The health of children in refuges for women victims of domestic violence: cross sectional descriptive survey

Objectives To describe the health and developmental status of children living in refuges for women victims of domestic violence and to investigate their access to primary healthcare services. Design Cross sectional survey. Setting Women's refuges in Cardiff. Participants 148 resident children aged under 16 years and their mothers. Main outcome measures Completeness of records on the child health system (register of all children that includes data on the child's health) for named health visitor, named general practitioner, and immunisation uptake; satisfactory completion of child health surveillance; Denver test results for developmental status; Rutter test scores for behavioural and emotional problems; reports of maternal concerns. Results 148/257 (58%) children living in refuges between April 1999 and January 2000 were assessed. Child health system data were incorrect (general practitioner and/or address) or unavailable for 85/148 (57%) children. Uptake of all assessments and immunisations was low 13/68 (19%) children aged <5 years had delayed or questionable development on the Denver test, and 49/101 (49%) children aged 3-15 years had a Rutter score of >10 (indicating probable mental health problems). Concerns were expressed by mothers of 113/148 (76%) children. After leaving the refuge, 22 children were untraceable and 36 returned home to the perpetrator from whom the families had fled. Conclusions The children had a high level of need, as well as poor access to sei vices. Time spent in a refuge provides a window of opportunity to review health and developmental status. Specialist health visitors could facilitate and provide support, liaison, and follow up.