for save the children uk.

This 2008 discussion paper shares Save the Children’s experience in working with community-based groups; the paper is an effort to stimulate dialogue by highlighting the successes and challenges of such work.

Mobilising Children & Youth into their Own Child- & Youth-led Organisations

Published: 2008 author: kurt madoerin. published by repssi.

Several decades of experience in working with vulnerable children across the planet had resulted in Kurt coming to believe that in the face of family, community and societal disintegration, the single most important supportive “intervention” that could be offered “to”, and more importantly “with” children and youth, might be the mobilisation of children and youth into their own child-led and youth-led organisations.

Community Action and the Test of Time: Learning from Community Experiences and Perceptions

Published: 2006 author: jill donahue and louis mwewa.

Case studies of mobilisation and capacity building to benefit vulnerable children in Malawi and Zambia.

Impact Evaluation of the VSI (Vijana Simama Imara) organisation and the Rafiki Mdogo group of the HUMULIZA orphan project Nshamba, Tanzania

Published: 2005 author: glynis clacherty and professor david donald.

The aims of the Humuliza Project are to develop a practical instrument to enable

teachers and caregivers to support orphans psychologically and to develop the

orphans’ own capacity to cope with the loss of their caretakers.

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Child abuse: A classic case report with literature review

Arthur m. kemoli.

Department of Paediatric Dentistry and Orthodontics, University of Nairobi, Kenya

Mildred Mavindu

Child abuse and neglect are serious global problems and can be in the form of physical, sexual, emotional or just neglect in providing for the child's needs. These factors can leave the child with serious, long-lasting psychological damage. In the present case report, a 12-year-old orphaned boy was physically abused by a close relative who caused actual bodily and emotional trauma to the boy. After satisfactorily managing the trauma and emotional effects to the patient, in addition to the counseling services provided to the caregiver, the patient made a steady recovery. He was also referred to a child support group for social support, and prepare him together with his siblings for placement in a children's home in view of the hostile environment in which they were living.

Introduction

For a long time, child protection in general has been perceived as a matter for the professionals specializing in social service, health, mental health, and justice systems. However, this problem remains a duty to all, and more so a concern for other social scientists such as anthropologists, economists, historians, planners, political scientists, sociologists, and humanists (e.g., ethicists, legal scholars, political theorists, and theologians) who contribute to the understanding of the concepts of and strategies in child protection and the responsibility for adults and institutions with roles in ensuring the safety and the humane care of children under their care. Child abuse, therefore, is when harm or threat of harm is made to a child by someone acting in the role of caretaker.[ 1 , 2 ] It is a worldwide problem with no social, ethnic, and racial bounds.[ 3 ] Child abuse can be in the form of physical abuse, when the child suffers bodily harm as a result of a deliberate attempt to hurt the child, or severe discipline or physical punishment inappropriate to the child's age. It can be sexual abuse arising from subjecting the child to inappropriate exposure to sexual acts or materials or passive use of the child as sexual stimuli and/or actual sexual contacts. Child abuse can also be in the form of emotional abuse involving coercive, constant belittling, shaming, humiliating a child, making negative comparisons to others, frequent yelling, threatening, or bullying of the child, rejecting and ignoring the child as punishment, having limited physical contact with the child (e.g., no hugs, kisses, or other signs of affection), exposing the child to violence or abuse of others or any other demeaning acts. All these factors can lead to interference with the child's normal social or psychological development leaving the child with lifelong psychological scars. Lastly, child abuse can be in the form of child neglect, when an able caregiver fails to provide basic needs, adequate food, clothing, hygiene, supervision shelter, supervision, medical care, or support to the child.[ 4 ]

It is usually difficult to detect child abuse, unless one creates an atmosphere that would encourage disclosure by the child being abused.[ 5 ] Nonetheless, a good medical and social history may help to unravel the problem. Signs and symptoms of child abuse commonly include subnormal growth of the child, unexplained head and dental injuries, soft-tissue injuries like bruises and bite marks, burns and bony injuries like broken ribs, in the absence of a history pointing to the cause or causes of the trauma. The present case report describes a child who was abuse by a very close relative, and who caused physical and psychological trauma to the young lad.

Case Report

Peter, a 12-year-old boy, accompanied by his maternal aunt, presented at the local university Dental Hospital (Pediatric Dental Clinic) in Kenya in October 2012, with a complaint of a large, painful left facial swelling related to the left upper incisors. He had been referred from a local rural hospital where he had been taken by the same aunt, for treatment of the swelling. The swelling had occurred only 2 days prior to visiting the local hospital, and 4 days before presenting himself at the University Dental Hospital. Enquiry about the causes of the swelling provided unclear answers. Family history indicated that the young boy was a first-born among three siblings (9-year-old girl, 5-year-old boy), and that their single parent (mother) had been deceased for 6 years due to HIV-related complications. The three children had moved to live with their maternal grandparents and their seven sons. The patient had no adverse past medical history and had never consulted a dentist previous to the present problem. The boy was in grade seven in a local primary school and had the aspiration of becoming a medical doctor in future. It was not possible to establish from the aunt or the boy the situation of the patient's other siblings.

An extra-oral examination showed a young boy with a normal gait, sickly, unkempt, rather withdrawn, and small for his age. He had asymmetrical face due to the swelling involving his left submandibular region and spreading upwards to the inferior orbital margin, febrile (39.1°C), a marked submandibular lymphadenopathy on the left side, the skin overlying the swelling was warm, shiny and fluctuant, and the lips were dry and incompetent (2 cm) and as shown in [Figures ​ [Figures1a 1a – c ]. However, the temporomandibular joint movements were normal. The patient was also found to have a big, healing scar on the dorsal surface of the left foot, the cause of which was also unclear [ Figure 1 ].

(a) Frontal and (b) lateral (c) profiles of the patient showing the facial asymmetry with the left submandibular to infra-orbital and the healing scar on the foot

Intra-oral examination revealed a young boy in the permanent dentition with un-erupted third permanent molars, poor oral hygiene with heavy plaque deposits on the tongue and a generalized but moderate inflammation of the gingiva. There was a grade three mobility in relation to 11, 12, 21, 22 and a grade two mobility in relation to 23, 24, 25 (Miller mobility index). There was intramucosal swelling in relation to 21-24 extending labially/buccally (measuring 4 cm × 3 cm) and palatally (measuring 3 cm × 2 cm). On elevation of the upper lip, active discharge of pus mixed with blood and some black granules could be seen emanating from the abscess. There were no alveolar/bone fractures elicited, but carious lesions were present on 46 (occlusal), 47 and 37 (buccal). Orthodontic evaluation showed Angles class I molar relation on the left and edge to edge tending to class II on the right side. The canines were in class I relationship bilaterally. There was an anterior over-jet of 3 mm (11/21), an overbite of 20%, coincidental dental/facial midline and crowding on the upper right arch with 15 palatally displaced as can be seen in Figure ​ Figure2a 2a – c .

(a) Intra-oral photographs of the patient showing the labial and (b) palatial swelling in relation to displaced 21 and 22 (c), generalized marginal gingival inflammation, palatally displaced 15, moderate dental plaque deposits and a moderate anterior dental crowding in the lower dental arch

For investigations, orthopantogram, intra-oral periapical 11, 12, upper and lower standard occlusal and bite wing radiographs were taken and examined. In addition, clinical photographs, study models, and vitality tests for the traumatized teeth were undertaken. A diet and nutrition assessment, full blood count, stool microscopic analysis for ova and cyst and bacterial culture and sensitivity were also undertaken.

The results of the radiographs showed un-erupted with potential impaction of 48 and 38, an upper midline radioluscence, widened periodontal space in relation to 11, 21 (with a mesial tilt), 22, occlusal caries on 46 and buccal caries on 47 and 37. There was the presence of root fractures involving the apical one-third of 21, 22. Vitality tests conducted on the traumatized incisors showed false positive (may be due to the presence of infection). The blood analysis showed the presence of neutrophilia (suggestive of bacterial infection), mild iron deficiency, but he was sero-negative. From the diet chart, the boy was generally on a noncariogenic diet that lacked the intake of fruits and animal proteins. Nutritional assessment revealed a boy with a height of 144 cm, a weight of 28 kg, and a body mass index (BMI) of 13.5 Kg/m 2 (below 5 th percentile (given the ideal BMI should be 17.8 Kg/m 2 in the 50 th percentile).

