ecpat journalapril2016

8/17/2019 ECPAT JournalApril2016

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ECPAT Internaonal328/1 Phayathai Road Ratchathewi

Bangkok 10400 THAILAND

Tel: +662 215 3388, +662 611 0972 Fax: +662 215 8272

Email: [email protected] Website: www.ecpat.net

Series Editor: Rebecca H. Rienhouse

Layout & Design: Manida Naebklang

April, 2016

Copyright © 2016, ECPAT Internaonal

This publicaon was produced with the nancial assistance of Irish Aid, Oak Foundaon, and Sida.The views expressed herein are solely those of the authors. The support received from the above-menoned donors does not constute endorsement of the opinions expressed.

ISSUE no. 11 for APRIL, 2016

During the draing of the arcles for this Journal, ECPAT Internaonal held two Global ExpertMeengs to elicit the advice from a variety of mul-sector specialists. The rst meeng, a RoundTable Discussion on Prevenng the Sexual Exploitaon of Children, was held in Geneva on 2 October2015 and parcipants included: Margaret Akullo, Alessia Altamura, Anastasia Anthopoulos, FlorenceBruce, Mark Capaldi, Donald Findlater, Susanna Greijer, Mark Hecht, Lori Heise, Christopher Mikton,Julia O’Connell Davidson, Lorraine Radford, Eliana Riggio, Dorothy Rozga, Maia Rusakova, Lucie Shuker,Joe Sullivan and Jane Warburton. The second meeng took place in Paris from 5-6 October 2015 andwas part of the Global Study on the Sexual Exploitaon of Children in Travel and Tourism. Parcipants

included: Angela Hawke, Catherine Beaulieu, Clara Sommarin, Dorine van der Keur, Dorothy Rozga,Eliana Riggio, Elise Bonneau, Emilia Pool Illsley, France Charlet, Frans de Man, Guillemee Vuillard,Ilana de Wild, Mark Capaldi, Mahias Leisinger, Prof. Mark Eric Hecht, Mechld Maurer, Milena Grillo,Dr. Najat Maalla M’jid, Özgür Kahale, Theo Noten and Vimala Crispin. ECPAT Internaonal wishes tothank all these individuals for their valuable me and inputs.


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TABLE OF CONTENTS

PREFACE 2

PREVENTING THE SEXUAL EXPLOITATION OF CHILDREN: A MAPPING

OF PRACTICE AND INTERVENTIONS 4

Introducon 4

A Model for Prevenon 5

Understanding Risks of Perpetrang Sexual Violence to Prevent SEC 5

Terary Level Prevenon: Reducing Risks Through Work with Oenders and Those withHarmful Sexual Behaviour; Current Pracce and Thinking 12

Prevenng Sexual Exploitaon by Reducing The Risks of Being Sexually Exploited 14

Conclusion: Issues, Quesons and Potenal Implicaons for Pracce 20

Bibliography 22

TOWARDS A PREVENTION FRAMEWORK FOR CHILD SEXUAL EXPLOITATION 26

Introducon 26A Typology of Risks & Vulnerability Factors Inuencing SEC 28

The Public Health Prevenon Framework: A SEC Applicaon 30

Accompanying Principles 34

Conclusion 36

Bibliography 37

BETTER UNDERSTANDING FOR BETTER PREVENTION OF THE SEXUAL

EXPLOITATION OF CHILDREN IN TRAVEL AND TOURISM: AN ANALYTICAL

FRAMEWORK FOR POLICY DESIGN 40

Introducon 40

A Framework for Structured Enquiry 41

Contexts of Exploitaon: Legal Environments, Locaons and Interacons 43

Vicms and Oenders: A Closer Look at the Contexts of Children and the Choices of Oenders 46

Back to Tourism and Travel: What Can the Sector Do? 50How do we Prevent SECTT?: Some Broad Lessons from this Framework 51

Conclusions 52

Bibliography 53

AUTHOR BIOGRAPHIES 56


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PREFACE

Over the last 25 years, much of the prevenon work to end the sexual exploitaon of children (SEC)

has been in developing responses around criminal jusce intervenons or broader awareness-

raising and campaigning of the dangers and harms associated with this type of child sexual abuse.

More recently, however, a number of sectors and agencies have been exploring the potenal of

developing a more nuanced and conceptual framework to tackle prevenon ulising a publichealth model. Such an approach has generally disnguished three levels of prevenon: Primary

Prevenon (prevenng SEC before it would otherwise occur); Secondary Prevenon (reducing the

risk of SEC in “at-risk” groups); and Terary Prevenon (prevenng further SEC oences through

intervenons specically targeng child vicms or oenders). The “prevenon dimension” is

arising from a growing interest in understanding and tackling social norms related to the demand

for sex with children which can then be approached through dierent angles and perspecves.

The new UN Sustainable Development Goals (SDG) agenda, adopted in September 2015,

provides an unprecedented opportunity for ending the sexual exploitaon of children. It poses afundamental queson regarding what may be the most eecve approach to prevent and protect

vulnerable child populaons from increasing exposure to sexually exploitave environments.

This latest ECPAT Journal (Series 11), Prevenng the Sexual Exploitaon of Children: Frameworks

for Intervenon, seeks to map and shape a framework to understand how diverse intervenons

can be applied to prevent dierent manifestaons of SEC. It emerges from a number of ECPAT-led

iniaves in 2015 which included an examinaon of evidence-based SEC prevenon frameworks

while also idenfying emerging responses to prevenon approaches in other aspects of the child

rights eld.

The rst arcle in this Journal, Prevenng the Sexual Exploitaon of Children: A mapping of

pracce and intervenons, outlines a prevenon framework for reviewing pracces globally

based on examples from the ending sexual violence sector. By illustrang interesng “lessons

learned” from prevenon intervenons, the arcle idenes some of the current gaps, ongoing

quesons and challenges in replicang or scaling up successful prevenon strategies.

The second arcle, Towards a Prevenon Framework for Child Sexual Exploitaon, starts from the

premise that global approaches to prevenon through a more “public health” lens will enable

child rights actors and duty-bearers to see how diverse intervenons can be applied in relaon

to dierent manifestaons of SEC as well as in various regions and naons of the world (due tocultural and contextual dierences). Key lessons learned are extracted from the conceptualisaon

of prevenon approaches in order to oer a more nuanced understanding of eecve prevenon

strategies. The paper proposes a dra conceptual framework which can be tested and developed

further.


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Emerging from the soon to be launched Global Study on the Sexual Exploitaon of Children in

Travel and Tourism is the third journal arcle: Beer Understanding for Beer Prevenon of the

Sexual Exploitaon of Children in Travel and Tourism: An analycal framework for policy design.

This arcle praccally illustrates an analycal framework, specic to a major manifestaon of

the sexual exploitaon of children. By focusing on prevenon, this framework aims to produce

changes in the contexts of the socio-economic environment and the contexts of potenal

oenders and child vicms.

From this Journal it is evident that dierent sectors and partners need to be connected to a

SEC prevenon agenda so that key factors and determinants that lead to the sexual exploitaon

of children can be adequately addressed. These may be socio-cultural, structural, situaonal,

relaonal, environmental or personal drivers, but they all need to be beer understood andintegrated into a much broader and more comprehensive framework. This Journal helps start

that process.

Rebecca H. Rienhouse

Legal Research and Monitoring Ocer

ECPAT Internaonal


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Prevenng the sexualexploitaon of children:A mapping of pracceand intervenons

by: Jane Warburton

INTRODUCTION

Exisng data suggests that vast numbers of children are sexually exploited, probably in all countries,every year. A response model can never reach all of those aected. We already know something of theimmediate and longer-term impact on child vicms, and the potenal for a wider ripple of impact or


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long and short term consequences that aect families, children and communies. However, the lack offocus on prevenng violence from happening in the rst instance, based on the assumpon that such

behaviour is inevitable, unchangeable, and/or is a marginal issue (none of which are valid), has meantthat the response to the recovery and reintegraon of child vicms of sexual exploitaon is always trying- and failing - to catch-up. As such, a model that seeks to prevent such abuse from happening in the rstinstance has to be the priority for future development.

