Notification of abuses against children and teenagers as an intrument for detection and prevention of violence in primary healthcare in Fortaleza, Ceará, Brasil

Child abuse communication was established in Brazil in the early 1990s under the Child and Teenager Statute. According to that Statute, any suspected abuses against children and teenagers must be obligatorily notified to the relevant protection bodies. This notification makes however the health professionals face a dilemma, as there are legal, professional and emotional pressures that influence their decision. This study addresses the view of professionals engaged in primary healthcare on the notification of abuses in their day-to-day activities. This is a cross-sectional study carried out in Fortaleza, Ceará, Brazil in 2007, which included 359 physicians, nurses and dental surgeons engaged in primary healthcare. Data indicated that such professionals are aware of the importance of establishing the notification of abuses in primary healthcare, as 85.7% considered that practice beneficial. 42.6% of those professionals said that the matter is hardly discussed in the workplace, and 76.6% of them do not read usually about it. 47% of professionals have already identified cases of abuses, but 55.6% of them failed to notify the fact to the relevant authorities. Problems mentioned by such professionals, which prevented them from notifying the fact during their activities included the fear of legal and emotional involvement, lack of expertise in the field, lack of service structure to support both the victim and the professional, among others. It was concluded that the notification of abuses against children and teenagers by primary healthcare professionals is still punctual and unsystematic. In this sense, the expansion of continued training programs, the improvement of institutions for children and teenager protection, and the expansion of professional support network institutions would both reduce the level of professional insecurity and increase the number of notification of abuses.