From the history adduced and the results of the investigations, a diagnosis of child abuse and neglect was reached, with the boy having suffered traumatic injuries resulting in facial cellulitis, Ellis class VI fracture involving 21, 22 associated dentoalveolar abscess and subluxation of 11, 12. In addition, there were dental carious lesions on 46 (occlusally), 47 and 37 (buccally) and a relatively severe malnutrition. The patient had also moderate plaque induced gingivitis, mild anemia (microcytic and iron deficiency), mild dental fluorosis, potentially impacted 48 and 38 and crowding in the upper right and lower anterior arches.

The objective of treating the boy was to eliminate the pain, infection, improve the general and oral health, restore carious teeth, improve esthetic and report the child abuse and neglect to the relevant authorities. In the initial phase of treatment, the patient was admitted for 4 days and placed on dexamethasone 8 mg stat, cefuroxime 750 mg 3 times a day, metronidazole 500 mg 3 times a day, diclofenac 50 mg tablets alternating 4 hourly with oral paracetamol 1000 mg 3 times a day, to run for 5 days. Patient was also placed on chlorhexidine mouthwash 10 ml twice daily for 7 days and ranferon (hematinics) 10 ml to be used twice a day for 1 month. The second phase of treatment included incision and drainage of the abscess, followed by the splinting of the mobile teeth in the upper dental arch using semi-rigid splint of 0.6 mm stainless steel round wire for 4 weeks while. Root canal treatment of 11, 21, 12, and 22 followed thereafter.[ 6 ] A referral of the patient was made the child support center in the main referral hospital, plus the patient was placed on future recalls to determine whether the patient would have overcome the problem and the oral health was maintained in good condition.

The third phase of treatment involved interceptive orthodontics with the extraction of 15 to relieve the crowding in the area. Oral hygiene instructions were availed to the patient and the guardian, placement of fissure sealants was done for the premolars and molars to help reduce plaque retention on these teeth, preventive resin restorations were placed on 37, 46, and 47. The root fractures involving the apical one-third of 21 and 22 meant that the two teeth were to be initially dressed using non setting calcium hydroxide, and after healing, root canals are filled in the usual manner [ Figure 3 ].

Postobturation intraoral periapial radiograph showing the restoration on 12, 11, 21, and 22

Nutrition evaluation had initially been done and when the patient was re-evaluated after 1 month, he had gained bodyweight up to 1 kg. The child support center continued to carry out psychotherapy, and during one of the sessions, the patient confessed to having undergone physical abuse and threatened not to divulge any information by one of the uncles. The center considered placing the boy into a children's home, probably together with his siblings. Radiographic examinations evaluation after 3 months indicated some external apical root resorption taking place on 21 and 22. Further follows-ups were to continue.[ 7 ] After 10 months, the oral health and general heath of the patient had remarkably improved as shown in Figure 4 .

Posttreatment photographs taken after 10 months showing improved oral health of the patient and the glimmer of confidence in the patient as shown in a-d respectively

All types of child abuse and neglect leave the affected child with long-lasting scars that may be physical or psychological, but they are the emotional scars that leave the child with life-long effects, damage to the child's sense of self, the ability to build healthy relationships and function at home, work or school. This situation can in turn result in the child turning to alcohol or drugs to numb the painful feelings. On the other hand, the exposure by the child to violence during childhood can increase vulnerability of that child to mental and physical health problems like anxiety disorder, depression, etc.,[ 8 , 9 ] and make victims more likely to become perpetrators of violence later in life.[ 10 ] The oral cavity can be a central focus for physical abuse due to its significance in communication and nutrition.[ 3 , 11 ]

A neglected and abused child like the one described here, can become helpless and passive, displaying less affect to anything whether positive or negative in his or her encounters.[ 12 ] The patient described was vulnerable to abuse as he already lacked the parental protection in his early life, and was living in a poor, but large family where competition for available resources must have been stiff. The abuser, therefore, his own uncle, probably did not like their presence gave him the assumption that the children would grow up to take away what he probably thought would be his dues from the family.

In Kenya and even in many other countries, data on the prevalence of child abuse is still scarce. A Kenyan study undertaken in 2013 showed that violence against children was very high, with 31.9% and 17.5% female and male, respectively reporting having been exposed to sexual violence, 65.8% and 72.9% female and male respectively to physical violence. In the same study, 18.2% and 24.5% female and male, respectively had been abused prior to attaining 18 years of age, and only 23.8% female and 20.6% male reported not having experienced any form of violence during childhood.[ 13 ] Child abuse in Kenya, therefore, appears to be a rampant problem within the society. In all cases of abuse reported in the literature, the perpetrators were most often well-known to the children. The motive of child abuse has not always clear, just as it was the case with the patient described here. The patient under study here hailed from a family with low socio-economic background where providing for extra needs in the family could have been a problem. Even during treatment of the patient the family found the cost of treatment to be very high and unaffordable to them, and a waiver of the cost had to be sought and obtained from the University Dental Hospital. Further, the child having been orphaned with the death of their single parent (mother) left these children unprotected and vulnerable to such abuse from uncles who may have been competing for same needs in an already crowded family. It is possible that factors as poverty, social isolation, and familial disruption could have contributed to the abuse meted by this boy.[ 1 ] The fact that the problem was established at this stage, it probably provided the patient and his siblings with the opportunity to get early support and avert serious health problems for them. The referral to the local child protection authority was done to attain this goal and also to have the children monitored consistently for their safety from further child abuse. The child protection agency was indeed considering placing them in the custody of a children's home, though sadly, according to a report by the Kenyan Government, the utilization of these support services had not been very high,[ 13 ] for reasons unknown.

The treatment of the patient was carried out in a humane manner, and assistance provided whenever possible to have the full treatment completed. The problem of nutrition was still a difficult one for this large family with a poor background. Nonetheless, the guardian was still briefed on the issue, and informed about the importance of a balanced diet for optimal growth and immunity boosting for such young child, and suggestions for alternative cost-effective foods for the child. It was hoped that the support services of giving the patient and probably his siblings a new home would help the young child to grow and develop normally without fear of abuse.

The management of child abuse can be complicated, and often require a multidisciplinary approach, encompass professionals who will identifying the cause of the abuse or neglect, treatment of the immediate problems and referral of the child to the relevant child protection authority for action. Counseling services for the child and the caregivers should form part of the management regime. In the present case, the objectives were met and the patient got full benefits of this approach.

Source of Support: Nil

Conflict of Interest: None declared.

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Case Studies and Scenarios

Case studies.

Each case study describes the real experience of a Registered Early Childhood Educator. Each one profiles a professional dilemma, incorporates participants with multiple perspectives and explores ethical complexities. Case studies may be used as a source for reflection and dialogue about RECE practice within the framework of the Code of Ethics and Standards of Practice​.

Scenarios are snapshots of experiences in the professional practice of a Registered Early Childhood Educator. Each scenario includes a series of questions meant to help RECEs reflect on the situation.

Case Study 1: Sara’s Confusing Behaviour

Case study 2: getting bumps and taking lumps, case study 3: no qualified staff, case study 4: denton’s birthday cupcakes, case study 5: new kid on the block, case study 6: new responsibilities and challenges, case study 7: valuing inclusivity and privacy, case study 8: balancing supervisory responsibilities, case study 9: once we were friends, ​​​​scenarios​​, communication and collaboration.

Barbara, an RECE, is working as a supply staff at various centres across the city. During her week at a centre where she helps out in two different rooms each day, she finds that her experience in the school-age program isn’t as straightforward as when she was in the toddler room. Barbara feels completely lost in this program.

Do You Really Know Who Your Friends Are?

Joe is an RECE at an elementary school and works with children between the ages of nine and 12 years old. One afternoon, he finds a group of children huddled around the computer giggling and whispering. Joe quickly discovers they’re going through his party photos on Facebook as one of the children’s parents recently added him as a friend.

Conflicting Approaches

Amina, an experienced RECE, has recently started a new position with a child care centre. She’s assigned to work in the infant room with two colleagues who have worked in the room together for ten years. As Amina settles into her new role, she is taken aback by some of the child care approaches taken by her colleagues.

What to do about Lisa?

Shane, an experienced supervisor at a child care centre, receives a complaint about an RECE who had roughly handled a child earlier that day. The interaction had been witnessed by a parent who confronted the RECE. After some words were exchanged, the RECE left in tears.

Duty to Report

Zoë works as an RECE in a drop-in program at a family support centre. She has a great rapport for a family over a 10-month period and beings to notice a change in the mom and child. One day, as the child is getting dressed to go home for the day, she notices something alarming and brings it to the attention of her supervisor.

Posting on Social Media

Allie, an RECE who has worked at the same child care centre for the last three years, recently started a private social media group to collaborate and discuss programming ideas. As the group takes a negative turn with rude and offensive comments, it’s brought to her supervisor’s attention.