This paper looks primarily at current pracce and asks: who is doing what, where and with whom, toprevent the sexual exploitaon of children. One of the recurring issues is the signicant gaps in theevidence about what works, including lile or no clarity or consensus about what constutes success.But this paper also starts from the premise that the absence of evidence of ecacy or impact does notmean that intervenons are ineecve. Gaps in the evidence are a major issue in terms of the potenalfor developing, scaling up or replicang such work, but it is important to recognise and appreciate the

current and potenal learning that is or could be oered by exisng intervenons. The paper oersexamples of interesng prevenon-related intervenons, including those that, through rigorous researchand evaluaon, have been able to demonstrate impact and concludes by exploring some of the currentgaps, ongoing quesons and challenges of prevenng the sexual exploitaon of children (SEC).

A MODEL FOR PREVENTION

A prevenon model, based on the World Health Organizaon (WHO) public health framework, looksat primary, secondary and terary prevenon eorts. The Lucy Faithfull Foundaon’s Eradicang ChildSexual Abuse (ECSA) project1 has used this to structure and categorise work aimed at prevenng sexualabuse and exploitaon of children. This looks at:

n Work aimed at prevenng sexual abuse/exploitaon before it happens (primary);

n Work aimed at those considered at high or higher risk of perpetrang sexual abuse/exploitaon and/or those at high risk of being vicms of it (secondary);

n Work aimed at reducing the risk of reoending or connuing to perpetrate sexual abuse/exploitaon,and/or of being revicmised (terary).

The tools developed by the Foundaon are intended to facilitate and provoke discussion and comparisonacross the isolated silos that have epitomised much of the prevenon work to date.

While this focus on the prevenon stages is very helpful, it might also be useful to think about an addionaldimension; who or what is being targeted. Much of the work to date has focused on inuencing individuals.However, this approach could be taking place without reference to the societal or structural drivers thatmaintain or perpetuate certain paerns of sexual abuse and exploitaon. This will be further discussed inthe secon addressing norms and societal tolerance.

UNDERSTANDING RISKS OF PERPETRATING SEXUAL VIOLENCE TO PREVENT SEC

A prevenon model is premised on understanding the risk factors or vulnerabilies for being a perpetratorand/or a vicm of sexual abuse or exploitaon and assumes that at least some of these elements areamenable to change. We know that these risk factors/vulnerabilies are complex, interconnected anddynamic. They operate at the level of the individual, community and society. Their impact is inuenced bythe presence or absence of protecve factors, again operang at dierent levels.

1 See: hp://www.lucyfaithfull.org.uk/ecsa_eradicang_child_sexual_abuse.htm


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Understanding the risk and protecve factors related to dierent forms of violence may help answer thequesons about the relevance of data from other sectors to a study of sexual exploitaon of children.

In the absence of comprehensive and specic data about perpetrators and vicms of child sexualexploitaon, much of this paper looks at the data generated from the broader category of sexual violence.The assumpon of some connecon between these dierent forms of violence needs further researchand tesng. Certainly, more needs to be understood about the similaries and dierences in respect ofthe risks and protecve factors that apply to dierent sorts of sexual violence.

Based on exisng evidence, it is clear that the risks of becoming a perpetrator and the risks of becoming avicm of sexual violence are similar.

“Riskfactorsforbeingaperpetrator include loweducaon, exposure to childmaltreatmentorwitnessing violence in the family, harmful use of alcohol, atudes accepng of violence and

genderinequality.Riskfactorsforbeingavicmofinmatepartnerandsexualviolenceincludeloweducaon,witnessingviolencebetweenparents,exposuretoabuseduringchildhoodandatudes

accepngviolenceandgenderinequality.2”

There may be a gender dimension to this. Are boys more likely to become perpetrators than girls, and girls

more likely to be vicms than boys? Under–reporng suggests the need for considerable cauon aroundsuch statements.

An increasing number of studies are looking at some of the factors that increase the risks linked tobecoming a perpetrator of sexual violence and/or an exploiter of children and young people. While there

are gaps in the sector’s knowledge, there is some understanding of the factors that make it more likelythat someone will become a perpetrator of sexual violence. Reviews of available evidence undertaken bythe Sexual Violence Research Iniave (SVRI), and the Partners4Prevenon programme in Asia highlightthe following groups of risk factors that escalate risks of perpetraon, which are potenally amenableto change: a strong associaon of men’s use of sexual violence and their own experience of violence inchildhood (as vicms and/or witnesses)3 4. Other adverse childhood experiences linked to later perpetraoninclude disrupted aachments, parental experience of excessive drug and alcohol use; strong genderinequitable norms and atudes5 (this is seen by some as the predominant risk cluster, both at a structuraland an individual level); and age – half of men that perpetrate rape did so for the rst me as juveniles6.Sexual violence is also associated with other forms of “delinquent” behaviour parcularly among youngperpetrators, including the use of weapons and the use of alcohol. In some ways all of these are connectedto certain views of masculinity and atudes towards gender.

Addional or more specic factors idened include:

n Aachment and personality disorders;

n Social learning and delinquency; and

n Substance abuse and the use of rearms7.

In determining appropriate intervenons or pracce, it is important to make some of the starngassumpons clear. These include:

n Sexual violence is widespread, across all sociees and predominantly perpetrated by men and boys;

2 World Health Organizaon (2016), Violence against Women Fact sheet No. 239, updated January 2016, hp://www.who.int/mediacentre/factsheets/fs239/en/

3 See: hp://www.partnersprevenon.org Fulu, Emma, etal . (2013), “Why Do Some Men Use Violence Against Women and How Can We Prevent It? Quantave ndings from the

United Naons mul-country study on men and violence in Asia and the Pacic”, UNDP, UNFPA, UN Women and UNV.5 Jewkes, Rachel (2012), “Rape Perpetraon: A review”, Pretoria: Sexual Violence Research Iniave.6 Jewkes, R., etal . (2011), “Prospecve study of rape perpetraon by young South African men; incidence and risk factors for rape

perpetraon”, Pretoria: SVRI.7 Jewkes (2012), “Rape Perpetraon”.


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n Prevenon of sexual violence cannot simply rely on empowering vicms or potenal vicms, or byresponding once the abuse has taken place; and

n Addressing the use of and tolerance of sexual violence is an issue for the whole of society.

The two principle strands of work explored are:

n Work with men and boys on reducing the risks of perpetrang sexual violence;

n Work aimed at reducing the risks of being exploited.

Prevenon work aimed at men and boys

Is male violence a biological inevitability? Clearly not. The majority of men, (around 80% according to thepreviously cited survey work undertaken by SVRI and others) are not perpetrators of extreme forms of

sexual violence. However, a signicant percentage of the male populaon do currently perpetrate someform of sexual violence. All intervenons aimed at prevenng this start from the basis that such behaviour,and the atudes and norms that maintain or “tolerate” it, can be changed.

To be eecve, we might assume that eorts to prevent such violence from happening must address boththe risk factors that operate at the level of the individual, and those that work at a societal or structurallevel. This includes challenging the acceptance or tolerance of the use of violence, understanding moreabout the risk factors and how they operate, and idenfying and expanding ways in which these risks canbe eecvely reduced, at both individual and structural levels. Dierent intervenons and programmesoperang at the individual and structural levels may complement, reinforce and thus accelerate or sustain

change. While this seems to be a realisc assumpon, it does need to be tested further as there is, as yet,lile documented evidence of these inter–relaonships.

The link between experience of sexual abuse as a child and later perpetraon is complex. It needs to takeaccount of gender and the presence or absence of protecve factors. It has been suggested that exposureto a number of interacng stressors/dicules is much more signicant than any one experience, includingbeing a vicm of sexual abuse8. The idea that the majority of sex oenders are or were all vicms ofsexual abuse has been challenged9. Dierent gures for prevalence have been generated using self–reportmechanisms (where more than 66% claimed to have been sexually abused) and those using polygraphtesng (which suggested about 29%, more in line with populaon gures in general), indicang someover–reporng by oenders10.

Those most likely to engage in sexual violence also reported higher rates of depression, low life-sasfacon,poor health, gang membership, alcohol and drug use, and the use of transaconal sex11.

