Improving paediatric care in the community.

The Lancet Series on violence against women and girls, while providing a global perspective on the subject and exploring possible preventive measures, fails to place enough emphasis on the extent to which violence affects the children of these women. According to our experience, many women admit that they have been victims of intimate partner violence only when it has been established that their children have been abused. When a mother is a victim of intimate partner violence her children are at a great risk of both physical and psychological abuse. In the Netherlands being a witness of intimate violence has recently been classifi ed as a form of child abuse. Women who are victims of intimate partner violence regularly attend hospital Emergency Depart ments but often do not reveal the cause of their injuries. However, experienced staff should be able to explore this issue in a sensitive, safe manner. In 2008, we introduced a programme (Hague Protocol) aimed at patients attending the Emergency Departments for injuries suspected to result from intimate partner violence. They are asked whether they are responsible for the care of children. If this is the case, a voluntary community child welfare agency subsequently contacts the family within 2 weeks to discuss the problem and organise the necessary support. This programme has been rolled out over the whole of the Netherlands. Worries that this might lead to avoidance of the Emergency Departments were proved to be unfounded. Health systems can help women and children who are victims of violence.