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Safeguarding children in affluent families

Professor Claudia Bernard undertook the first piece of social work research in the UK to explore child abuse in affluent families.

Through investigating problems faced by social workers intervening with affluent parents, this research drew attention to an underexplored area of child social care.

Exploring child neglect in affluent families

Social work research and literature has tended to focus on child abuse in poor and working-class families.

Professor Bernard established a partnership with the City of London Corporation, a London borough, to explore the nature of child neglect in affluent families,

An initial review confirmed that most child protection social work is perceived to be focused on families in poverty. Training for social workers used case studies almost exclusively from poorer families, even in more affluent areas.

Commissioned by the City of London Corporation, Professor Bernard led a national study exploring how social workers engage with parents from affluent backgrounds in suspected child neglect cases.

The study focused on twelve of the wealthiest local authorities in England, including interviews and focus groups with frontline social workers and managers.

[Bernard’s findings] empower colleagues to be more confident in challenging affluent families.

Accredited Independent Safeguarding Consultant, Department for Education

The findings

Bernard’s research found that recognising and naming child neglect in affluent families can be difficult.

Children from these families who came to the attention of social workers had high-quality housing, diets and education opportunities, making it hard to evidence cases of emotional neglect – the most common type of abuse in affluent families.

The research also showed that affluent parents used their social and financial capital to manipulate the child protection system. Parents sometimes obstructed interventions, for example by threatening legal action or directly contacting senior managers and councillors.

These factors made it difficult for social workers to intervene in suspected child abuse cases, posing serious challenges for safeguarding children at risk.

Changing the social work field and beyond

Professor Bernard’s research led to policy changes on social work with affluent families in the City of London and five other London boroughs, affecting the work of over 4,800 social workers. The impacts of the policy changes were shared with all 343 local authorities in England.

The research has brought about change beyond the social work field, with several independent schools incorporated the findings into their safeguarding policies.

The regulatory body for independent schools uses the insights in their training of over 700 inspectors and the Council of International Schools uses the research to provide child protection and student well-being training in international schools across the globe.

Children from middle-class and affluent families suffer childhood neglect in less visible ways.

UK Adverse Childhood Experiences

• Research article
• Open access
• Published: 17 September 2013

A qualitative case study of child protection issues in the Indian construction industry: investigating the security, health, and interrelated rights of migrant families

• Theresa S Betancourt 1 , 2 ,
• Ashkon Shaahinfar 2 ,
• Sarah E Kellner 2 ,
• Nayana Dhavan 2 &
• Timothy P Williams 2 , 3  

BMC Public Health volume  13 , Article number:  858 ( 2013 ) Cite this article

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Many of India’s estimated 40 million migrant workers in the construction industry migrate with their children. Though India is undergoing rapid economic growth, numerous child protection issues remain. Migrant workers and their children face serious threats to their health, safety, and well-being. We examined risk and protective factors influencing the basic rights and protections of children and families living and working at a construction site outside Delhi.

Using case study methods and a rights-based model of child protection, the SAFE model, we triangulated data from in-depth interviews with stakeholders on and near the site (including employees, middlemen, and managers); 14 participants, interviews with child protection and corporate policy experts in greater Delhi (8 participants), and focus group discussions (FGD) with workers (4 FGDs, 25 members) and their children (2 FGDs, 9 members).

Analyses illuminated complex and interrelated stressors characterizing the health and well-being of migrant workers and their children in urban settings. These included limited access to healthcare, few educational opportunities, piecemeal wages, and unsafe or unsanitary living and working conditions. Analyses also identified both protective and potentially dangerous survival strategies, such as child labor, undertaken by migrant families in the face of these challenges.

Conclusions

By exploring the risks faced by migrant workers and their children in the urban construction industry in India, we illustrate the alarming implications for their health, safety, livelihoods, and development. Our findings, illuminated through the SAFE model, call attention to the need for enhanced systems of corporate and government accountability as well as the implementation of holistic child-focused and child-friendly policies and programs in order to ensure the rights and protection of this hyper-mobile, and often invisible, population.

Peer Review reports

In India, there are an estimated 40 million migrant laborers in the construction industry [ 1 ], who together make an immense contribution to the country’s rapidly developing economy [ 2 ]. Many of these laborers are parents who migrate with their young children to work and live in very challenging conditions [ 3 – 5 ]. Despite a broad epidemiological “migration and health” literature [ 6 ] and the documented impact of labor migration on child health [ 7 , 8 ], including explorations of child maltreatment in migrant families [ 9 – 12 ], little research has examined the health, safety, development, and well-being of migrant workers’ children. Using the methodology of a social science case study [ 13 ] conducted at a large construction site in the National Capital Region near Delhi, India, we examine dynamics influencing the security and well-being of migrant children and families who live near and work in infrastructure development projects.

Public health implications of migration for children and families

Migrants worldwide comprise a heterogeneous population that includes more than 214 million international and 740 million internal migrants [ 14 ]. The reasons for migration are diverse: for some, it is necessitated by civil conflict, natural disaster, development, or trafficking; while for others, it is out of desperation to escape profound poverty. The field of public health has traditionally focused on how mobile populations contribute to communicable disease epidemiology e.g. [ 15 ]. There is, however, a growing literature on migration and health, which addresses a variety of topics including: mental health [ 16 ], reproductive health [ 17 ], maternal and child health [ 18 , 19 ], tobacco and substance use [ 20 , 21 ], occupational health [ 22 ], and child abuse and neglect e.g. [ 9 ]. Studies have generally indicated that the drivers of migration, such as socioeconomic status [ 7 , 8 , 23 – 25 ], closely determine migrant health, rather than the process of migration itself. Increasingly, research has highlighted structural and institutional factors that affect migrant health, such as denial of medical care and its relationship to child survival [ 7 ].

Migration has implications for family well-being, including the safety, development, and education of children of migrant workers. Parental absence and struggle for survival have been tied to harmful socio-emotional impacts on children left behind [ 26 – 28 ]. With regards to the education of children of migrant families, researchers have found both positive impacts from remittances [ 29 , 30 ] and negative effects due to lack of parental support and supervision [ 26 , 31 ] as well as disincentivization by the prospect of migration [ 32 ]. Researchers seeking to understand the complex connections between family migration and child abuse have also highlighted poverty and socioeconomic stress [ 9 , 10 , 33 , 34 ], as well as social isolation and lack of social capital [ 11 , 12 , 33 – 35 ]. Frequent mobility has also been correlated with child maltreatment within families [ 36 , 37 ] as well as in neighborhoods and communities [ 38 – 40 ].

Labor migration and construction in India

The drivers and consequences of labor migration in India are as diverse as its regions and peoples [ 41 ]. While rural–urban and interstate migration make up relatively small portions of all migration in India (18% and 13% of 315 million migrants, respectively, per the 2001 census) [ 42 ], rapid development has increased these numbers. By recent trade union estimates, there are approximately 40 million interstate migrants in the construction industry alone [ 1 ]. This group of internal migrant workers, defined in the Interstate Migrant Workmen Act of India as “any person who is recruited by or through a contractor [including middlemen] in one State under an agreement or other arrangement for employment in an establishment in another State”, and their families, comprise the general focus of the present study [ 43 ].

Cyclical migration has long been an important livelihood strategy for the rural poor of India [ 44 , 45 ]. Seasonal climate fluctuations in regions such as the flood-prone Ganges basin and the rain-dependent semi-arid tropics make for agrarian lifestyles fraught with risk and food insecurity [ 4 , 46 , 47 ]. Landlessness and social-deprivation [ 3 , 48 , 49 ], indebtedness [ 4 , 50 ], and limited employment opportunities [ 44 , 49 , 50 ] all drive individuals and families to migrate.

The impact of migration on families and communities varies. While longitudinal field studies in India indicate improved wages and income among migrants over time [ 2 , 48 , 51 ], the most economically and socially-deprived have remained in debt [ 50 , 52 ]. Deshingkar and colleagues summarized their observations in Madhya Pradesh: “…for the poorest groups of migrants, especially unskilled and uneducated Scheduled Castes (SCs) and Scheduled Tribes (STs) who still migrate through agents, or who cannot enter remunerative … work because of discrimination, working conditions and earnings are far from ideal and positive changes in living standards are less certain and slower” [ 2 ]. Though some studies suggest migrants are more able to resist exploitation [ 2 , 51 ], recent reports document illegally low wages and strenuous work hours [ 4 , 53 , 54 ].