How all of these factors connect causally or inter-relate is not clear from the data, but understandingmore about the trajectory and connecons might help in developing a range of intervenons that cancontribute to reduced risks of perpetraon.

Reducing risks by reducing childhood exposure to violence in the family seng

There is a link between the experience of or witnessing violence in the family and later perpetraon ofsexual violence. Thus, intervenons aimed at reducing violence in the family, family support, strengtheningparent–child aachment and promong posive non–violent forms of discipline, are all strategies with

8 Hacke, Simon (200), “What works for children and young people with harmful sexual behaviours”, Barnardo’s publicaons.9 Richards, Kelly (2011), “Mispercepons about child sex oenders”,Trends&issuesincrimeandcriminaljusce, no.29, Canberra: Australian

Instute of Criminology (September 2011).10 Ibid. 11 Fulu, etal . (2013), “Why Do Some Men Use Violence Against Women”.


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the potenal to reduce the perpetraon of sexual violence, in the short, medium and longer term. Most ofthese intervenons to date have focussed at the level of the individual or family. However, it is possible to

envisage broader policy and structural frameworks that apply some of these lessons and understandingsto encourage an environment that is pro-family, and arms and applauds posive parenng.

Evidence about eecveness of such intervenons comes predominantly from work in high incomecontexts, but a review of work in low and middle income countries12 suggests that parenng intervenonsin some of these countries have improved parent–child relaonships and reduced negave parenngpracces, lessened the incidence of violence within families, and can contribute to reducing the likelihoodof the later perpetraon of violence by children from those families. Two high quality studies oeredmodels for intervenon design in low–resource sengs. They suggest that “it is feasible to: use non-professional local sta to deliver intervenons to parents; deliver intervenons through home visits; and,

add intervenons to roune health services for pregnant women and new mothers.”13

Further researchin lower income contexts, specically aimed at establishing if and how these mainstream parenngprogrammes might contribute to a reducon in violence, is currently being implemented in Tanzania andUganda, supported by SVRI14.

Reducing the risks of perpetraon of sexual violence through understanding andchallenging social and structural norms that perpetuate sexual violence

Social norms theory suggests that it may be more eecve to understand and focus on changing socialnorms rather than individual atudes. Social norms operate in, and inuence virtually all of the situaons

faced by communies. They condion or dictate the behaviour of individuals. Targeng certain normsmay be especially relevant “for addressing situaons of violence, including exploitaon and abuse againstchildren and women, as these are primarily the result of social interacons.”15

Social norms theory suggests that for behaviour to change, it is necessary to understand and focus onchanging dominant social norms rather than seeking to generate change through challenging individual’satudes and beliefs. Understanding more about norms, how they operate and thus how they might bechanged is a key element in framing future work.

The recent surveys undertaken in a number of dierent countries and contexts, using rigorous toolsand analyc frameworks16 have highlighted a number of common societal factors associated with theperpetraon of violence. Inmate partner violence is strongly associated with gender inequity at both theindividual level, and in terms of the dominant norms shared by men and women. This has been idenedby some as the predominant factor determining the use of and atudes towards sexual violence17. At asocietal level, the data idenes power dierenals, gender and gender inequitable atudes, includinga sense of male entlement to sex, as some of the crical drivers of violence against women. The useand tolerance of violence may be seen as simply a queson of who has power and the ability to use thatpower to maintain a posion of dominance. Where the vicms of violence are children, especially femalechildren, power is related to both age and gender, both of which correlate negavely with power andstatus in many sociees. It is essenal to assess how risks and protecve factors around reducing the risksof perpetraon of violence against children really are similar to or dier from those that make violenceagainst women most likely.

12 Knerr, Wendy,etal . (2011), “Brieng Paper: Prevenng child abuse and interpersonal violence in low- and middle-income countries”, SVRI.13 Ibid.14 See: hp://www.svri.org/primaryresearch.htm15 UNICEF (2013), Report of Advisory Group Meeng: “Social Norms and Community-based Care Programming in Humanitarian Sengs:

Building ‘Good Pracce’ Approaches for Primary Prevenon of Response to Sexual Violence Against Women and Girls Aected by Conict”.16 Including the IMAGE study, PartnersPrevenon and SVRI.17 Jewkes (2012), “Rape Perpetraon”.


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Social norms interplay with individual characteriscs, and are armed by other experiences or challengedby protecve and posive elements within the individual, family and environment. Negave norms can

be maintained and reinforced through the behaviour associated with them. These all contribute to adistorted and limited vision of masculinity based on power, strength and control which can contribute tothe normalising of sexual violence, the use of sexual aggression and a sense of male entlement. As anexample, the Partners4Prevenon surveys found that rape was most commonly associated with a senseof sexual entlement; reported by 70 – 80% of those who had raped18.

Men Care and their global fatherhood campaign, is trying to challenge aspects of norms aroundmasculinity and gender, and highlight posive alternave versions of men and fatherhood. Strategiesinclude community dialogue, informaon sharing, highlighng possible alternave views and visions, andenlisng the support of key inuencers or alternave champions19.

Transformaonal work needs to be seen as a process that generates a sustainable momentum which is then“mutually–reinforced”. Once that crical momentum or pping point is reached, there is a real prospectof men and women’s atudes around gender norms and the behavioural and praccal implicaonsof such norms being irreversibly changed. Work targeng norms has to be planned, strategic and wellmonitored. It needs to be carefully tracked to determine if and what is changing over me. It needsto be comprehensive, sequenced and nuanced to deal with parcular issues or contexts. Broad basedmessages and scaergun methods of reaching people are liable to be o-target and o-message for manygroups. Work that is currently underway in East Africa, looking at applying social norms theory to beerunderstand the structural drivers of HIV transmission, including sexual violence and sexual behaviour,

is helping to gain much beer insights into who the key reference groups are, key opinion formers andinuencers, and poinng to a more targeted approach for work aimed at changing norms and behaviour20.Such work oers crical insights into how to plan and implement eecve communicaons, media andcampaigning work.

Eorts need to build on the fact that the vast majority of men do not use sexual violence. The results ofsurveys in Asia found signicant numbers of men expressed frustraon and concern about the negavebut dominant noons of what it means to be a man. Others have already found ways of behaving thatembodies gender equity and power sharing. Understanding more might lead to idenfying possibleopportunies and entry points for the dicult task of changing something so entrenched.

To be eecve in changing male atudes and the norms around the use of violence, engagement withwomen and girls is a necessity. Partners4Prevenon included women in their surveys, and found thatthey tended to be more conservave and gender inequitable than their male counterparts. As daughters,partners and mothers, these atudes are crucially important in maintaining gender inequity.

The media can play an important role in reinforcing or challenging dominant norms. The ways in

which gender roles are depicted in the media, how masculinity and femininity are portrayed, canhave a major inuence, parcularly in relaon to how children and young people think about andunderstand societal expectaons21. In addion to countering the negave inuences, it is importantto recognise the opportunies for more eecvely using this power to challenge and change them, at

scale. This requires good strategies, alliances that bring together dierent skills and entry points andtraining22 23.

18 Ibid.19 See: hp://www.men-care.org/20 UKaid, Department of Internaonal Development, “Tackling the Structural Drivers of the HIV Epidemic (STRIVE)”, hp://rd.dd.gov.uk/

Project/60850/Default.aspx21 See, for example, the work being supported through the Geena Davis Instute: hp://www.thegeenadavisinstute.org/index.php22 See: hp://www.ungei.org/resources/les/beyond_access_media_guide.pdf; see also: hp://www.mediaed.org/cgi-bin/commerce.

cgi?display=home; hp://www.globalgiving.org/projects/support-youth-challenging-gender-stereotypes/23 See:hp://www.nhserewash.com/safeguarding/all_of_our_concern_commercialisaon_sexualisaon_hypermasculinity_report_family_lives.

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Reducing risks through school-based intervenons

The data, collected from a variety of contexts and cultures, shows that age, i.e. being young, is a risk factorin the perpetraon of sexual violence. Partners4Prevenon found that 50% of perpetrators commiedacts of sexual violence for the rst me while they were teenagers24. This clearly suggests that the focus ofviolence prevenon work must include work targeng young men and boys in terms of inuencing theirbeliefs, atudes and behaviour, before they become entrenched. The aim would be both to inuenceindividual knowledge and behaviour, but also to encourage change in broader societal percepons andnorms.

