key: cord-1010014-gsqgsrho authors: Petrowski, Nicole; Cappa, Claudia; Pereira, Andrea; Mason, Helen; Daban, Rocio Aznar title: Violence against children during COVID-19 Assessing and understanding change in use of helplines date: 2020-09-25 journal: Child Abuse Negl DOI: 10.1016/j.chiabu.2020.104757 sha: 0ddde3d47469d9095a6142d03ff756c4f4b8a77b doc_id: 1010014 cord_uid: gsqgsrho BACKGROUND: Many of the measures taken by countries to contain the spread of COVID-19 have resulted in disruptions to child protection services. Despite this, many countries have worked to ensure that child helplines remain operational, making such mechanisms even more critical for reporting and referring cases of violence and for providing support to victims. OBJECTIVE: The purpose of this paper is to document what has occurred, and been reported, to child helplines during the COVID-19 pandemic. PARTICIPANTS AND SETTING: The study entailed primary data collection from child helplines and a search of media articles and news stories. METHODS: Child helplines submitted data on the contacts received during the first six months of 2020. Data on contacts related to violence were also available from 2019, and used as baseline. The media search used a combination of search terms to identify relevant articles and news stories published between March 1 st and June 17 th 2020. RESULTS: Overall, the number of contacts to helplines seems to have drastically increased since the beginning of the pandemic. However, the number of contacts related to violence has increased in some countries, while it decreased in others. CONCLUSIONS: While a mixed picture emerges with respect to violence, the increase in overall contacts made to helplines provides evidence that such services are a critical lifeline for many children and women during times of crisis. Child helplines should be strengthened, and child protection services should be designated as essential during emergencies to ensure children receive the support they need. While research on the impact of COVID-19 on violence against children is only at the early stages, evidence has begun to emerge. In an online survey of 288 parents of at least one child age 12 or younger in the United States, 1 in 5 respondents said they had used physical punishmentdefined as spanking, hitting or slappingwith their children in the previous two weeks which included a period of time during which social distancing guidelines had been issued by the government (Lee & Ward, 2020) . In the same survey, parents also reported an increase in conflicts with their children and an increase in yelling or screaming, using harsh words, and spanking or hitting their children more often since the start of the pandemic. When it comes to the relationship between COVID-19 and intimate partner violence, which can harm children who witness this in the home, a recent review of papers found mixed results. Among the 10 studies identified (out of a total 12) that included some specific measure(s) of domestic violence, three reported an increase in the indicators measured, one reported a decrease, three reported no change and three had mixed findings (Peterman, O'Donnell, & Palermo, 2020) . The majority of these papers utilized data coming from police or crime report records in high-income countries. Two of the papers were from other settings: Dhaka, Bangladesh (which analysed qualitative data from in-depth interviews) and Mexico City (which utilized call center data). Changes in availability of, and access to, violence-related services during COVID-19 have also been documented. As result of the current pandemic, many of the prevention and containment measures taken by countries to control the spread of the disease, including the establishment of national lockdowns, curfews and other actions have resulted in disruptions to child protection services by either forcing suspensions altogether or requiring significant adjustments to the way services are delivered to children and families. Disruptions have affected both core family and child welfare services such as child protection case management and other follow up specialized services for child victims of violence and abuse (UNICEF, 2020a) . A recent estimate from UNICEF indicates that 1.7 billion children live in countries where there has been a disruption of violence prevention and response services due to COVID-19 (UNICEF, 2020a) . Case management services and home visits for children and women at risk of abuse were among the most commonly disrupted services, with over 50 per cent of countries reporting suspensions or significant drops in these services. Data coming from service providers support the notion that suspension, or interruption, of child protective services as a result of COVID-19 restriction measures has inhibited child maltreatment reporting. For instance, the California Department of Social Services reported an 18 per cent drop in child maltreatment referrals (received by anyone) in March 2020 compared to a year ago (Amaro, 2020) and in the state of Georgia, the Division of Family and Children Services said that reports of suspected child abuse and neglect had declined by 50 per cent since the closure of schools on March 18 th (Prabhu, 2020) . The Texas Department of Family and Protective Services saw a 48 per cent drop in the number of child abuse reports received when comparing the first and last week of March 2020 (Streicher, 2020) . Similar declines in reporting to child protective services in the United States was also documented in media articles from Iowa, Kansas, Ohio, Maryland, Rhode Island, Virginia and Wisconsin and from some other countries such as Jamaica and New Zealand. County-level data from the Florida Child Abuse Hotline also indicate that the number of child maltreatment allegations made during the months of March and April 2020 when schools were closed were 27 per cent lower (the equivalent of 15,000 fewer cases) than would otherwise be expected for these two months (Baron, Goldstein, & Wallace, 2020) . The decline in allegations of child maltreatment observed in March and April 2020 closely resembles declines recorded at other times of the year when schools are typically closed, such as during winter holidays and the summer months of July and August (Baron, Goldstein, & Wallace, 2020) . During school closures and the suspension of many leisure/sports/recreational activities, children are simply no longer in contact, or are reaching out more confidentially or less regularly, with many of those who would typically notice and report signs of abuse. Indeed, a substantial body of evidence supports the notion that schools, at all times, play a major role in reporting cases of violence against children (Benson, Fitzpatrick, & Bondurant, 2020) . While COVID-19 containment measures have disrupted several referral and reporting mechanisms for victims of violence, the available evidence also suggests that child helplines are one of the least affected of the child protective services, with only around 10 per cent of countries reporting disruptions that were in most cases addressed by mitigation measures (UNICEF, 2020a). Helplines are typically telephone-based services (and often also text, online chat or email), which makes them operational even in situations where services based on physical interactions are restrained. J o u r n a l P r e -p r o o f Child helplines are relatively easy and cost-effective to establish. Unlike other formal child protection reporting mechanisms (through schools, police, child protection authorities or health care centres), child helplines offer a clear advantage as they provide a confidential channel for children to speak openly and receive advice without confronting the formalities of a child protection system. Child helplines also present the opportunity to capture cases of violence from particularly vulnerable populations of children who have very limited access, or are afraid to reach out to, formal reporting mechanisms. One key caveat is that access to child helplines is dependent on the availability of reliable as those provided by service providers, but a number of caveats need to be considered when assessing the usefulness of such data to understand incidence and patterns of violence in times of COVID-19. Data on children's experience of violence are gathered by authorities and service providers from diverse sectors such as police, prosecutors and courts, health, education, and social welfare. In countries with well-developed and functional administrative systems, such is often the case in upper middle-income and high-income countries, administrative data are a useful tool for generating insights into both the utilization and demand for services to prevent and respond to violence. Such data can also be used to explore patterns and trends in identification, reporting and response to violence over time, to assess and inform service capacity and resource allocation and estimate service costs. Child helplines are an example of one source of such data since they typically record and keep track of at least some basic information on each contact received. Administrative data are also commonly used to support referrals to the child protection authorities and the consequent case management and provision of the required specialized services (UNICEF, 2020b). While administrative data are critical for planning, budgeting and improving quality of service delivery, such data do not provide estimates of the number, proportion and characteristics of children who experience violence. For this, statistically representative surveys on actual experiences of violence are needed. Indeed, administrative data only reflect a small portion of the children who experience violence, since a large number of children never report their experience J o u r n a l P r e -p r o o f to official agencies and service providers. In many cases, only the most severe cases of violence against children are reported. Indeed, levels of disclosure, help-seeking behaviour and reporting by children who experience violence to professionals are very low. Based on data from 30 countries, only 1 per cent of adolescent girls who have experienced forced sex reached out for professional help (UNICEF, 2017) . A secondary analysis of nationally-representative Violence Against Children Surveys data in six countries concluded that the prevalence of help-seeking behaviours ranged from 23 per cent to 54 per cent for informal disclosure, from 16 per cent to 28 per cent for knowledge of where to seek formal help, from under 1 per cent to 25 per cent for formal disclosure or help-seeking, and was only between 1 per cent and 11 per cent for receipt of formal help (Pereira et al., 2020) . While primary reasons for not seeking help varied by country, the most common ones included self-blame, apathy and not needing or wanting services. Because many countries have worked to ensure that child helplines remain operational during the pandemic, helplines have become an even more critical mechanism for proving counselling and support to children, and for reporting and referring cases of violence, in times when schools and other channels have been disrupted. Data collected by these service providers can therefore provide important insights to better assess and understand how children are faring during times of crisis, and fill a void left when other reporting mechanisms, data sources and modes of data collection, such as other administrative records and surveys, have been suspended or postponed. The purpose of this paper is therefore to document what has occurred, and been reported, to child helplines during COVID-19. In addition, the paper discusses the implications of using such information to make inferences about the impact of the pandemic on violence against children. The first data source used in this paper was a survey of child helplines that was conducted with support from Child Helpline International (CHI). As of May 2020, CHI