An emerging body of literature documents numerous threats to the health and well-being of migrant children in India, including poor living conditions [ 3 – 5 , 54 ], frequent injuries of workers [ 1 , 4 ], poor access to drinking water [ 4 , 5 , 53 ], and sexual violence towards women and children [ 53 , 55 ]. Furthermore, urban migrant laborers have great difficulty accessing government programs otherwise accessible in rural settings, including those for health care and insurance [ 4 , 54 , 55 ], childcare [ 4 , 54 , 56 ], education [ 53 , 56 ], and food rations [ 5 , 53 , 54 ]. However, the interrelated and interdependent relationship of these threats to child health and well-being is often overlooked.

Conceptual framework

A rights-based, holistic model of child security, the SAFE model, provided the conceptual basis for the present study. Situating child protection within the nested social ecologies of families, communities, and the larger political, cultural and historical context, the SAFE model examines interrelatedness among four core domains of children’s basic needs and rights: S afety/freedom from harm; A ccess to basic physiological needs and healthcare; F amily and connection to others; E ducation and economic security [ 57 ]. Of central importance to SAFE is the idea that insecurity in any of these fundamental domains threatens security in the others. The SAFE model posits that in the face of child security threats, children and families demonstrate considerable agency, adopting survival strategies to meet their basic security needs. These survival strategies may take risky forms (with cascading negative effects on other dimensions of child security and well-being) or adaptive forms [ 57 ]. For instance, to overcome family economic insecurity, some families may give their child over to bonded child labor while others may organize workers’ collectives to secure a loan to start a small business. The purpose of the SAFE model is to identify and build on adaptive strategies while also highlighting risky strategies in order to enact preventive interventions, provide alternatives, or end third party manipulation [ 58 ].

Fundamental concepts of the United Nations Convention on the Rights of the Child (CRC) [ 59 ], such as the evolving capacities of the child and the interdependence and interrelatedness of child rights and basic security needs, are implicit to the SAFE model. The SAFE domains also map onto rights delineated in the CRC, such as the rights to life, survival, and development (e.g., Art. 6); education (Art. 28); health (Art. 24); family connections (e.g. Arts. 9, 20); and protection from violence (Art. 19) as well as various other special protection articles (e.g. Arts. 32–40) [ 59 ].

Case study design and research questions

We applied a case study methodology [ 13 ] to identify factors affecting children’s security and well-being at a construction site in the National Capital Region of India using the SAFE model as a theoretical framework for our data collection. A case study approach has particular utility in addressing the “how” and “why” of contemporary phenomena within their real life contexts [ 13 ]. Furthermore, this approach allowed for an in depth examination of issues related to child protection on a single site and the resulting elucidation of complex phenomena. As with prior applications of the SAFE model e.g. [ 58 ], we specifically sought to illuminate child protection threats facing children in families migrating for work in India’s construction industry with particular attention to the SAFE domains and their interrelatedness. We also sought to identify adaptive and dangerous survival strategies used by migrant families. The study was guided by four research questions: (1) What conditions lead children and families to the site?; (2) What are the security threats facing children at the site as described by children, adults, local community representatives, and child protection stakeholders in the National Capital Region?; (3) How do children and families of the site cope with or respond to security threats and situations of adversity?; (4a) In what ways, if any, do public and private sectors of civil society work to support the security and well-being of migrant children and families on the site?; and (4b) More generally, how do local stakeholders think public and private sectors can promote the security and well-being of migrant children and families, if at all?

Our study methods placed particular emphasis on triangulation of information pertaining to the study site, and included key informant interviews, focus groups discussions, ethnographic observations, and a thorough exploration of relevant peer-reviewed and grey literatures. The research was facilitated by Mobile Crèches, a non-governmental organization (NGO) in Delhi that works with the developer at the construction site to provide an early childhood development-oriented crèche and daycare center to care for migrant children during the work day. Indian law requires the establishment of a crèche at sites with more than 50 women [ 60 ], but the law is rarely implemented [ 61 ] (Table  1 ).

Study sample and recruitment

The research team worked closely with Mobile Crèches to select and recruit study participants. Purposive sampling was used to select participants from the construction company leadership, government, civil society, as well as migrant workers and children living and working at the site. We conducted six focus groups, including: two with female workers (N = 15, median age 26), one with male workers (N = 5, median age 35), one with adult “Malda workers” (described below; N = 5, median age 25), one with young boys (N = 4, median age 11), and one with young girls (N = 5, median age 7). A small group of children and adolescents, who were on the site without their parents, were deemed by the research team in discussion with the host NGO too vulnerable for involvement and were excluded from the study. Each focus group consisted of four to ten people and lasted from one to two hours. We also conducted seven in-depth interviews with providers who work with the children at and near the site (e.g. school teachers and child care providers; see Table  2 ). Six developer and contractor representatives at various levels of leadership and employment as well as a local business owner were also interviewed. In order to locate this case study within a larger political context, we also spoke with eight key informants from the government and international and local NGOs.

Data collection

Primary data were collected in the months of January and July 2010, with additional “member checks” (described below) in January-February 2011. All interviews and focus groups were conducted in Hindi or English by local research assistants trained in research ethics and qualitative interviewing techniques. Working in pairs, one research assistant conducted the interview while the other took detailed field notes. All focus groups were held in the local language (Hindi), and key informant interviews were held in English or Hindi. Focus groups and interview guides were open-ended in nature (e.g., “What problems, if any, do children and families face in this site?”), and interviewers probed to gain further insight into emerging issues. Depending on respondent preference, interviews were recorded digitally or via detailed note-writing. All interview and focus group data were transcribed, de-identified, and stored electronically with access limited to authorized research staff, ensuring participant confidentiality. Local research assistants worked in small teams to make accurate Hindi to English translations. Ethical approval was obtained from both the Human Subjects Committee of the Harvard School of Public Health and a local Community Advisory Board in Delhi. Verbal informed consent and independent child assent was obtained from all participants. Parental consent for their children’s participation was obtained at least one day prior to the child focus groups. Participants were given opportunities to ask the local research team any questions before, during, and after the focus group discussions.

Data analysis

Our method of qualitative data analysis included open coding, category construction, and axial coding to examine relationships between categories consistent with a grounded theory-based analysis [ 62 ] and Thematic Content Analysis (TCA) [ 63 ]. This approach entailed a 4-stage procedure: 1) We first conducted an open-coding process of all data using both SAFE model informed categories as well as findings arising organically from the data. 2) Categories and themes that were most saturated in the data informed the development of a coding scheme, e.g., “poverty”, “access to medical care” “hunger”. 3) To examine reliability, two team members trained in the coding scheme independently coded 10% of transcripts. The code book was refined and reliability testing was repeated until all coding was at 80% reliability. 4) Using the code book, the qualitative dataset was coded in Nvivo 8 [ 64 ], a qualitative data analysis program.

After multiple readings of the data, emergent themes were identified and specific codes representing core themes or phenomena were developed. The codebook underwent several iterations with input from multiple coders, allowing its structure to be refined and adapted over time [ 65 ]. This approach was further supplemented by axial coding [ 62 ] to examine the interrelatedness between key concepts and identify cross-cutting themes. In January-February 2011, members of the research team returned to Delhi to re-contact several study participants and to undertake follow-up interviews and focus group discussions through a validation exercise known as “member checks” [ 66 ] (N = 38 participants).

Factors driving family migration to construction site

The laborers, many from the rural areas of distant states such as Bihar and West Bengal (see Table  3 ), likened their experience as a migrant worker to “going abroad” or living in pardes (foreign land). “ If a person has … everything, then why would they come here in this jungle to live ”, explained one female laborer (age 45). “ [Only] [t]he ones who have some problem or are suffering would come here ”. Most laborers and families came to the construction site through jamadars or thekedars from their village, middlemen hired by contractors to sort out logistics related to recruitment, transport, and, in some cases, on-site accommodation. Others arrived through previously migrated family members or through direct company recruitment. A number of respondents had recently migrated for the first or second time: “ It’s been five days since I arrived here. I have just come from home. Earlier when I was here, I stayed for nine months ”. (female laborer, age 21). Many had spent years in pardes , moving from work site to work site, often in association with the same company. As one male worker described, “ We came here and have stayed here since 1995. And we used to go to our native place and come back. I go once or twice in a year to my village. Again, I come to join the same construction firm ” (age 55). Citing the costs and risks associated with travel, many migrants would visit the village infrequently. One group of male laborers referred to as “Malda workers” work on short-term, 50-day contracts, which permit them to pay off small debts, work in their agricultural “off season”, and return home (typically Malda and Cooch Behar districts of West Bengal) to their families and land regularly. No indication of forced labor, coercion, or human trafficking emerged from our observations or discussions with children and adults.