Primary level intervenons include mainstream work in schools and alternave educaon sengs. Thishas the potenal to reach all young people before they become perpetrators. The “standard intervenon”

might also be developed or enhanced to strengthen work with those considered at higher risk (secondarylevel prevenon) and those who have already oended (terary).

One of the starng points for challenging and changing gender norms, atudes and beliefs among school–aged children is understanding what they are, how they vary, and idenfying appropriate strategies forchallenging percepons and norms that are problemac. Research conducted in Bulgaria in 2012 byGender Educaon, Research and Technologies Foundaon25 surveyed 1600 children aged between nineand seventeen. They found that across a number of dimensions children hold non–equitable atudes andbeliefs around gender. Children are inuenced by their family and community atudes and norms, andthe media. These socially determined stereotypes potenally impact a whole range of behaviour and life

opportunies for both boys and girls.

The school environment and the teaching that takes place there can empower, instruct and model genderequitable atudes and behaviour. Schools can also be places where violence is rounely pracced bythose in authority (oen men), in the name of discipline; they can reinforce harmful masculinies, abusivepaerns of power and authority, and sustain a regime where vicms are impotent and silenced. Trainingand challenging these negave norms can change the dominant behaviour paerns. The Good SchoolsProgramme, implemented by Raising Voices in Uganda, has recently demonstrated signicant reduconsin the use and witnessing of violence in schools through engagement, discussion and oering alternaveways of understanding and disciplining children26. To be eecve the intervenon is more than a one

o lesson; it is a whole school approach, which models respect and gender equitable approaches andchallenges negave behaviour and violence.

One of the mainstream entry points has been through sex or sexuality educaon. While such programmesare widespread, their content and aims vary considerably. Internaonally, clear guidance around contentand delivery modalies has been developed, parcularly in the context of their use as part of eortsaimed at HIV/AIDS prevenon and response. Evaluaons tend to look at teenage pregnancy and sexualhealth, onset of sexual acvity, reducon in the frequency of sexual acvity, reducons in numbers ofsexual partners, and increase in condom and contracepve use27. Programmes’ eecveness has beendemonstrated for youth from a variety of racial, cultural and socioeconomic backgrounds, though mostof the evaluaons of this work have been undertaken in higher income countries. Though the majority ofsuch programmes have been implemented in school sengs, there is clearly scope for such work to be24 Fulu, etal . (2013), “Why Do Some Men Use Violence Against Women”.25 See: “Gender equality: the percepons and atudes of children”, as part of Gert’s “Schools for gender equality and against violence” project

(12 February 2013), hp://www.gert.ngo-bg.org/arcle231.html26 Devries, Karen, et al . (2015), The Good Schools Study, hp://evaluaon.lshtm.ac.uk/good-schools-study/; See also: United Naons Girls’

Educaon Iniave, Safe Schools Program, hp://www.ungei.org/resources/index_2822.html27 Examples include: Alford, S., et al . (2008), “Science and Success: Sex Educaon and Other Programs that

Work to Prevent Teen Pregnancy, HIV & Sexually Transmied Infecons”, Washington, D.C.: Advocates for Youth;Wight, Daniel (2011), “The eecveness of school-based sex educaon: What do rigorous evaluaons in Britain tell us?”, Educaon and Health 29(): 67-73; United Naons Joint Programme on HIV and AIDS (1997), “Impact of HIV and Sexual Health Educaon on the Sexual Behaviour ofYoung People: a Review Update”, Geneva: UNAIDS Best Pracce Collecon.


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undertaken in less formal sengs, with out of school children and young workers.

A considerable body of work aimed at helping to inform children about the risks of abuse and exploitaonhas been developed for delivery to younger children in schools, parcularly in higher income contexts. Arecent review suggests that while there is evidence of the posive impact of “school–based educaonalprograms [that] teach children, [in terms of] ... how to idenfy dangerous situaons, refuse an abuser’sapproach, break o an interacon, and summon help ... promote disclosure, reduce self–blame, andmobilize bystanders” there is lile evidence about “whether educaon programs reduce vicmizaon”28.There is some discussion in the literature that such work may in fact increase the level of violenceassociated with sexual abuse in some instances.

Learning from this body of work and thinking about how all these elements might be combined to

strengthen their eecveness can provide useful ideas for future developments. But direct evidenceabout if and how they impact risks of perpetraon or experience of sexual violence generally, or sexualexploitaon specically, is rare or non-existent. While intuively we might assume that a mul–prongedapproach implemented simultaneously in schools, families and through the mass media with the largercommunity will create synergies and make success more likely in each of the domains, there is lileevidence as yet to support this.

As such, one of the weaknesses in many programme evaluaons is the choice of indicators or measures ofsuccess. A lot of work limits itself to measuring and reporng on changes in knowledge and self-reports,perhaps about actual or planned changes in behaviour. This is understandable, given the ethical, nancial

and lack of data challenges, but the assumpons about the validity of such measures need to be testedin dierent sengs. Stepping Stones29 and Sisters for Life30, both implemented in South Africa, have beenable to demonstrate sustained changes in atudes and behaviour over me, and in the laer example,have shown a considerable reducon in the use of violence towards a partner.

Reducing risks by inuencing bystander atudes and behaviour

Work focusing on bystander atudes and behaviour represents a growing body of work that recognisesthe value of “working with men and boys as potenal allies, and to culvate their commitment to andcapacity for prevenng and intervening.”31

A rigorously evaluated sexual violence prevenon programme aimed at increasing the role of thebystander, based on a community of responsibility model, demonstrated both atudinal and behaviourchange which were sustained over me. This programme was delivered in only one session, reachingboth women and men as potenal bystanders, teaching them how to intervene safely and eecvelyin cases of sexual violence before, during, and aer incidents with strangers, acquaintances or friends32.This suggests that if an intervenon complies with the best available evidence in terms of content andtargeng, it might help to maximise impact, even with a very low level of “treatment”.

Work that aims to help people to beer protect children in their families and communies is premisedon the belief that equipping people with informaon helps them be more alert to the warning signs in

the behaviour of a “would–be abuser”, themselves or others, and encourages and supports them to takeacon to stop it. StopitNow has been implemenng such programmes in the United States since 1992,

28 Finkelhor, D. (2009), “The prevenon of Childhood Sexual Abuse”, hp://www.unh.edu/ccrc/pdf/CV192.pdf29 See for example: hp://www.steppingstonesfeedback.org/index.php/page/Resources/gb?resourceid=230 Kim, Julia, et al . (2009), “Assessing the incremental eects of combining economic and health intervenons: the IMAGE study in South

Africa”, Bullen of the World Health Organizaon, 87(11): 82-832.31 Ricardo, Chrisne, Eads, Marci and Barker, Gary (2011), “Engaging Boys and Young Men in the Prevenon of Sexual Violence”, Pretoria: SVRI

and Promundo.32 Banyard, Victoria L., etal . (2007), “Sexual violence prevenon through bystander educaon: An experimental evaluaon”, Journalof

CommunityPsychology35, Issue (May 2007): 63-81.


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and the United Kingdom since 200233. It is always hard to generate reliable data about prevenon eorts,but their data about the numbers of people accessing and using their informaon and reporng concerns

to their help lines suggests that these services are reaching and informing potenally protecve adults,both men and women.

TERTIARY LEVEL PREVENTION: REDUCING RISKS THROUGH WORK WITHOFFENDERS AND THOSE WITH HARMFUL SEXUAL BEHAVIOUR; CURRENT PRACTICEAND THINKING

Much of the work that is labelled “prevenon” of sexual violence against children focuses on work with

those who have already been convicted. It certainly dominates the more accessible literature on the topic.

The assumpons underpinning this focus area are that:

n The majority of those engaged in harmful sexual behaviour with children are men and boys;

n Most sex oenders start sexually abusive behaviour as children or young adults;

n Early intervenon is helpful in reducing the risks of perpetraon; and

n Many intervenons have only been tried and tested in high–income, high–resource environments andnew models of work that can be helpful in low–income contexts need to be found.

