1. Impact of Child Law on hospital protection services: Sultan Qaboos University Hospital (SQUH) experience Muna Al Saadoon, College of Medicine and Health Sciences, SQU, Oman
Results and discussion: A total of 48 cases (58.3% female) were reported during the study period. The mean age of the children was 5.1 years (SD 4.17). It was noted that there was increase in the number of reported cases to the MOSD and MOH from 20 cases to 28 cases per year after the law was issued. The reported cases of discharge against medical advice (DAMA) increased from 1 case to 8 during the same period (table 1).
Table 1. cases of CAN reported and managed by CPSC, SQUH
The rise in the number of DAMA is possibly due to the sensed legal obligation by the doctors after the issue of the law. Cases that used to be discharged and documented as discharge on request, most likely after the law are being labeled as DAMA. The awareness of the doctors about reporting the cases of DAMA is good but the number of reported cases is less than the reported rate of DAMA in SQUH (4). The second observed finding is the standardization of reporting all cases to the regional CPC. This improved the care provided to the children and helped in avoiding duplication of services such as psychological intervention between SQUH and MOSD. The third positive impact is the central process of taking decisions about the need of legal intervention rather than CPSC taking such decision as practiced prior to the law. The follow up of the reported cases, availability of feedback, improved communication about outcome was also evident. The law gave the national child protection committee the legal frame to follow up cases and provide the required services to children even if the parents were resisting that. This was evident from ability of the national child protection team to contact the families of children with DAMA and assure that the child is receiving health care in other health facilities. Families also were referred to the legal authorities for intervention if they deny the child from a required health services.
Introduction
Oman ratified the Convention on the Rights of the Child in After that many Royal Decrees and laws were issued to protect children (1). This effort was crowned by the Oman Child Law which was issued by a Royal Decree No. 22/2014 in May It is composed of 79 Articles that state the child rights, protection measures and penalties for violating them. It defines the child as “every person has not completed eighteen years of age”. The law created a new official job to oversee the process of assuring the protection of the child “Delegate of Child Protection”. It also gave the definitions of violence, exploitation and abuse within the Omani context for the first time (2). Including definitions, process of reporting and identifying responsible authorities for each step are important to standardized the service provided. The law also pave the way for the Child Protection Committee members to have legal power when implementing the articles.
Ministry of Social Development (MOSD) initiated a system of looking after victims of child abuse and neglect (CAN). In 2008 it developed task groups in the different regions to study and follow up children subjected to abuse. These teams were then upgraded to committees. Many workshops to evaluate the teams, identify training needs, develop training plan and train committee members were conducted ( ). Currently there are 11 Child Protection Committees with 150 members in the different regions. The members represent MOSD, Ministry of Health, Ministry of Education, Ministry of Legal Affairs, Ministry of Justice, Ministry of Manpower, Sultan Qaboos University Hospital, Women Associations and the Royal Oman Police. Professionals nominated include: Doctors, Nurses, Social Workers, Psychologists, Law enforcement professionals, Prosecutors and Police officers. In 2012 the MOSD also established the Directorate of Family Protection with a home to look after victims. It provides accommodation, health and psychological intervention, legal advises and raise awareness in the community about child protection. The child protection guidelines were developed in Several training courses on the guidelines were conducted in The MOSD also initiated a Child helpline to support and supplement the existing family counselling line.
SQUH was the first hospital in Oman to formulate Child Protection team within the Department of Child Health in The team was then upgraded to a hospital committee “Child Safety and Protection Committee” (CSPC) in This audit will evaluate the impact of the Child Law on the activities of the committee focusing on the reporting system.
Method: The CPSC registry of all reported and managed cases during the period May 2013 to May 2015 were reviewed. Data collected include age of child, gender and type of abuse suspected.
Conclusion: Child Law did have positive impact in enhancing detection and reporting of cases of child abuse and this increase was more for DAMA.
Recommendations: As the law made reporting mandatory by the health providers, there is a need to make the reporting system known to all. Hence, there is a need for more interaction with the community and professionals to educate them about the law, child right and child protection. Developing child advocacy center at the level of each region with dedicated professionals representing the multidisciplinary child protection teams is required for better services.
References
1. UNICEF Oman Charting progress towards child protection in Sultanate of Oman. Findings of a national consultative workshop, 27th October.
2. Oman Child Law.
3.General Secretariat of the League of Arab States. Arab comparative report on the extent of implementing the recommendations of the study of the Secretary-General of the United Nations to stop violence against children (Arabic). 2010
4. Al Sadoon M, Al Shamousi K. (2013). Discharge against medical advice among children in Oman:. SQUMJ. 13 (4), p534_538