Frequently cited drivers for migration included the opportunity to “earn and eat”, family indebtedness, limited land ownership, and poor fertility of land in villages. Laborers shared stories of migration to meet basic needs for their families: “ Earlier I was a tailor master in Malda. I owned a shop … but I left the work as my youngest daughter was sick. I have spent so much money on her treatment … I was running out of money ” (male supervising laborer). One mother explained, “ We have three children two boys and one girl. We have a house that is made up of mud that is falling down. With the thought to re-build our house and to educate my children we have come here ” (age 25). Another described how her family was compelled to migrate, “ I do not have fields, and there are no rains. In the village, we were dying from hunger and thirst, so we have left children there and have come only with one son to work here on this site ”. (age 30). Still, others cited their intent to help secure a better life for their children. A female migrant (age 22) explained, “ We are poor. We are taking care of, raising our children … to make them move forward, we are earning money. If we educate our children, we will make them into something ”. All of the women in our focus groups were parents; two-thirds of these mothers had children living with them and their husbands on the site, nearly half of whom also had children living with grandparents in the village.

Safety and freedom from harm at the construction site

Displayed prominently at the entrance of the construction site was a sign that read, “ Parents must warn children that this is an unsafe area ”. Large machinery, moving vehicles, and precariously-situated construction materials were ever-present on the site. Children, in particular, expressed worry about their parents’ safety. They recalled incidents that had occurred at other sites where children or workers had been severely hurt or killed, resulting in a preoccupation with the safety of their parents: “ When people work in this site … [they] climb from a rope … then they fall, then people die” , said a girl, age 8. In fact, between July 2010 and January 2011, two workers had died in falls on the worksite.

Access to basic physiological needs: housing, food insecurity and accessing medical care

Living conditions & basic amenities.

Workers and their families lived in cramped, temporary structures, termed jhuggis, made of either corrugated tin or brick and mortar. During the course of our fieldwork, entire portions of the housing area were destroyed and moved due to expanding construction on the site. Many families spent their day off rebuilding or tending to their shelters, a time-consuming and labor-intensive task. While the site manager cited the danger electricity would pose in the tin jhuggis , the lack of electricity for fans or other cooling systems proved especially burdensome and potentially dangerous given high humidity and temperatures exceeding 100°F in the summer months: “ Poor people come from far off and feel so hot here. We stay inside and are drenched in sweat, but still they do not provide us with any electricity… ” (female worker, age 35). To cope with the extreme heat, particularly when the crèche was closed, children would spend time in half-built, multi-story towers where, as one boy (age 12) put it, “ winds … [give] people a calm and cool situation” . Unsupervised, they were placed at risk of falling from the towers or being injured.

The quality and availability of basic amenities, including housing, access to drinking water, affordable food, and proper sanitation were also of primary concern to participants. Many children expressed nostalgia for their village life, citing the heat, cramped jhuggis , and lack of open space. One girl (age 7) insisted, “ Everyone, boys and girls, says it is better back home ”. Although workers were generally satisfied with the availability of clean water, some reported conflicts over communal pipelines. Food was also readily available near the site; however, given their lack of access to ration cards and the high price of food around Delhi, some migrants struggled to afford food and needed to purchase it from the grocery shop owner, or lala, on credit. Sanitation at the site was observed to be poor, with latrines that were often full and seldom cleaned. The lack of separate facilities for men and women was distressing for female workers. Despite these various concerns, the multiple layers of accountability and relative powerlessness of workers meant change was unlikely; as one man (age 55) lamented, “ We cannot do anything. If we will ask, we will be kicked out of this place ”.

Health & healthcare

Many migrate to a worksite in hopes of improving family well-being; yet the health challenges they encounter in pursuing this survival strategy may put children and families at further peril. Respondents familiar with the site described health issues ranging from water-borne and other infectious diseases to heat-exhaustion, dehydration and other work-related problems. Unresolved malnutrition and anemia were both common among children [ 67 ]. While the crèche offered some medical support for children and their families, there were divergent opinions about whether the company or contractors provided care for workers’ children. One male worker (age 35) asserted that there was “ [n]othing for the children ” and that “ the facilities are only for the workers ”. Conversely, a supervisor for a sub-contractor claimed that their facilities were available to both workers and their families. Options for workers themselves were also limited as employers only took responsibility for provision of, transportation to, and payment for care related to work place injury or illness. Basic first aid was provided on the construction site and in the crèche, and an ambulance was reportedly available around the clock. However, in case of off-duty health problems among workers or of more serious injuries or illnesses among children, workers and families had to seek off-site care and pay out of pocket. Informed choice of providers was uncommon, and many participants reported going to informal practitioners of herbal and other alternative medicine as well as unlicensed providers without any medical background in the nearby market. One female worker (age 25) lamented, “ Here there are doctors, some are good and some are bad … there is no fixed doctor, so what do we do? [When we’re] in trouble, we have to go back to our village ”. Primary care services, such as adult health screening, mental health services, and chronic disease management, did not appear readily available.

The costs of paying for healthcare, medications, and other associated expenses (e.g. transportation) were a resounding concern among workers. As one woman (age 35) explained, “ If [the doctor] gives us two injections, it costs us Rs.200 [$4.45 USD]. We are already in so much debt, and if we are not well, how would we go to work? ” Missed work meant lost wages for ill workers, posing additional risk to their families. To save time, many visited private hospitals rather than seek the largely free services at a government hospital, which was reportedly farther away. By law, the contractors are responsible for covering costs of work-related injuries; however, as a manager with the development company admitted, “…not everyone gets to take advantage of the contractor all risk policy because migrants are … a floating population and are not necessarily recognized by the contractor ”. Similarly, due to barriers to registering as local labor welfare board beneficiaries or obtaining documentation of Below Poverty Line (BPL) status, very few workers had access to locally-implemented health insurance schemes intended to provide financial assistance for hospitalizations and chronic care. Thus, in the face of high healthcare costs, workers often turned to their jamadars or thekadars for loans and accompaniment to medical care, adding potentially substantial debt which could force them to extend their work or contract periods.

Family and connection to others: limited monitoring and constant pressure

Construction work meant that many parents were spending long hours without direct capacity to monitor their young children at the site, which became additionally challenging without the presence of extended family. The existence of a functioning crèche at the site greatly mitigated some of the risks due to parental inability to monitor their children. According to both male and female laborers, sexual violence was of diminishing concern. This may be linked to a trend towards leaving school age girls with extended family in the village. One crèche staff member reflected on this survival strategy: “ I saw that earlier young girls [migrated] with their parents, but many crimes occurred like assault … When they went back to their village, they talked about these problems, and awareness increased. Now they leave their young girls at their home” . Issues of family conflict arose infrequently in focus groups and interviews. However, the use of alcohol, and cramped living spaces, were both mentioned as linked to domestic and intimate partner violence. A local teacher, who noted that children were at times reluctant to go home due to violence, reflected on these factors: “ Society demands certain things from kids, and parents have zero economic power. Sometimes they beat kids and women when children ask for their needs to be met”. Child labor was also a seldom-raised topic, but in addition to the adolescent Malda workers and a few teenage children working on the site with their parents, a number of children worked at the worksite canteen, businesses in the nearby market, and in rag-picking in exchange for food and shelter. These children were some of the most vulnerable in this site. We were unable to interview these children and adolescents without being observed by their supervisors and were unable to obtain parental consent given limited information about their family members.

Education and economic security: looking to the future

Children at the site faced numerous barriers to education and learning due to issues of distance, expense, lack of documentation, and frequent movement. A few older boys and one girl were able to attend a nearby private school due to reduced-payment options that were offered for children of migrant workers. However, the nearest government school was far away and across a busy highway. While a few children did attend, responses suggested it was too dangerous to access for many children at this site, thus impeding their right to universal primary education [ 68 ]. Speaking to the de facto discrimination faced by migrant children without residency documentation, the manager of a development company explained, “Although the schools don’t have official rules against [migrant] children, they are not willing to admit children who do not have some degree of permanency”. Even when a child was able to enroll in school, a wide range of obstacles hindered learning, including: the lack of electricity and thus lighting in the jhuggis, a generally poor study environment at home, inability to afford or access tutors, as well as domestic responsibilities that led to school absenteeism. As a local teacher at a private school observed, “ Our kids who are migrants, they really struggle. They have a really difficult time because they compare themselves to [non-migrant] kids ”. These prevailing concerns around education were tied to most parents’ decision to leave their school-aged children (particularly girls) with extended family in the village, allowing uninterrupted schooling. As one man (age 35) asserted, “ We cannot keep our children here; otherwise their education will spoil ”. Not surprisingly, most school-age children on the site were not in school. Apparently having no other safe place to go, many spent their days in the crèche.