While the focus of much of the rest of this paper has been on prevenng sexual violence in the rst instance,there is interest in and support for work with those who are convicted of sexual oences against childrenas a means of reducing the risks of further oending. Much of the evaluated pracce around prevenonhas focused on this terary prevenon work with individuals post–oence. Despite its prevalence in theliterature and discussions, there are limitaons:

n The vast majority of the work is taking place in the United States, Northern Europe and Australia. Thereare very few studies in low resource contexts;

n Lile or no data rigorously comparing outcomes of dierent terary prevenon approaches; and

n Almost no comparison of the costs and impact of terary versus primary or secondary prevenoneorts.

There are downsides to this approach; its dominance limits the development of alternaves. Certainlyin many contexts terary prevenon work receives all, or a disproporonate share, of the availableresources, which in turn curtails the development of, or even thinking about, other models. This limitsopons and discourages innovaon.

It is probable that simply transferring any model of pracce from one context to another is neither possiblein terms of resources, nor eecve in terms of outcomes.

“Whilstpotenallytempng,theapplicaonofonenaon’s“soluon”inadierentcountry–intheabsenceofananalysisoftheulityofthat“soluon”tothedierenttypesandcircumstancesofabuseinthatcountry–canleadtopoorpolicyandpraccethatfailstotackletheproblemofCSA[childsexualabuse].Everynaonneedsthecondenceandknowledgetodevelopanddeploya responsesuited to its owncircumstances rather than to simply implementsoluonscreated

elsewhere” 34.

33 See: hp://www.stopitnow.org.uk/; hp://www.stopitnow.org/34 Lucy Faithfull Foundaon (2013), Eradicang Child Sexual Abuse project yer.


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But terary prevenon work has demonstrated some posive outcomes. With dedicated resources andthe polical and public support to develop intense therapeuc models of work for convicted child sex

oenders, there are indicaons of reducons in rates of recidivism. However, opinion around impactis divided. Research suggests that good assessments, that idenfy good candidates for therapeucprogrammes, are crically important; i.e. terary prevenon programmes are not universally eecve.There are chronic oenders, perhaps 10% of those convicted of sexual oences against children35, whohave oended over most of their lives, show lile movaon to change and oend against large numbersof children; these oenders are very dicult to deter through standard intervenons. For them, alternaveapproaches may be necessary. This suggests that risk predicon and good assessment are key elements inselecng the right candidates for therapeuc programmes.

It has been suggested that many of the available tools, though widely used, are of limited value and that

community–based programmes are generally more eecve than prison - based programmes, althoughthe majority of investment goes to prison-based work36. This may be the result of high rates of publicconcern and polical pressure to be seen as punishing, controlling and containing such oenders.

Some approaches that take place outside of correconal instuons are being implemented and evaluated.One model of working in communies with professional supervision and management through systemsof community support, oversight and accountability is the Circles of Support and Accountability (COSA)programme. This uses groups of volunteers with professional supervision to support sex oenders as theyreintegrate into society aer their release from prison. Evaluaons of COSA indicate that parcipaon in aCOSA programme can result in stascally signicant reducons in repeat sexual oences in 70% of cases,

relave to that predicted by risk assessment or matched comparison subjects37

. While such results areextremely encouraging, more work and longer term evaluaon are needed to strengthen the evidence forsuch work, and to determine if and how such a model might be adapted to dierent contexts.

Currently, there is lile or no exchange and reecon that crosses the very established silos that separateterary prevenon intervenons from eorts that might be labelled as primary or secondary prevenoneorts. In the absence of a common language, shared indicators and dierent ways of reporng success,this segregaon or separaon is perpetuated. This means that opportunies for learning, sharing resultsand adaptaon are extremely limited. A project being coordinated by the Lucy Faithfull Foundaon projectECSA38 aims to nd out more about eecve and promising primary, secondary and terary prevenonresponses to child sexual abuse from around the world, and facilitate an acve discussion and exchange.At the heart of the work is support for “out of the silo” thinking and debate, creavely connecng peopleemploying diverse strategies and expanding the focus. By sharing and supporng reecon and discussionon the best available evidence from primary, secondary and terary prevenon work, the project hopes tosupport the development of responses and prevenon eorts that are realisc, sustainable and eecve.

Work with adolescents with harmful sexual behaviours

Given esmates that a very signicant percentage of those sexually abusing children are themselves underthe age of eighteen, and that most men who will ever perpetrate a rape will do so for the rst me asadolescents39, it is important to explore what we know about reducing the risks of oending/re-oendingby adolescents.

35 Smallbone, S., Marshall, W.L., and Wortley, R. (2008), “Prevenng child sexual abuse: Evidence, policy and pracce”, Cullompton, Devon:Willan Publishing.

36 Ibid.37 Wilson, R. J., Cortoni, F., and McWhinnie, A. J. (2009), “Circles of Support & Accountability: A Canadian naonal replicaon of outcome

ndings”, SexualAbuse:AJournalofResearch&Treatment, 21(): 12-30.38 See: hp://www.lucyfaithfull.org.uk/oak_foundaon_internaonal_toolkit.htm39 Jewkes, R., etal . (2011), “Gender inequitable masculinity and sexual entlement in rape perpetraon in South Africa: ndings of a cross-

seconal study”, SVRI and South African Medical Research Council.


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Young people who sexually oend are a diverse group, with dierent backgrounds, oence and risk prolesand treatment needs. There is research that oers some opmism about the potenal for reducing the

risks of sexual oending by young people0

. It stresses the importance of not viewing adolescents just as“small adults”; work with young people needs to take full account of the specic developmental stageand needs of this populaon. It also suggests that intervenons should be holisc, looking both at thespecic abusive behaviour, but also wider aspects of the young person’s funconing, cing the posiveresults generated by developmentally specic cognive behavioural work. There is evidence that suchapproaches have supported young people to move away from spiralling paerns of sexual abuse intoappropriate and healthy forms of sexual expression41.

Work that is explicitly resilience- based is interesng and promising. It takes account of the fact that not allchildren exposed to the same risks or adversies will respond in the same way. Many young people with

harmful sexual behaviours have low self esteem, limited life opportunies and chances to set their owngoals; all factors that are suggesve of low levels of resilience. Work aimed at strengthening resilience andenhancing self esteem and social competence may be crical in helping them change, something that canbe lost in the intervenons that focus only on the decits or problemac behaviours.

“Programs that appear most likely to demonstrate treatment eects are those that address funconing in a broad range of areas, including the individual, family, school and communitysystems...arelianceonindividual–levelintervenonsbythemselvesappearsunlikelytoleadtothereduconsinrecidivismassociatedwiththemoreholisctreatmentapproaches.Italsoappears

thatinvolvementoffamiliesisanadjuncttosuccessfultreatment.” 42

Community-based intervenons can be delivered at signicantly lower cost than those relying onresidenal provision, and may be more or as eecve.

Opmism about the future for young people with sexually harmful behaviour is also based on anunderstanding that the rates of transion from adolescent to adult sex oender are now thought to bemuch lower than previously assumed. The challenge for programmes for adolescents who sexually oendis therefore to provide “high quality assessment” and “appropriate intensity of intervenon for higher–risk youth, while ensuring that valuable treatment resources are not wasted and that lower–risk youthand their families are not drawn into intensive, protracted, and oen highly intrusive intervenons.”43

PREVENTING SEXUAL EXPLOITATION BY REDUCING THE RISKS OF BEING SEXUALLYEXPLOITED

To prevent the sexual exploitaon of children it is necessary to understand the risks that make it morelikely that someone will be a vicm, and how risks and protecon interact. These risks and protecvefactors operate at a range of levels – from societal and structural to individual, family and community.However, it needs to be remembered that many of these factors are linked. Many children’s lives arecharacterised by a range of risks that create complex, connected dicules that demand a range ofconnected or coordinated opportunies and/or intervenons to break the vicious cycle of disadvantage

and vulnerability. Dening children by any one “label” is a gross distoron of their reality.