had over 168 member organizations (including both full and associate members) in 139 countries and territories around the world. All member organizations are helplines rather than hotlines. Full members are those that are fully operational while associate members are start-up child helplines or those that have been operating for less than one year. They estimate that over 20 million children and young people access child helplines within the network every year (Child Helpline International, 2015). The survey requested child helplines to report about contacts received both directly from children as well as from adults. This includes contacts received through any outlet (i.e., phone calls, Internet chats, emails, SMS messages etc.). The results presented in this paper are based only on 'counselling' contacts which are defined as those for which some form of support such as advice, guidance, or referrals were provided (i.e., it does not include contacts that were silent, missed, abusive and/or tests). Two rounds of surveys were conducted. During the first round, which took place between April and June 2020, Child Helpline International invited all their child helpline full members (n = 133) to submit data on the contacts received in the first quarter of 2020. Seventy-one child helplines from 63 countries submitted data, representing a 53 per cent response rate. The response rates namely the reasons or the topics why the child contacted the helpline. First, the child helplines were asked to report the total monthly numbers of contacts they received in January, February, and March 2019 (to serve as baseline) and 2020. For 2020, the child helplines were invited to report both the total number of contacts, and the number of contacts that were related to COVID-19. The definition of a 'COVID-19 related contact' were those that could be either directly or indirectly associated with COVID-19. For example, this could include a contact in which COVID-19 was directly mentioned. Focusing on these COVID-19 contacts, the survey then asked the child helplines to indicate the number of COVID-19 contacts received disaggregated per reasons of contact, organised according to CHI's 13 categories framework including violence (Child Helpline International, 2020). Twenty-six helplines provided data on violence-related calls. A second survey was launched in July which requested CHI members to report the total monthly numbers of contacts they received in the second quarter (April to June) of 2019 and 2020. As with the first survey, helplines were also requested to report on the number of contacts received specifically in relation to COVID-19 for the second quarter of 2020. Different from the first survey, this second round of data collection captured the number of contacts received (both for all reasons and for COVID-19) disaggregated by reason of contact. This change was introduced to address the fact that the classification of contacts as being related to COVID-19 could be prone to different interpretations by helpline staff. In addition, both the total number of contacts received as well as COVID-19 contacts further broken down within the categories of violence, mental health, family relationships and peer relationships were also sought. Forty-nine child helplines from 46 countries submitted data during the second wave (representing a 37 per cent response rate). These 46 countries are home to around 920 million children under age 18 years, representing J o u r n a l P r e -p r o o f roughly 39 per cent of the world's population of children. All of the 46 countries that are represented among the second quarter survey results had also submitted data in the first quarter survey (with the exception of Colombia). There were a total of 48 child helplines that reported data for the first and second quarter of 2019 and 2020 (although some did not systematically report all monthly totals). This paper analyses data from these 48 helplines ( To explore how the COVID-19 pandemic has impacted reporting of violence against children to helplines, a Google search of media articles and news stories published between March 1 st and June 17 th 2020 was conducted using the following combinations of key search terms: ("covid" OR "covid-19" OR "covid 19" OR "coronavirus") and ("child abuse" OR "child maltreatment" OR "violence against children") and ("covid" OR "covid-19" OR "covid 19" OR "coronavirus") and ("domestic violence" OR "family violence" OR "violence against women" OR "intimate partner violence"). Articles which included statistics on changes in domestic violence reporting to helplines and hotlines were searched given that research has shown that children witnessing violence at home or living with a mother who is a victim of domestic violence are at a heightened risk of themselves experiencing abuse within the home (Levendosky & Graham-Bermann, 2001; Tajima, 2015) . While the search terms did not include 'helpline' or 'hotline', criteria for inclusion encompassed the availability of any statistics or figures on changes in the number of reports received by helplines (either child helplines or those for reporting of domestic or gender-based violence) or hotlines. Articles and stories which simply speculated an increase (or decrease) in reporting or actual levels of child abuse or domestic violence, without the inclusion of any supporting evidence, were excluded. While the search was conducted using key terms in English, some additional relevant articles and news stories published in other languages were also included and translated using Google translate. The media search identified a total of 70 articles which met the inclusion criteria. These articles span 26 countries (see Table 2 ) and within the United States alone, articles covered 21 States. Slightly more than half of the articles included data on reports made to child helplines or hotlines for reporting of suspected cases of child abuse while the remaining half of the articles included statistics