Work & wages

Financial concerns were at the forefront of discussion for adult migrant workers. Despite the site manager’s assurance that workers “ do not express concern over wages ”, construction workers told a story of working extended hours for low, piecemeal wages and having only every other Sunday off. Malda workers instead received payment in advance of their 50-day contract period and had no days off. Many workers claimed that payments for piecemeal work and other wages could be delayed, even for months, although not universally reported. However, workers did commonly describe an improvement in wages and financial circumstances relative to opportunities in the village. Nonetheless, many workers, particularly unskilled laborers, were still struggling to provide for their families, much less to save earnings. As one mother (age 35) explained, “ We have to take care of the whole family; we came here to save money. If he would increase the rate, we would save a little. The amount we earn goes to eating ”. In response to these difficulties, delayed payments, and other unexpected costs, respondents reported borrowing money from family, friends, coworkers, or their jamadars or thekadars . Parents also worked overtime to provide for and meet the basic needs of their families. In contrast to other sites, where participants described that women are generally subject to reprimands and deductions in wages for breastfeeding, this site was notably sensitive to the needs of breastfeeding mothers, and women did not report difficulty feeding their infants. Yet, given that the law allows only two nursing breaks per day The Maternity Benefits Act, [ 69 ], section 11, crèche employees needed to provide supplemental formula feeding. Meanwhile, a number of children in the crèche were being monitored for mild and moderate malnutrition and were provided with nutritional supplements.

Protective processes

A sense of community solidarity, social support, and the presence of the crèche were all important sources of risk mitigation and protection at the site. Despite difficulties with wages, living conditions, health care, and access to other services, conflicts among workers did not appear to be common or significant. A crèche employee observed that workers “… become friends and … live like brothers and sisters ”. With many workers living together in “lanes” based on their language and region of origin, communal living also appeared to transcend some of the tension that could otherwise arise from differences in origin, caste, and religion. As one female worker (age 33) explained, “ We are all laborers and live together with each other happily. Every one helps each other ”. Although relationships among migrants were often brief, workers were able to rely upon their community support by turning to one another in times of need. A few respondents suggested their personal sense of faith by invoking God’s role in protecting their children or allowing their family’s success, representing an emergent and preliminary theme.

The crèche also served a protective role that had broader implications for families. One of its primary functions was to provide a safe and caring environment for children during the day, allowing both mothers and fathers to work. As one mother (age 22) noted, “ [Without] such a service or facility, where would we have left our children? Children would come after us to the site … How would we earn our livelihood then? ” The crèche provided basic health care services and regular doctor visits (including growth-monitoring, immunizations, and de-worming), meals to children during the day, and informational sessions for parents on issues like school enrollment. Although not designed to replace school, it also provided younger children an opportunity to develop cognitive, motor, and language skills as well as classroom discipline important for school readiness. The crèche also served to free older siblings from the task of childrearing. The crèche was a safe, child-friendly haven in an otherwise harsh physical environment, in utter contrast to most construction sites, where, as one key informant described, “ the young child is invariably either left alone, unattended, or in the care of siblings … [and] the implications for a child’s development can easily be gauged” . The NGO also worked to mainstream older children into local schools and to encourage provision of basic amenities at this site.

Invisible children, invisible families: the key informant perspective

Our key informants from government agencies and non-governmental organizations reflected upon a scenario in which vulnerable and hyper-mobile migrant families are surrounded by the complex layers of accountability of a rapidly expanding Indian economy. Grappling with the confluence of challenges facing migrant workers and their children, our respondents emphasized the obligations of local and national governments as well as corporations towards the fulfillment of the rights of this marginalized and often “invisible” population.

As described in the Indian labor migration literature, our key informants discussed the overlapping factors that both drive already vulnerable families towards migrant labor and make them more vulnerable in the process. One labor expert highlighted the role of discrimination and lack of economic opportunity: “ I would describe this as compounding vulnerabilities … Indeed, the caste system is there; there are other minority groups that are discriminated against too. For example, some Muslim communities – many of them are what we call “backwards” [per the “Other Backward Classes” classification]. There are absolutely no opportunities for these people; they have no hope for the future and are therefore quite vulnerable”. Another respondent from a child protection NGO saw migration as leveling the playing field of vulnerability across castes: “ Once they come here, the vulnerabilities are quite the same for them as migrants … Except that of economic status – may be able to afford services … Looking at similar economic standard with people migrating, the vulnerabilities are very similar ”.

Hypermobility poses particular challenges to migrant children’s education. As local NGO stakeholder explained: “ We have very bright children who study in the village but who have migrated or have shifted schools four or five times a year, and they are in an inappropriate class because they have missed so much. And there is no scope for them to ever get on with the education and ever do anything but manual work in the future ”. Furthermore, though Indian policy prohibits requiring children to present birth or transfer certificates in order to access a new school Right of Children to Free and Compulsory Education Act, [ 68 ], lack of awareness and compliance poses an illegal barrier to migrant children’s right to education. A child protection expert explained: “ A school teacher unaware that this is a law, would continue to insist on these certificates. So that would be the work of a civil society in informing the school teacher that you can now not stop a child on any excuse”. Amidst so many obstacles, according to our respondents, migrant families further face corporations and governments unwilling to take accountability for fulfilling their rights. One construction site general manager discussed the lack of incentive in this area: “There is competition between different contractors for jobs; the bidder with the lowest price generally wins the contract. As companies reduce their budgetary requirements to stay competitive, one of the first things to go is often the amenities provided for children and workers ”. One key informant explained that destination states often see migrants as a drain on local resources and thus hesitate to take responsibility for them. As a development expert elucidated, “ It’s possible that within the next two or three years, the government may think seriously about working on some strategies to reach them. But as of now they are invisible. They are neither in the rural planning, neither in the urban planning—nobody talks about them. They are in a limbo” . Such planning is further complicated by the difficulty of precisely capturing complex and varied migration patterns in the census.

In order to improve accountability and uphold existing policy, local experts offered various suggestions, including: maximizing interstate coordination; developing memoranda of understanding among development stakeholders with a monitoring agency; granting corporate and government contracts to builders only upon provision of required services (e.g. crèche); and empowering and educating workers and children to advocate for their rights. As one key informant advised, “ If migration must happen … then we must take steps to make it safer. There should be outreach to communities of origin [and] dialog and information-sharing with subcontractors, with children and families, about their legal right for safety and fair treatment ”. Another respondent argued against use of the term “corporate social responsibility”, remarking, “ If they would just follow the law, that would be fine ”.

Migrant work is a survival strategy that poses many threats to healthy childrearing. Utilizing the SAFE model as a lens towards child protection, this study yielded in-depth insight into the complex dynamics affecting the security and well-being of migrant children and families at a construction site near Delhi. Families encountered ongoing economic insecurity and a host of other risks for child protection, including: children living and playing in unsafe areas and potentially facing violence at home ( S afety); limited access to appropriate medical care as well as risks of malnutrition ( A ccess to basic physiological needs); reduced parental monitoring, family separation, and trade-offs between time with children and the need to work ( F amily connection); and limited school access for school-age children as well as a tenuous economic state ( E ducation/Economic Security). These basic security domains were also interrelated and interdependent. In general, as explained by Orellana and colleagues, migrating “families who are pressed for household survival do not have the luxury to foreground children’s ‘developmental needs’” [ 28 ], p. 587. For instance, the family’s decision to migrate to secure their economic situation often had consequences for their children’s access to school, which increased an intergenerational cycle of “distress migration”. Similarly, a mother’s need to work and the limited options for exclusive breastfeeding likely heightened children’s risk of diarrheal illness and respiratory infections [ 70 – 72 ] as well as risk of malnutrition [ 73 ]. Furthermore, vulnerable families migrating to “earn and eat” and meet their basic needs, encountered an unforgiving urban landscape that posed new and unique risks to children’s security and affronts to their basic rights. As Rogaly and Rafique have described in the context of seasonal migration in West Bengal, many of the families in our study had no hope to save or pay off debt and were simply in “a struggle to stand still” [ 52 ].

This case study has exemplified a clear need to work expediently towards the realization of the rights of this hyper-mobile, invisible population. To this end, it is necessary to both fill gaps in Indian legislation and to improve the implementation and enforcement of existing laws. A recent report by the National Commission for Enterprises in the Unorganized Sector, noted that the vulnerability of migrant workers and their children stems largely from “the lack of or ineffective implementation of … [as well as] … lack of awareness among the workers regarding existence of the laws” meant to ensure their entitlements and protect their well-being [ 56 ], p. 165. Mechanisms for ensuring accountability and implementation are not apparent in the law governing corporate responsibility in India, especially in the unorganized sector.