0 Hacke (200), “What works for children and young people with sexually harmful behaviours?”.41 Ibid.42 Nisbet, Ian, Rombouts, Sacha and Smallbone, Stephen (2005), “Impact of programmes for adolescents who sexually oend”, NSW

Department of Community Services.43 Ibid.


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Previous experience of sexual exploitaon

Much of the work on sexual exploitaon to date has focused on rescuing children from situaons ofexploitaon, and supporng and facilitang their physical and emoonal recovery. These projectsrecognise the importance of and potenal for “prevenng future exploitaon” through supporngchildren to successfully and permanently exit a situaon of sexual exploitaon, on the basis that childrenwho have been sexually exploited are at a much increased risk of being re-exploited in the future. Thefocus of the work is thus both recovery and successful reintegraon44.

There has been considerable debate about what is eecve in facilitang the recovery and reintegraonof children who have been sexually exploited. The data is limited; in most instances there has been nomedium or long term follow up or tracking of the aected children and their communies; thus the data

on the real impact in terms of risks of reintegraon is very limited.

A qualitave research project in India, supported by the Oak Fellow on Recovery and Reintegraon fromUHI/Perth College, with the School of Women’s Studies at Jharkhand University, followed by a consultaonwith praconers, idened some key recommendaons for pracce45:

n Engaging with and listening to children to get their inputs into the development of programmes andpolicy. The absence of children’s voices in design, monitoring and evaluaon of intervenons was asignicant weakness in ensuring that services responded to the needs of children and their families,and remained on track as the situaon evolved;

n Developing relevant, real and sustainable opportunies for educaon, training and work, toprovide alternave sources of income for children and their families. Many of the exisng projectswere cricised for their lack of relevance in terms of longer term livelihood and income generaonopportunies; some had very high operang costs and were probably not scalable or replicable. Manybore no relaonship to market realies and longer term job opportunies; and

n Working with communies to reduce sgma. For many girls, in many contexts, the community connuedto blame the children for their abuse, and perceived them as “damaged”. One of the consequences ofthis was that the girl and her family search for a marriage as soon as possible. In one follow up studyundertaken by Groupe Developpement, both the girls and their families saw marriage, as quickly aspossible, as the best possible outcome. Given that the negave atudes towards these girls connueto prevail in many communies and may well be shared by prospecve husbands, there are clearlyconcerns about the nature of some of these marriage contracts46.

More broadly, the work undertaken through UHI-Perth College as a follow up to the Asquith and TurnerReport47, has included a review of current pracces focused on reintegraon (“going home”), integraoninto new communies, safe accommodaon, and educaon and training. Four working papers highlightwhat is currently being implemented. However, these papers emphasise the lack of research and rigorousevaluaon, the absence of consensus on what constutes success and almost no longitudinal studies todemonstrate the sustainability of changes in risk factors48. This makes it dicult to compare ndings, drawout learning and idenfy successful strategies to inform future development of pracce and policy. Work

on establishing an agreed framework for monitoring and evaluang pracce is ongoing9.

44 hp://www.childrecovery.info/ is a website, supported by Oak Foundaon, aimed at expanding and exchanging experse and insights frompraconers and researchers across regions.

45 School of Women’s Studies (2012), “Look at us with respect: Percepons and experiences of reintegraon: The voices of child survivors ofsexual exploitaon and praconers in West Bengal and Jharkhand”, India: Jadavpur University.

46 Ibid .47 Asquith, Stewart and Turner, Elspeth (2008), “Recovery and Reintegraon of Children from the Eects of Sexual Exploitaon and Related

Tracking”, Geneva: Oak Foundaon.48 The Child Recovery and Reintegraon Network, The “what do we know about...” series, hp://www.childrecovery.info/Our-working-

papers.175.0.html9 See: hp://www.childrecovery.info/leadmin/pdf/130116_M_E_Reintegraon_Toolkit_Plan.pdf


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Barnardo’s specialist intervenons with sexually exploited children in the UK have idened a range offactors associated with increased risks of being sexually exploited. Their intervenons targeted reducing

these risks and/or strengthening the protecve factors. The outcomes included:

n A reducon in the number of episodes of going missing;

n Reduced conict and improved relaonships with parents and carers;

n Access to safe and stable accommodaon;

n An improved ability to recognise risky and exploitave relaonships; and

n An increased awareness of their own rights.

Taken together, they concluded that these outcomes represented a signicant reducon in the risk of theongoing sexual exploitaon for the young people concerned50. This might be both a secondary and teraryprevenon strategy, targeng both those who have already been exploited and those considered at highrisk.

Oak Foundaon, with the support of an expert advisory group and local research teams in three researchsites (Bulgaria, Ethiopia and Nepal), commissioned acon research, the Bamboo project, designed to ndout more from children about if and how the dierent factors that may contribute to resilience interactwith and inuence risks of and recovery from sexual abuse and sexual exploitaon 51. The project is rstand foremost about listening to children, to understand more about their experiences, to inform thinkingand the development of intervenons. The risks idened conrmed much of what is already known, andincluded:

n Disrupted families and weakened support networks, whether the result of children moving, familymembers migrang or the death of parents;

n Experience of abuse and its impact on self-percepon and self-esteem resulng from and reecngthe negave percepons of others towards vicms of abuse;

n Experience of violence in families, communies and schools;

n Economic imperaves, and the lack of alternave means of earning money or supporng themselves;

n Being out-of school;

n

Peer norms – feeling part of, and being supported by a group in which sexual exploitaon was acommon pracce; and

n Targeng by exploiters.

The research also asked children about what had helped them overcome their experiences of abuse andexploitaon. Most children cited informal sources of support as the most important; individuals in thelocal community who supported them, treated them with respect, provided basic needs and were oeninstrumental in conrming their worth and inherent dignity.

Understanding and addressing risks associated with domesc work

Children in domesc work face a combinaon of factors that make them incredibly vulnerable to abuse;isolaon, dependence, power dierenals, separaon from family and other support networks, lowstatus, low self esteem and lack of alternaves. According to the Internaonal Labour Organizaon (ILO),17.2 million children are in paid or unpaid domesc work in the home of a third party or employer52.50 Sco S. and Skidmore P. (2006), “Reducing the risk: Barnardo’s support for sexually exploited young people, a two-year evaluaon”, Essex:

Barnardo’s, hp://www.barnardos.org.uk/reducing_the_risk_report.pdf51 More informaon available on the Oak Foundaon Bamboo Project website: hp://www.oakfnd.org/node/131852 Internaonal Labour Organizaon, “Child labour and domesc work”, hp://www.ilo.org/ipec/areas/Childdomesclabour/lang--en/index.

htm


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This carries inherent risks of abuse and exploitaon, including non-payment of wages, physical violence,emoonal abuse and sexual abuse53.

The Bamboo research project in Ethiopia and Nepal found that the experience of abuse and exploitaon indomesc work was one of the factors that precipitated or contributed to the move into sexual exploitaon.Children in Ethiopia commented on the lack of any alternave way of earning money once they le theirwork place, as a result both of the immense sgma they felt was associated with being a vicm of sexualabuse, and their own lack of qualicaons/marketable skills.

Research with children in domesc work suggests that the intervenons which appear to be having themost posive impact for child domesc workers are those which seek to: “(1) maintain or re-establishcontact between the child and her/his close relaves; (2) intervene directly with their employers in a

non-confrontaonal way; (3) support the establishment and strengthening of groups of domesc workersto represent and help themselves; (4) encourage child domesc workers back to educaon and to retainthem by, for example, making schooling more child-friendly, in parcular, more girl-friendly”54.

