Primary care

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

Elspeth Webb, senior lecturer, ^a Judith Shankleman, research health visitor, ^c Meirion R Evans, senior lecturer, ^b Rachel Brooks, clinical lecturer. ^a

^a Department of Child Health, University of Wales College of Medicine, Cardiff CF14 4XW, ^b Department of Epidemiology and Public Health, University of Wales College of Medicine, ^c Sure Start, Primary Care Directorate, Cardiff and Vale NHS Trust, Lansdowne Hospital, Cardiff CF11 8UL

Correspondence to: E Webb webbev{at}cf.ac.uk

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 services. 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.