One crucial gap in government planning and implementation relates to migrant rights to identity and documentation. For migrant workers in the unorganized sector, these rights have particular salience to the ability to access legal entitlements. In Indian policy, this is delineated as contractors’ responsibility to issue passbooks to migrant workers in the Inter-state Migrant Workmen Act [IMWA, 43, article 12] as well as the directive of state labor welfare boards to maintain registrations and provide identity cards for workers (who have worked 90 days) in the Building and Other Construction Workers Act [BOCWA, 60, articles 12–13]. Despite these laws and efforts like India’s Unique Identification Card pilot project, obtaining such documentation is often a challenge due to migrants’ transitory status and short-term residency. This lack of documentation impedes access to various basic services at migrants’ destination, including food rations and children’s education. While India’s Right of Children to Free and Compulsory Education Act [ 68 ] dictates that children should at no time be turned away for lack of documents, study findings suggest the clause lags in implementation. Disruptions to children's educational experience may have implications for their lives and future livelihoods.

While responsibility for providing services and protections is delineated in law and policy, lack of enforcement leaves many corporations shirking responsibility for providing for their workers and their families. For example, the BOCWA describes responsibilities for construction project employers (e.g. government-owned entities, private developers and sub-contractors), to provide drinking water, latrines and urinals, accommodations, first aid, canteens, and other services to mothers and their families. With accountability diffused so broadly across different stakeholders at the study construction site, viewpoints expressed across various layers of management were at best disconnected from and at worst disingenuously ignorant of the daily realities of migrant workers and their families. However, while there is also the requirement for provision of childcare for children under six at sites with more than 50 women, this task is not explicitly assigned to the employer nor is it enforced. In the site where the present case study was situated, the crèche played a fundamental role in nurturing child development and monitoring child safety and nutrition. Sector-wide provision of such services, implemented by corporate actors in partnership with local governments, would fill a critical void in the rights of migrant children, with long-term benefits to their health and capability [ 74 – 78 ].

Clearly, the government plays a crucial role in delineating the obligations of corporations, ensuring these obligations are met, and shaping policy that affects migrant families. Using the IMWA and BOCWA as well as myriad other broader labor policies as guidelines, each state’s labor welfare board has flexibility to implement their own rules and local schemes. For instance, the local labor welfare board near our case study site recently announced, though has yet to implement, a school transportation scheme for children of construction workers. Similarly, large sums of funds collected from corporations according to the Building and Other Construction Workers’ Welfare Cess Act [ 79 ] have yet to be used for worker welfare schemes.

Moreover, the Government of India has developed cross-sectoral efforts and government-civil society partnerships to protect children from maltreatment and exploitation, such as the newly implemented Integrated Child Protection Scheme (ICPS). With explicit mention of children of migrant families, this policy aims to “create a protective environment by improving regulatory frameworks, strengthening structures and professional capacities at national, state, and district levels so as to cover all child protection issues and provide child friendly services at all levels” [ 80 ]. The ICPS includes provisions to counter some of the barriers to protecting marginalized or vulnerable children and should include those living and even working on construction sites. In the years ahead, implementation of the ICPS in India has the potential to reduce risks to child health and development by addressing vulnerabilities across the SAFE domains examined here.

Limitations

This study intended to capture an in-depth understanding of the complex dynamics facing migrant families in one construction site in India. While the analysis was successful in this regard, several limitations should be acknowledged. First, the use of a case study methodology limits our ability to generalize to other construction sites locally or nationally in India. While the external validity of the study is limited in this manner, the internal validity of our qualitative approach was bolstered by the inclusion of a range of stakeholders as well as the triangulation of key informant interviews, focus groups, observations, and document review. Along this same theme, our study focused on the status of children and families living and working on the construction site with minimal probing regarding the children left at home in the village. These children may face yet uncovered and significant health and protection risks; more research focused on these populations is required. Second, the existence of a crèche at the site studied allowed us to gain access to the site and our participants, but may also have successfully mitigated the intensity of some of the child protection threats that might be present in sites without a crèche. We would hypothesize that a site managed by a developer receptive to providing a crèche, such as the one used in this study, might generally be more child-, family-, and worker-friendly than those sites that do not have a crèche. However, despite an estimated 40 million migrant laborers in India’s construction industry alone, the law requiring crèches at construction sites is rarely implemented, and most sites would likely paint a much worse picture. Finally, though various techniques in data collection and analysis were utilized to minimize biased responses (such as monitoring dominant respondents, assuring confidentiality, triangulating with on-site observations, and conducting member checks), the sensitive nature of focus group discussions and the relative powerlessness of migrant workers may have limited the sensitivity for uncovering the full depth of adversity faced by families on the site. Nonetheless, our discussions with workers and their children yielded a substantial variety of child protection issues and related coping mechanisms, which did not vary significantly by respondent.

As the Indian economy continues to expand and urbanize, labor migration will undoubtedly continue as a mode of subsistence or survival among rural families. Through analyses using the SAFE model of children's security, this study provides a lens for viewing the constraints faced by migrant children and families who undertake a broader array of survival strategies to cope with their circumstances. It demonstrates the feasibility and utility of taking this holistic and human rights-based approach to child protection analyses. In light of the complex conditions facing this hyper-mobile population, findings suggest policymakers, corporations, and civil society must work to develop initiatives to implement and enforce the rights of migrant workers and their children to identity, family, health, safety, development, education and economic security. The Government of India is certainly legally bound by the Convention on the Rights of the Child to protect these rights for all children, without discrimination based on gender, caste, or other status [ 59 ]. Corporations must similarly be compelled to ensure the well-being of India’s future human capital by promoting child-friendly development.

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Acknowledgements

This research was made possible by the Oak Foundation, the Francois-Xavier Bagnoud Center for Health and Human Rights, Mobile Crèches (Delhi), and the Harvard School of Public Health. We are also endlessly grateful to Katrina Hann, our wonderful Indian research staff, and the children and families who contributed to this study. This work was funded by the Oak Foundation.

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Theresa S Betancourt

Research Program on Children and Global Adversity, François-Xavier Bagnoud Center for Health and Human Rights, Harvard University, 651 Huntington Avenue, Boston, MA, 02115, USA

Theresa S Betancourt, Ashkon Shaahinfar, Sarah E Kellner, Nayana Dhavan & Timothy P Williams

Department of Social and Policy Sciences, University of Bath, Bath, UK

Timothy P Williams

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The authors declare that they have no competing interests.

Authors’ contributions

TSB conceived of the study and participated in its design and coordination along with TW and AS. TW and AS conducted the primary qualitative fieldwork. TSB, ND, and AS conducted the validity-enhancing member checks. All authors, including SK, contributed to the qualitative data analysis and helped draft and finalize the manuscript. All authors read and approved the final manuscript.

Ashkon Shaahinfar, Nayana Dhavan contributed equally to this work.

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Betancourt, T.S., Shaahinfar, A., Kellner, S.E. et al. A qualitative case study of child protection issues in the Indian construction industry: investigating the security, health, and interrelated rights of migrant families. BMC Public Health 13 , 858 (2013). https://doi.org/10.1186/1471-2458-13-858

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Received : 07 August 2012

Accepted : 04 September 2013

Published : 17 September 2013

DOI : https://doi.org/10.1186/1471-2458-13-858

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Online harm and abuse: learning from case reviews

Summary of key issues and learning for improved practice around online harm and abuse.

Published case reviews highlight that the online world presents a growing number of challenges for those working to protect children and young people from harm and abuse. For example, children may be exposed to harmful content online, or be subjected to online grooming, sexual abuse and exploitation.

This briefing looks at case reviews published between 2015 and 2022, where online harm or abuse was a key factor.

It summarises:

• key issues around online harm and abuse highlighted in the case reviews
• reasons why some children and young people are particularly vulnerable to online harm and abuse
• learning to help professionals prevent and respond to incidences of online harm and abuse.

Please cite as: NSPCC (2022) Online harm and abuse: learning from case reviews. London: NSPCC.

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Failures in child protection: a case study, additional details, no download available, availability, related topics.

Case study: what the Philippines is doing to end online child abuse

Juvy Mae T. Navarro Social Welfare Officer, the Philippines Department of Social Welfare and Development

This article is written by Juvy Mae T. Navarro, social welfare officer at the Department of Social Welfare and Development in the Philippines. Navarro is also a 2020 WePROTECT Global Alliance Fellow, a global programme to end exploitation of children, hosted in partnership with Apolitical. 

