"Projekt Kinderschutz" (child protection project) in Lower Saxony. Balance of the model phase

Every day in Germany 11 children are mistreated, 39 children are sexually abused and 3 children die per week as a result of maltreatment and neglect. The total frequency of child abuse in Germany is estimated to be approximately 1.4 million children per year. Infants are in particular danger. These figures and the new Bundeskinderschutzgesetz (Federal Child Protection Act) which came into force on 01 January 2012, emphasize the necessity for comprehensive and reliable child protection. The Institute of Legal Medicine of the Medical School in Hanover, provides a specialized service called the "Projekt Kinderschutz" (Child protection project) offering a discipline-based consultation and qualified medical diagnostics for private medical practitioners and clinicians in Lower Saxony who are confronted with cases of alleged or suspected sexual and/or physical child abuse. The aims of the project are to improve the early recognition of suspicious cases and to provide a fast, comprehensive and easily accessible forensic medical service. In the period from October 2010 and March 2013 all cases where the Institute of Legal Medicine of the Medical School in Hanover was contacted by an easily accessible route within the framework of the "Projekt Kinderschutz" were analyzed retrospectively. The assessment included the documentation form developed for the project, the recording of the telephone consultation as well as the files and teleconsultation notes. The age and gender of the child, location of the consultation examination as well as the questions and origin or discipline of the contacting physician were evaluated. Additionally, the relationship between the offender and the injured child and the time of presentation were analyzed in cases where suspicion of maltreatment or abuse were confirmed. Finally, the results of the forensic pathological findings and the subsequent procedures were analyzed. In the study period a good interdisciplinary cooperation was established with the various project components of the "Hotline Kinderschutz" (child protection hotline), forensic examinations in outpatient child protection in Hanover and Oldenburg, on-site and on-line consultancy services and numerous workshops and seminars. A total of 291 cases of alleged or suspected child abuse were assessed and questions relating to case management and legal issues as well as the interpretation of findings were addressed. The outpatient child protection has developed into a competent partner for protection of children, for safeguarding parental rights and last but not least for collection of evidence. The sure diagnosis of sexual abuse or physical maltreatment in childhood is of far-reaching importance because false accusations due to flawed findings can lead to severe psychiatric and social consequences in the family, for the child and the accused. The "Projekt Kinderschutz" provides a valuable contribution to do justice to the interdisciplinary responsibility for child protection in addition to support in individual cases.