Experience of violence and other forms of abuse in early childhood

Several studies (generally from North America or Europe) have suggested that one of the primary risksassociated with being sexually exploited is the experience of abuse in childhood, parcularly sexual abuse(although it is also clear that only “a small proporon of children who are sexually vicmized subsequentlybecome involved in trading sex for goods or money.”)55 Child sexual abuse, parcularly severe forms, and

the co-existence of physical abuse, is a signicant risk factor for sexual revicmisaon56

. Child sexual abuseis also associated with engagement in high-risk sexual behaviour, such as early age of sexual acvity,mulple sexual partners and “selling or exchanging” sex57. Studies suggest that the experiences areconnected both through the psychological and emoonal consequences of abuse, and the increasedlikelihood of engaging in high-risk behaviours – leading to “a vicious cycle for many youth.” 58

One study involving in-depth qualitave research with forty-seven young and older people (all involvedfrom an early age in prostuon) described how in order to exit and recover from such exploitaon, theyhad to overcome some very concrete dicules59. These may have preceded or happened alongside theirsexual exploitaon. They included nancial dicules and debt; drug dependency; single parenthood;lack of qualicaons and training to enable them to look for alternave employment; housing problems;

criminal convicons (through prostuon); and abusive partners and/or pimps. Furthermore, manyexperienced low self-esteem, depression and other mental health problems. The same challenges werealso highlighted by the young people who parcipated in the Bamboo study in Ethiopia. The longeryoung people remained involved, the more entrenched became the paerns of behaviour that kept themexploited, making it dicult for them to nd a way out, parcularly when they had lost contact with familyand friends and their most direct peer groups were also all involved in sex work60.

Most studies highlight a range of negave developmental experiences that are present in the lives ofmany of the young people who are sexually exploited/engage in sex work in later life. These include familyproblems; arguments at home; abuse and/or violence; running away from home or from substute care;truanng from school; peer pressure; drugs; and losing contact with family and social networks.

53 See: Blagbrough, Jonathan (2008), “’They respect their animals more’: Voices of child domesc workers”, An-Slavery Internaonal, hp://www.anslavery.org/includes/documents/cm_docs/2009/t/they_respect_their_animals_more_08.pdf

54 Children Unite (2013), “Policy Brieng: Child domesc work and the 2013 World Day Against Child Labour”, 12 June 2013, hp://www.childrenunite.org.uk/wp-content/uploads/2011/12/Policy-Brieng-WDACL.pdf

55 Lalor, Kevin and McElvaney, R. (2010), “Child Sexual Abuse: Links to Later Sexual Exploitaon/High-Risk Sexual Behaviour and Prevenon/Treatment Programmes”, TraumaViolenceAbuse 11(): 159-77.

56 Classen (2005), cited in Lalor and McElvany (2010), ibid .57 Spatz Widom, C. and Kuhns, J.B. (1996), “Childhood Vicmizaon and Subsequent Risk for Promiscuity, Prostuon, and Teenage Pregnancy:

A Prospecve Study”, AmericanJournalofPublicHealth 86(11):1607-1612; an interesng prospecve study that followed over 1000 peopleover me.

58 Stoltz, etal . (2007), cited in Lalor and McElvaney (2010).59 Taylor-Browne, Julie (2002), “More Than One Chance: Young People Involved in Prostuon Speak Out”, London: ECPAT UK.60 See: Oak Foundaon, The Bamboo Project on Child Resilience, hp://www.oakfnd.org/node/1318


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Separaon from family, including those in state care

Children who are separated from their families face a heightened risk of being sexually exploited. This maybe the result of the combinaon of dicules and disrupons, including those experienced in the familyof origin, possibly some form of abuse, the death of a parent or poverty. Children who migrate or movewithout their families are extremely vulnerable to sexual exploitaon, in transit and/or on arrival. Thismight be due to both those early life dicules that lead to the separaon, and to the loss of a protecveor support network. Children on the move, children in state care and children living and working on thestreet are all also targeted by exploiters, making these children especially vulnerable.

A signicant percentage of women and girls currently involved in sex work or being sexually exploitedwill have been in state care at some stage in their lives. A Report from the UK Children’s Commissioner

suggests that exisng literature on child sexual exploitaon in the UK indicates that between 20% and35% of sexually exploited children are or have been in care, i.e. they are massively over-represented inthe numbers of sexually exploited children61. Work in the UK has highlighted the targeng of such childrenby potenal exploiters, who are alert both to failings in the system, and to the ease with which thesechildren, who mistrust or are alienated from most other adults, can be manipulated and exploited.

In addion, children leaving the care system in many countries have few sources of support. Services andsupport oen stops when children leave instuons, or reach 18 years of age. This might be the resultof gaps in educaon, lack of income and earning opons, high risk behaviours and/or poorly developed

judgements that would help them idenfy risks and disnguish between posive and exploitave

relaonships.

Being out of school

Recognising the range of risks linked to the lack of access to educaon, there is a substanal body of workaimed at promong and sustaining girls’ enrolment in school. Much of this work measures outcomes interms of enrolment or school aendance; few programmes look in detail at if and how this impacts on theexperience of sexual exploitaon and other forms of violence. The Girl Eect website62 provides incrediblypowerful data on the range of benets for the individual, family, community and country that can begenerated by improving girls’ access to school. Stascs shows that if adolescent girls stay in school,

compared to their out of school peers, they start sexual acvity later, are less likely to be subjected toforced sex, and if sexually acve, are more likely to use contracepon. They are likely to marry later andhave fewer children. As a primary and secondary intervenon, there would appear to be some very clearbenets of geng and keeping girls in school.

The Berhane Hewan project in Ethiopia63 showed signicant impacts on the social, educaonal andhealth status of adolescent girls in a relavely short period of me. The programme included communityengagement on issues around early marriage and educaon for girls, coupled with economic incenvesthat were provided to families who did not marry o their daughters during the project period. Given thatearly marriage is both abusive and exploitave, and linked with increased risks of other forms of sexualexploitaon (as for many girls the only opon for geng out of an abusive marriage may be throughrunning away and having to nd any means of earning a living on their own), this approach oers aninteresng example of a secondary prevenon intervenon.

61 Oce of the Children’s Commissioner (2012), “Brieng for the Rt Hon Michael Gove MP, Secretary of State for Educaon, on the emergingndings of the Oce of the Children’s Commissioner’s Inquiry into Child Sexual Exploitaon in Gangs and Groups, with a special focus onchildren in care”, hp://media.educaon.gov.uk/assets/les/pdf/o/occ_accelerated_report_for_the_secretary_of_state_for_educaon.pdf

62 See: hp://www.girleect.org/explore/taking-the-girl-eect-to-scale/deck-assets-the-world-for-girls63 Erulkar, Annabel S. and Muthengi, Eunice (2007), “Evaluaon Of Berhane Hewan: A Pilot Program To Promote Educaon & Delay Marriage in

Rural Ethiopia”, Populaon Council.


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While the data makes the benets of girls being in school very clear, it must also be noted that schoolsthemselves, and the journey to school, can increase the risk of sexual violence. Eorts to reduce these

risks, through community engagement and improved accountability for the behaviour of teachers andothers within the schools (and in other organisaons), have helped to deliver safer spaces for girls64.

Being out of school is also associated with increased risks of becoming part of a gang. Recent work –parcularly in South Africa65 and the UK66 – has highlighted the importance of gang membership, both as arisk factor for being sexually abused and/or exploited, and for becoming a perpetrator of sexual violence.

Poverty

Poverty is recognised as a major risk factor that works on a number of dimensions of risk, including child

marriage, sexual violence, including sexual exploitaon, but also inadequate care and increased risks ofall forms of violence67.

In many cases, the connecons are simple and obvious. Children without an alternave means ofgenerang an income to meet basic needs are at higher risk of being sexually exploited. Where parentshave to work outside the home, in the absence of alternave forms of child care, even very young childrencan be le unsupervised. In other cases, the connecons are more complex but the evidence suggestsclear connecons between signicant child protecon decits or risks and poverty.

Much of the work undertaken on assessing and addressing some of the risky behaviours associated with

economic drivers comes from HIV/AIDS related work. The exchange of sex for money or gis in sub-Saharan Africa has been widely reported. It is generally interpreted as a consequence of women andgirls’ poverty and economic dependence on men68. Many have noted that impoverishment makes youngerwomen vulnerable to the encements of older men or ‘sugar-daddies’69. Recent research in Tanzania70 hashighlighted how such behaviour can change social norms. This research idened how there is a growingacceptance and expectaon that adolescent girls provide sex (to boyfriends) in exchange for nancialand other benets that are used for meeng basic needs, including school fees. The social norms (ofat least certain reference groups) suggest that girls and young women might under-value themselves ifthey did not negoate some form of remuneraon in exchange for sex. In turn, families are informed andinuenced by such norms. One consequence is that they oen do not allocate any or sucient familyresources to their adolescent girls, assuming that their “boyfriends” will meet the shorall. One of theconsequences of this is the increase in the number of sexual partners, to maintain or increase the “gis”or payments received over me.