This article was originally published on Apolitical .

Patricia (not her real name) is an 11-year old child who is currently in the protective custody of the Philippine Government after she was rescued in May 2020 from online sexual exploitation. Her alleged trafficker is her mother, while the whereabouts of her father are unknown since they have been separated since Patricia was three years old.

She is an only child and her family are rural migrants. Her mother was laid off from work when the  Covid-19  pandemic outbreak stymied demand from the factory she was working in. A man she met on social media offered her money in exchange for photos of Patricia, and that was how the exploitation of her child started. The rescue happened during the enforced community quarantine that had been in place due to the pandemic, and there was no way to return her immediately to her relatives. Therefore, the rescuing social workers decided to refer her to a residential care facility for protective custody.

A crisis of poverty and perception

In a recent study conducted by the faith-based anti-human trafficking organisation,  International Justice Mission  (IJM), key findings show that online sexual exploitation of children (OSEC) in the Philippines is usually a family-based crime. Traffickers tend to be young Filipina women who are related to the child and financial gain is a common motivation for traffickers to commit OSEC.

This is not surprising in a country where 16.7% of the population —  17.7 million Filipinos — lived in poverty in 2018 . By engaging in OSEC, family members and relatives can get access to easy money. At the same time, even the least lucrative forms of OSEC, such as sending photos, is equivalent to more than a few days of minimum wage pay.

Patricia’s mother does not believe that she is exploiting her child because she was only sending photos of the child to the customers, and the payment she received from them is what sustains them

Aside from poverty, another important aspect is the availability of employment opportunities. In 2020,  the unemployment rate  reached 10%, and 4.6 million Filipinos above the age of 15 found themselves unemployed. Given this grim economic environment, some Filipinos resort to the easy way of obtaining financial gains through committing OSEC.

Morally speaking, some traffickers do not see OSEC as a crime even if they receive payments for it, since their children are not touched and physically violated by their customers, who can only see their children’s bodies online. This was the case with Patricia’s mother. She does not believe that she is exploiting her child because she was only sending photos of the child to the customers, and the payment she received from them is what sustains them. She is also not convinced that the experience will have a lasting impact on Patricia as she was not physically touched or harmed by the customers.

A commitment to end child abuse

To coordinate the interventions of all stakeholders in addressing all forms of abuse, neglect and exploitation of children, the Philippine Government formed the Committee for the Special Protection of Children (CSPC).

A significant accomplishment of the CSPC is its  Case Management Protocol . It highlights the roles and responsibilities of the different government agencies based on the  principal and comprehensive law for the protection of children against abuse and exploitation . It also serves as a guide of all concerned government agencies,  non-government organisations  and stakeholders, instituting a set of standards that will ensure the protection of rights of child survivors of abuse, neglect and exploitation throughout the case management process.

A significant part of the Case Management Protocol is the mandate that social workers from the Department of Social Welfare and Development (DSWD) have to assign children to protective custody. Protective custody shall be implemented if the investigation discloses sexual abuse, serious physical injury or life-threatening neglect to ensure the child’s safety. The child shall be immediately removed from the home or establishment where the child was found and must be placed under the protective custody of DSWD.

When non-offending relatives are not qualified and no concerned citizen is available to provide protective custody to the adolescent survivors of abuse, the government steps in and makes them wards of the State by placing them in its residential care facilities.

Because Patricia’s mother couldn’t see the harm she had caused, the rescuing social workers decided to put her under protective custody in a government RCF. There was no way for them to escort the child to her relatives in the province because of Covid-related travel restrictions

The residential care facility  (RCF) is a 24-hour group care that provides alternative family  care  arrangements to poor, vulnerable and disadvantaged individuals or families in crisis whose needs cannot be adequately met by their families and relatives or by any other forms of alternative family care arrangements over a period of time.

It provides the following  services  to children survivors of abuse, neglect and exploitation: social services, homelife services, educational services, vocational and skills training program, health/ medical services, dietetic services, psychological services, socio-cultural recreation, spiritual enhancement, legal/ paralegal assistance and progressive integration with family and community.

When a child survivor of OSEC is admitted in a residential care facility, the other aspects of the case management process are still fulfilled by the appropriate government agencies. Law enforcement relative to the OSEC case are still managed by the National Bureau of Investigation or Philippine National Police. The Philippine Department of Justice on the other hand manages the prosecution of the case. These interventions are done in coordination with the OSEC survivor’s social worker in the RCF.

Managing mandates

In Patricia’s case, and in other cases of children who have been rescued from abusive and exploitative situations, a clear definition of the roles and responsibilities of all stakeholders involved is very important in effecting a well-coordinated implementation of child protection policies.

Because Patricia’s mother couldn’t see the harm she had caused, the rescuing social workers decided to put her under protective custody in a government RCF. There was no way for them to escort the child to her relatives in the province because of Covid-related travel restrictions.

There was also no trusted person of the child in the community who can take her in for protective custody since their neighbours are afraid of meddling with their family’s affair and of contracting the disease. As a last resort and for the best interest of Patricia, she was referred to a residential care facility, knowing that the child will be provided with the necessary interventions needed for her healing and recovery from her abusive experience.

It is a given that the various government agencies involved in preventing OSEC and other form of child abuse have different mandates and roles; however, they should find a common ground where they can collaboratively work with each other for the sole purpose of protecting the rights of the children they serve. In the Philippines, the CSPC Case Management Protocol became the venue for the different government agencies to coordinate their interventions for child protection, including OSEC cases. Through the coordinated efforts of all stakeholders involved, the provision of necessary services and interventions for the children survivors of abuse is guaranteed while their rights are upheld and protected. —  Juvy Mae T. Navarro

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of WeProtect Global Alliance or any of its members.

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Child Protection at the IRC

Child Protection Case Management

What is case management  .

CASE MANAGEMENT is a way of organizing and carrying out work to address an individual child’s (and their family’s) needs in an appropriate, systematic and timely manner, through direct support and/or referrals, and in accordance with a project or program’s objectives 1 .

Child Protection case management can be provided in emergency and development settings using social work approach to address a range of child protection concerns. Case management services can be provided as part of a strategy to reduce inter-connected risks and vulnerabilities that cause protection violation or as a response to violations that children have experienced. Having case management procedures in place ensures quality, consistency, and coordination of services.

Key Points about Case Management  

• Should focus on the needs of an  individual child and their family, ensuring that concerns are addressed systematically in consideration of the  best interests of the child and building upon the child and family’s resilience.
• Should be provided in accordance with the established case management process, ensuring each case follows a series of steps (as shown below) involving  children’s meaningful participation and family empowerment throughout.
• Involve the  coordination  of services and supports within an interlinked or referral system
• Require systems for ensuring the  accountability of case management agencies (within a formal or statutory system where this exists).
• Are provided by one key worker (referred to as a  caseworker or case manager) who is responsible for ensuring that decisions are taken in the best interests of the child, the case is managed in accordance with the established process, and who takes responsibility for coordinating the actions of all actors.

At the IRC, we use a case management approach to a various set of humanitarian issues

Core Steps of Case Management

Guiding Principles for Case Management 

• Prioritise the best interests of the child
• Non-discrimination
• Adhere to ethical standards
• Seek informed consent and/or informed assent
• Respect confidentiality
• Ensure Accountability

Specific Resources

The current Case management training package is the result of two years of work led by the International Rescue Committee on behalf of the Global Case Management Task Force. The project was funded by USAID/BHA.  After a wide desk review, consultations with CMTF members and surveys with case management staff from 41 countries, Child Protection Case Management Training materials were updated and new content has been added. The training materials were developed through a lengthy and iterative process with feedback provided by members of the CMTF as well as pilots in Iraq, South-Sudan and Kenya.

This updated Child Protection Case Management training package includes a series of trainings to further strengthen the capacity of child protection caseworkers. Child Protection Case Management competencies are developed gradually, as well as through experience and with the support of a supervisor. To promote gradual learning and integrate supervision and coaching opportunities, these trainings are structured in three different levels:

• Level 1 Foundational training
• Level 2 Competency-based training
• Level 3 Advanced training.

It is recommended that child protection caseworkers, supervisors, and managers in humanitarian settings complete the different levels of training. The main target audience remains child protection caseworkers.

The Inter-Agency Case Management Supervision and Coaching Training package (2018) forms a complementary training within this learning and development strategy.

The Facilitator’s Guide, Level 1, Level 2 and Level 3 Child Protection Case Management training materials are available in English, French, Spanish and Arabic.

Have a look at the different resources here