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Evaluation report

2008 Jamaica: Assessment of the Child Abuse Mitigation Project at the Bustamante Hospital for Children (C.A.M.P. Bustamante)



Author: Jennifer Jones and Audrey Brown

Executive summary

Background:
CAMP Bustamante originally emerged from the Inter-Sectoral Working Group on Children and Violence and was developed by a multi-agency technical working group. For the first six months the project was funded by UNICEF and for the remainder of the period by the National Health Fund, with specific inputs such as the cost of establishing a database, from UNICEF. The aim of CAMP Bustamante was to develop a rapid hospital based response to suspected child abuse, by identifying and treating children between 0-12 years of age who attended the Bustamante Hospital for Children for injuries sustained as a consequence of violence. CAMP Bustamante was designed utilizing an ecological approach that addressed the needs of the family, the school and the community through the establishment of a multi-agency response that drew on the support and expertise of child protective services and community and non-governmental agencies in an effort to mitigate violence related injuries in children.

Purpose/Objective:
Three project objectives were set for CAMP Bustamante (12 January 2004 - 30 September 2008)
1. To develop and implement a hospital-based model to identify and refer victims of violence
2. To improve parenting skills and conflict resolution
3. To develop and implement an intervention model within the child’s environment (home, school, church) through interaction with existing community-based programmes

Methodology:
1. Literature Review of national and international research on the effects of violence on children’s development, including reviewing best practice models and services similar to those offered by CAMP Bustamante in developing and developed countries.
2. Qualitative analysis from reports and database information as well as data collected in semi-structured interviews
3. Quantitative analysis of project in relation to client data and key project indicators, including stakeholder referrals and follow-up activities.
4. Risk analysis in relation to socio-economic/demographic factors, types of violence, instruments used (if data exists).
5. Cost effectiveness analysis.

Findings and Conclusions:
The weaknesses of CB were in the areas of:
• Rapid response – its own perhaps overambitious target of a 72 hour response was hardly ever achieved and only about a third of the cases were visited within two weeks;
• The recording of vital case information on the database which has a lot of missing data and lacks the capacity, as programmed, to capture critical indicators such as repeat injuries, no. of counseling sessions held, socio-economic information on housing and so on;
• Few useful links with community based organizations, critical for developing a community intervention model, and strong links with only three NGOs.
• Governance. The effectiveness of the project could have been strengthened by a stronger governance system to oversee management and monitor quality assurance, as well as by a stronger multi-agency, multi-disciplinary approach to case management.

Recommendations:
Six months bridging financing be immediately found to continue the project at Bustamante Children’s Hospital until final decisions are made.
The Child Abuse Mitigation Project be placed under the Office of the Children’s Registry and piloted for eighteen months at Bustamante Children’s Hospital and Cornwall Regional Hospital, working in collaboration with the primary health care clinics. Ultimately all hospitals with a CAMP would be linked to a Type V Health Centre where screening for the risk of child abuse would be implemented.



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