Projects implemented by BRAC in Uganda, for example, have demonstrated that eorts aimed exclusivelyat economic opportunies have shown less posive and sustained change than those that combinehealth-related educaon with livelihood or life skills training. This suggests that there has been greatertake up of the health-related messages when these are oered alongside opportunies for cash transferprogrammes and other economic incenves such as income generaon. Similarly, the impact of livelihoodtraining was greater when given alongside informaon that helped reduce the girls’ exposure to risky

64 See: hp://www.chsalliance.org/who-we-are65 Jewkes, Rachel, etal . (2009), “Understanding Men’s Health and Use of Violence: Interface of Rape and HIV in South Africa”, Pretoria: Medical

Research Council.66 Jago, Sue, etal . (2011), “What’s going on to Safeguard Children and Young People from Sexual Exploitaon? How local partnerships respond

to child sexual exploitaon”, University of Bedfordshire.67 Marcus, Rachel (201), “Child Protecon Violaons and Poverty in Low and Middle Income Countries”, ODI, hp://www.odi.org/

publicaons/90-child-protecon-violaons-poverty-low-middle-income-countries68 For example, Dunkle, K., etal . (200), “Gender-based violence, relaonship power, and risk of HIV infecon in women aending antenatal

clinics in South Africa”, TheLancet 363(919): 115-121.69 See for examples: hp://www.unicef.org.mz/cpd/references/8-womenGirls_AgeDisparate.pdf70 Wamoyi, Joyce, etal . (2010), “Transaconal sex amongst young people in rural northern Tanzania: an ethnography of young women’s

movaons and negoaon”, ReproducveHealth 7(2).


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hp://www.oakfnd.org/node/1318

hp://www.partners4prevenon.org

hp://www.steppingstonesfeedback.org/index.php/page/Resources/gb?resourceid=24

hp://www.stopitnow.org/

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Towards a PrevenonFramework for ChildSexual Exploitaon

by: Sallie Yea

INTRODUCTION

The prevenon of the sexual exploitaon of children (SEC) has been the subject of wide-ranging non-governmental and governmental intervenons over the past twenty-ve years, with the United NaonsConvenon on the Rights of the Child (CRC) forming an inial locus for acons. Prevenon of SEC ishighlighted in internaonal human rights mechanisms and declaraons, as well as in the mandates of


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UN Special Procedures and the Special Representave of the Secretary-General on Violence againstChildren. The CRC, the Oponal Protocol on the sale of children, child prostuon and child pornography

(OPSC), and the Protocol to Prevent, Suppress and Punish Tracking in Persons, especially women andchildren (Palermo Protocol), all require that States Pares take measures to prevent SEC. These measuresinclude the adopng or strengthening of legislaon and policies, promong awareness-raising campaigns,establishing educaon and training programmes and conducng research.1

While intervenons aimed at SEC vicm protecon and recovery are endless,2 in perusing the availableliterature, relavely lile published work has appeared on the development of a prevenon frameworkto guide intervenons in combang SEC, including evaluaons of their eecveness and possibiliesfor replicaon as examples of good pracce.3 More signicantly, there has been lile progress towardsdeveloping a similar framework to that which has been developed in relaon to protecon/recovery.4 Indeed, this situaon tends to mirror that of the development of intervenons in the related an-

tracking sector, where it has been widely recognised that prevenon work has not proceeded with thesame degree of rigour or success as protecon and prosecuon intervenons, despite the importanceaributed to prevenon work in internaonal laws on human tracking and child rights.

The aim of this paper is to work towards the development of a framework to enhance the eecvenessof intervenons aimed at prevenng SEC. The focus on prevenon is sorely needed because, as suggestedabove, it tends to be less systemacally treated in eorts to reduce SEC than eorts at either proteconor criminalisaon. The paper aempts to achieve this aim by considering the applicability of elementsof prevenon frameworks developed in relaon to the public health sector, and through a consideraonof various types of vulnerabilies that have led to SEC by drawing on diverse case studies globally todevelop typologies. Arguably, and as has been recognised by others,5 SEC has not been addressed in a

comprehensive and, more signicantly, coordinated manner, which in large part explains the relaveineecveness of long-term prevenon work in the eld. For example, the key intervenons aroundprevenon to date have been based on either a criminal jusce approach, which priorises invesgaonand criminalisaon of oenders (and possibly their rehabilitaon), or on an awareness-based approach,which can be oriented to the general public or to target groups, such as tourists, educators and so on.While the eecveness of these intervenons and approaches on which they are based is variable at best,they do illustrate that there are signicant gaps in approaching prevenon in SEC more broadly and inproviding a guiding logic and integrated approach to exisng intervenons.

A public health prevenon framework model is parcularly signicant because it disnguishes betweenthree (possibly four) levels of intervenon: 1. Primary Prevenon (that is, prevenng SEC before it would

otherwise occur); 2. Secondary Prevenon (that is, prevenng SEC in groups considered to already behigh risk); and 3. Terary Prevenon (that is, prevenng further SEC oences through intervenons whichspecically target child vicms and/or oenders). There have been aempts to apply this framework torelated sectors aimed to enhance the rights and protecon of children, such as child welfare.6

This paper begins with a brief review of recent studies of SEC, including CSEC, with the aim of drawing outthe major risk and vulnerability factors inuencing its manifestaons, which ulmately will help to idenfyrisk factors (which are central to conceptualise in the context of prevenon work). Following this, the mainelements of the widely-adopted public health prevenon framework are introduced, and a prevenonframework is proposed for SEC, drawing on and adapng this framework. Addional principles are thenbriey outlined for the eecve implementaon of the framework.

1 See Arts. 3 & 35 of the CRC, Art. 9 of the OPSC and Art. 9 of the Palermo Protocol.2 More signicantly, there have been several eorts to develop a framework for vicm protecon and recovery drawing on ecological systems

theories and concepts (parcularly noteworthy is that developed by: McIntyre, Bonnie L. (201), “More than just rescue: Thinking beyondexploitaon to creang assessment strategies for child survivors of commercial sexual exploitaon”, InternaonalSocialWork 57(1): 39-63).

3 Warburton, J. (2016), “Prevenng the Sexual Exploitaon of Children: A Mapping of Prace and Intervenons”, ECPAT InternaonalJournalNo.11, Bangkok: ECPAT.

4 Important excepons are: Jones, Adele D., etal . (201), “An Integrated Systems Model for Prevenng Child Sexual Abuse: Perspecves fromthe Caribbean”, Hampshire: Palgrave; Lucy Faithful Foundaon (n.d.), ECSA Project, hp://www.lucyfaithfull.org.uk/ecsa_eradicang_child_sexual_abuse.htm

5 Barnitz, Laura (2001), “Eecvely responding to CSEC: A comprehensive approach to prevenon, protecon, and reintegraon services”, ChildWelfare 80(5): 597-610.

6 United States Department of Health and Human Services (n.d.), “Framework for Prevenon of Child Maltreatment”, Washington D.C.: US DoHHS.


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A TYPOLOGY OF RISKS & VULNERABILITY FACTORS INFLUENCING SEC

The sheer range and diversity in situaons of SEC globally render any task of generalisaon dicult.Studies have shown various predictors (indicators) for the prevalence of SEC, including family background,7 ethnicity/ethnic minority status,8 school dropout and/or previous experiences of physical assault,9 socio-economic status,10 physical disability11 and cultural norms and values.12 These various indicators havebeen idened for dierent contexts, including Switzerland, the United States, South Africa and thePhilippines. Rather than expounding on individual factors (as in the studies cited above), I extrapolatethese various risk and vulnerability factors according to six types. These are: structural, situaonal,relaonal, environmental, personal (related primarily to potenal vicms) and demand-led factors (whichrelate primarily to potenal clients, perpetrators and other beneciaries, such as business owners andintermediaries/facilitators). These are of course arbitrary demarcaons and others may idenfy addional

categories, or amend the on

ecpat journalapril2016

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