on reports made to helplines or hotlines dedicated to domestic violence or violence against women issues or to generic helplines. Of the 26 countries captured by the media search, 10 were also covered by the child helpline survey. As of March 1 st 2020, only two of the 26 countries had an SI score above 50, while by June 1 st 2020, all of them did. << Table 2 about here >> Countries covered by the media search and countries' SI scores The available evidence from the media search on whether prevention and control measures to curtail COVID-19 has led to an increase or decrease in reporting of violence shows a mixed picture. Based on the media search, slightly more than half of the articles (37 out of 70) documented an increase in the total number of calls received by helplines or hotlines. This corresponds to reported increases in 25 of the 26 countries for which articles were found. However, this does not necessarily translate into a direct increase in calls related to violence against children or domestic violence since the nature of the calls received was not always made explicit or in some cases, it was simply stated that the increased calls were related to concerns over COVID-19. For example, Canada's Kids Help Phone saw a 112 per cent increase in calls in April 2020 as compared to a year prior, and this included a spike of 28 per cent in calls specifically related to violence (Slaughter, 2020) . In Australia, the free online and telephone counselling service for youth reported that the number of contacts received since January related to the coronavirus had increased by 25 times (Gerova, 2020) . Uganda's Child Helpline dealt with an increased number of cases (881) since the national lockdown in that country began in late March compared to its average case load (248) (Donovan, 2020) . The Childhelp National Child Abuse Hotline, which operates in Canada and the United States, said that calls were up by 20 per cent and texts by 439 per cent between March 1 and 24 compared to the same time period in 2019 (Donaghue, 2020; Childhelp, 2020) . What this means is that in some places, the surge in calls to helplines seen during periods of lockdown cannot be directly attributed to increased reporting of violence but might J o u r n a l P r e -p r o o f rather be indicative of people reaching out to request information or ask questions related to COVID-19. Despite the above, the media search did reveal an increase in reporting to child helplines of concerns specifically related to violence and abuse in countries including France, India, and the United Kingdom. For instance, France's child abuse hotline (Allo Enfance en Danger 119) saw the number of calls from minors alerting to their own dangerous situation increase by 34 per cent during the first three weeks of confinement in the country as compared to an equivalent three-week period in February before the measure came into effect (Franceinfo, 2020 (Rukmini, 2020) . Lebanese officials reported a 100 per cent increase in the number of calls received to a hotline in relation to violence against women at home during the month of March while the country was under lockdown (Khalife, 2020) . The Association of Women for Action and Research's helpline for women in Singapore saw a 33 per cent increase in calls related to family violence in February (when the first coronavirus infections were detected) compared to the same period in 2019; this in stark contrast to national data suggesting a decline in cases between 2016 and 2019 (Sambhi, 2020) . In Tunisia over a period of just five days in March, a hotline set up for reporting of domestic violence witnessed a spike in the number of calls received about abuse of women (Asharq Al-Awsat, 2020). As was the case with child helplines, a number of articles citing data from Belgium, Bosnia and Herzegovina, Brazil, Cyprus, Ireland, Montenegro, Spain and Turkey made reference to increased calls and reports to domestic violence helplines and hotlines during periods of lockdown. However, the nature and types of calls received were not specified and therefore it is unclear whether these reflect increased reporting of incidents of domestic violence or simply an increase in the number of contacts made to the services for any number of reasons. Since mid-March in the United States, the National Domestic Violence Hotline has reportedly received more than 2,000 calls in which COVID-19 was cited as a condition of abuse (Sandler, 2020) ; however, it is not clear whether this represents any change in the usual number of calls received. On the other hand, reporting of violence to hotlines has reportedly dropped in some contexts. Notably, in the United States, decreased reporting to child abuse hotlines has been documented in 19 states on the basis of results from the media search. Reported declines in calls made to state and J o u r n a l P r e -p r o o f local hotlines for reporting child abuse and maltreatment ranged from 14 per cent to 69 per cent. For instance, California saw a 60 per cent decline in the number of reports made to the San Diego child abuse hotline during the first week of school closures (Hong, 2020 (Koloff & Rimbach, 2020) . Typically, Oregon's child abuse hotline receives around 700 calls every weekday from people reporting child safety concerns, but that number dropped by more than half on March 16 th , the day primary and secondary schools were ordered to close and the hotline had not received more than 300 calls in a single day in the week that followed (Young, 2020). Louisiana, Montana and Oklahoma have all reported declines in calls to state child abuse hotlines of around 45 per cent since schools were ordered closed in those states in March 2020 (Hanson, 2020) . Other states which were found to have documented declines in reports made to child abuse hotlines include Arizona, Colorado, Florida, Illinois, Maine, Missouri, Nevada, Pennsylvania, Tennessee, Texas and Washington State. In Jamaica, the largest residential facility