Windhoek – “The injury pattern did not match the father's account, so I involved a social worker,” recounts Julia Kaiyamo, a doctor at Katutura Health Centre in Windhoek, Namibia, of a recent case she treated. Kaiyamo’s assessment was informed by training she received on addressing child maltreatment.

Almost 40% of Namibian girls and 45% of boys experienced physical, sexual or emotional violence during childhood, according to the 2019 Violence Against Children and Youth Survey, the latest available data. Many survivors do not receive care services, with only half reporting physical violence and just 15% receiving support. In 2019 and 2020, Namibian police recorded 5427 gender-based violence related cases, though more recent and comprehensive data on violence against children are limited.

Children account for 10% of reported murder cases and 32% of reported rape and attempted rape cases annually. Around 80 children are removed from their homes each year due to abuse or neglect, with many more cases going unreported, according to police data. Critical gaps remain, however, including lack of comprehensive training for professionals handling these sensitive cases.

For Dr Kaiyamo, it was thanks to the training, delivered with support from World Health Organization (WHO), that she was able to determine the cause of the three-year-old’s injuries, which had been misrepresented by her father, she says.

To address the problem, the Ministry of Gender, Poverty Eradication and Social Welfare, in collaboration with the Ministry of Health and Social Services, as well as WHO, trained 37 health workers and police officers on the WHO clinical handbook for on child maltreatment. The handbook is a practical guide, equipping health workers with the skills to support children in care settings including health facilities and gender-based violence victim protection units. The Ministry of Gender, Poverty Eradication and Social Welfare established child protection forums at multiple administrative levels in Namibia to foster multisectoral coordination. The constituency, the smallest political and geographical unit in Namibia’s administrative system, serves as the local foundation for implementing these coordination structures, working directly within towns or villages.

In an effort to strengthen the training of health care providers on the protection of children against violence, abuse and exploitation, Namibia, with support from the Government of Japan, became the second country globally and the first in Africa to adopt the clinical handbook on child maltreatment.    The  trainings will equip frontline health workers, social workers and police officers with evidence-based strategies to implement WHO guidelines and effectively identify and respond to all forms of violence against children.

“The training added significant value to my role, especially through the Listen, Inquire, Validate, Enhance Safety, Support Child and adolescent-friendly caregiver support approach,” says Dr Kaiyamo.

This first-line response approach ensures that health workers provide compassionate, safe and effective care for young victims of violence, notes Dr Kaiyamo, pointing out that her colleagues were initially hesitant to document abuse cases in health cards due to fear of being called as witnesses in court. However, after gaining a deeper understanding of WHO’s clinical handbook on child maltreatment, they now conduct thorough examinations and refer victims to the gender-based violence victim protection unit, which also handles cases involving violence against children.

Social workers, who are often on the frontline responding to violence against children, get referrals from police, teachers, hospitals or directly by survivors themselves.

“The workshop allowed me to reflect on the impact of violence on victims and refreshed our approach to handling cases,” says Cherrie Philemon, a senior social worker at the Ministry of Gender, Poverty Eradication and Social Welfare.

“Namibia's leadership as one of the pathfinding countries committed to ending violence against children is commendable. The adaptation of the clinical handbook will further support the implementation of the National Agenda for Children and strengthen the capacity of the health workforce to provide quality care for children at risk of maltreatment,” says Dr Richard Banda, WHO Representative in Namibia.