A public health approach to preventing child abuse in low- and middle-income countries: a call for action.

Violence against children is prevalent across all countries and cultures, with the burden of child injury and violence heaviest in low- and middle-income (LAMI) settings. There are several types of program to prevent child abuse, with family-based approaches to prevention being the most comprehensively researched and successful interventions in high-income settings. In LAMI countries, however, there is very little research evidence for the prevention of child abuse. We conducted a systematic search of relevant databases for studies published between 1995 and 2011 and the search revealed only one relevant study. There is thus a need for research into child maltreatment prevention in LAMI settings, taking account of local resources and contexts. In the light of the lack of evidence, we focus on two case studies that document the use of home visiting by community health workers perinatally to improve maternal and child outcomes. We propose four areas for action moving forward, including increased investment in early intervention and prevention programs, development of a research agenda that prioritizes prevention research, integration of implementation research into efforts to scale up interventions, and improving systematically collected information on child maltreatment.