for victims of domestic violence reported that calls to its helpline had slowed significantly since containment measures had been introduced (Barrett, 2020). Since administrative data derived from helplines (and other service providers) reflect reporting of incidents of violence, it cannot be used to determine whether indeed violence against children (or women) has increased (or decreased) during the COVID-19 pandemic. In other words, such data can shed light on how reporting (and indeed service availability) might be changing but not on whether (or how) the underlying magnitude of the issue is changing. An analysis by Child Helpline International of global child helpline data collected over a ten-year period from 2003 to 2012 showed a steady increase in contacts, and the number of child helplines reporting, over this period (Child Helpline International, 2013) . They suggest that this indicates that children and young people are feeling more empowered than before to reach out to child helplines to get information, support and care; that there is increased accessibility and awareness; and that there are new and emerging issues that need to be addressed by decision-makers. The increased use and contacts made to child helplines documented in both the results from the media search and the survey provides some evidence to suggest that such services are a critical lifeline for many children and women during times of crisis. While there was a 57 per cent increase in the total number of contacts to helplines between the first 6 months of 2019 and 2020, the overall number of VAC-related contacts decreased by 17 per cent between any quarter of 2019 and the second quarter of 2020. In particular, in slightly less than half of the helplines (17) there has been an increase in violence contacts while in the same number (i.e., 17), there has been a decline, and for seven there have been no change. While evidence of the effectiveness of helplines to reduce child maltreatment still needs to be established, the fact that such helplines provide an outlet for children to ask questions or talk about things that concern them, including violence, is in and of itself important. Of course, the quality and type of services provided by child helplines across the world may vary greatly and it is J o u r n a l P r e -p r o o f therefore plausible to expect that their usefulness and ultimate impacts will also vary. The implications of this are that there is potential value in strengthening and equipping child helplines with sufficient resources and staff capacity to handle an increased volume of calls during an emergency, but also of the need for investing in preparedness plans to ensure that conditions are in place such as access to protective equipment, training and tools so child helplines can continue to operate effectively and carry out their vital work when a crisis breaks out and other providers are unable to deliver services. Indeed, previous evidence Of course, there can also be a number of alternative explanations for increased contact such as the fact that people are staying home much more frequently than would otherwise be typical given the restrictions to work, social, leisure and community activities in many places. The spike in calls to helplines documented during periods of lockdown in some places could be the result of people simply wanting to request information or ask questions. On the other hand, findings that suggested a decline in some places in contacts to helplines are perhaps not altogether surprising given that one of the most common public health responses to COVID-19 has been the closure of primary and secondary schools. Additionally, a drop in the number of children reporting to child helplines could be indicative of access issues such that vulnerable populations, including children, are less able to safely reach out for help when confined or in close quarters with those who may be perpetrating violence and abuse. This implies a need to seek out innovative solutions and adopt alternate mechanisms that facilitate and promote access for users to reach services under such conditions. Efforts should also be made to raise public awareness of the existence and continued availability of helpline services even during times of crisis. Finally, the analyses exploring the relationship between reporting about violence to child helplines and restriction measures in place to respond to the pandemic did not yield any clear pattern. An important limitation of the media search includes the fact that it was not exhaustive. Additionally, a thorough quality assessment of the media sources publishing the articles was not conducted (although some effort was made to prioritize articles and stories from known and reputable news outlets). Finally, only those articles that were publicly available and free to access were included and since the search was conducted in English, articles in other languages were not systematically picked up. When it comes to the survey of child helplines, only 71 helplines submitted data for the first quarter of 2020 and 49 for the second quarter of 2020. Therefore, the inferences drawn from the data can only be partial. The survey conducted in the first quarter of 2020 did not include questions about J o u r n a l P r e -p r o o f the reasons for all contacts, but only for the COVID-19 contacts, so it was not possible to utilize these data for the analyses on violence due to lack of comparability with the data from the survey from the second quarter of 2020. Also, child helplines were not able to report on whether the violence-related contacts were made by repeat callers or by new ones, which is key to assessing changes in number and characteristics of beneficiaries. Finally, changes to staffing and operating hours for the child helplines that participated in the surveys may have occurred during the pandemic, but an assessment of how this might have impacted reporting was beyond the scope of this study. The above