IMPACT: Interventions and mitigations to prevent the abuse of children - it’s time - a public health oriented systems model for change

There are few issues more relevant to today’s society, both in the Caribbean and elsewhere, than those relating to child sexual victimisation and its effect on individuals, families and communities. In response to this major public health and social problem, the last three decades have witnessed the proliferation of programmes to prevent child sexual abuse (CSA). Yet questions have been raised about the scope, focus and effectiveness of these programmes in preventing CSA. While still contributing to this debate and informed by Smallbone’s et al. (2008) integrated theory and the public health model as theoretical frameworks, this chapter discusses the proposals for a model of child protection (IMPACT) which aims to translate findings from research commissioned by UNICEF into CSA in the Eastern Caribbean (Jones and Trotman Jemmott, 2009) into interventions to address the problem and to provide robust evidence of what works best in this context. Current approaches to CSA in Caribbean countries as elsewhere in the world are primarily reactive, responding only after individuals have already committed the offences. The model proposed shifts the focus from the back-end approach (identifying and punishing offenders) to an evidence-based, public health oriented prevention-centred approach (preventing CSA before it would otherwise occur, and preventing reoccurrence - secondary prevention) that mobilises families, communities, professionals and agencies in the protection of children.