available evidence clearly highlights that it is challenging to draw definitive conclusions about reporting of violence against children to helplines during COVID-19 given the mixed picture that has emerged. Future research is needed to understand whether the impact of the pandemic on violence against children mostly relates to an increase in the severity and frequency of abuse, as opposed to an increase in the overall magnitude and scale. The hypothesis here being that caregivers and homes which are not violent prior to an epidemic would not necessarily become violent as a result but rather that situations in which children were already living in violent or dysfunctional family settings prior to a global crisis could deteriorate further. Understanding the reasons why children and people contact helplines by strengthening or establishing accurate and reliable reporting systems is a necessary first step to interpreting any changes in their use. Further understanding of help-seeking behaviours among child victims of violence, alongside improved data quality and availability, will be critical to strengthen reporting mechanisms, response services and prevention strategies. As mentioned above, more research is also needed to evaluate the effectiveness of child helplines in reducing maltreatment, taking into account the quality and functioning of child helplines since the impact is likely to be linked to these other factors. Additionally, it will be critical to analyse how the reporting levels to child helplines, child protection authorities and other service providers evolve as both the pandemic and the containment measures take a global scope in the months to come. Finally, the effects of the COVID-19 crisis on the maltreatment of children who are unable to reach out to child helplines due to their young age (such as infants, toddlers or other young children) or certain vulnerabilities, such as children with certain disabilities, should be further investigated, alongside the assessment of how the crisis has impacted other forms of violence, such as exposure to peer and community violence.. Containment measures to control COVID-19 have resulted in disruptions to child protective services. The disruptions to such services have also inhibited reporting of cases of child abuse and maltreatment. Child helplines however have remained operational in most countries. The results of the current study shed light on some of the challenges with drawing definitive conclusions about reporting of violence against children to helplines during COVID-19 given the mixed picture that has emerged. There is evidence indicating that some child helplines have recorded an increase in calls related to violence against children and women while in other cases, reporting of violence has reportedly dropped. As a result, and considering that data from child helplines do not consistently provide information on the reasons of the calls, it cannot be concluded at this stage that any reported increase necessarily reflects an increase in the number of cases of violence against children recorded by child helplines. In order to ensure national capacities to monitor trends during the pandemic and track progress against Sustainable Development Goal target 16.2 more generally, countries need to strengthen their routine monitoring systems for collecting data on violence against children. This entails J o u r n a l P r e -p r o o f investing in both periodic population-based surveys that collect prevalence data on violence and robust administrative data systems. Strengthening the quality of records along with reporting mechanisms across agencies receiving reports on violence, including child helplines and schools, should be prioritized. As child helplines are less likely to be disrupted than other child protection services following containment measures, they are a critical platform to provide counselling and support to children, to report and refer cases of violence, and to provide data to track use of services and cases. Disparities in global connectivity and access to devices by children, and limited capacities of child helplines to provide services across countries remain key challenges to realizing the full benefits and potential of child helplines. Additionally, the usefulness of such data to guide policy, learning and practice will depend to a large extent on whether the information collected is reliable and sufficiently detailed. In the case of using such data to understand violence, it is necessary, as a minimum, to collect information on the reason and type of contact being made since child helplines generally deal with a wide range of issues. Additional details about the caller (such as sex and age) and incident being reported (if there is one) would also be important to distil data useful in informing responses to violence. Accordingly, child helplines should be strengthened and equipped with sufficient resources and staff to handle increased demand and need of services during an emergency and make necessary referrals. Understanding the reasons why children contact child helplines by establishing accurate and reliable reporting systems is a necessary first step to interpreting any changes in their use. Recognizing the essential nature of child protection services would also be indispensable to ensure child victims receive support. This implies a need to seek out innovative solutions that facilitate and promote access for children to reach child protection services under containment measures. Efforts should also be made to raise public awareness of the existence of child helpline services even more during times of crisis. Public and private investment to improve connectivity will also be important. Macedonia could not be included in the figure as there were no SI scores for these countries. Glossary: New Data Framework. 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Fresno-area officials fear child abuse going unreported amid coronavirus quarantine. Bee.