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Much violence against children remains hidden and is often socially approved, according to the United Nations Secretary-General's Study on Violence against Children presented yesterday to the UN General Assembly. For the first time, a single document provides a comprehensive global view of the range and scale of violence against children. Violence against children includes physical violence, psychological violence, discrimination, neglect and maltreatment. It ranges from sexual abuse in the home to corporal and humiliating punishment at school; from the use of physical restraints in children's homes to brutality at the hands of law enforcement officers; from abuse and neglect in institutions to gang warfare on the streets where children play or work; from infanticide to so-called "honour" killing. "The best way to deal with violence against children is to stop it before it happens," says Professor Paulo Sérgio Pinheiro, the Independent Expert appointed by the Secretary-General to lead the Study. "Everyone has a role to play in this, but States must take the primary responsibility. That means prohibiting all kinds of violence against children, wherever it occurs and whoever is the perpetrator, and investing in prevention programmes to address the underlying causes. People must be held accountable for their actions but a strong legal framework is not only about sanctions, it is about sending a robust, unequivocal signal that society just will not accept violence against children." The Study, which combines human rights, public health and child protection perspectives, focuses on five 'settings' where violence occurs: the home and family, schools and educational settings, institutions (care and judicial), the workplace, and the community. Extreme violence against children may hit the headlines but the Study concludes that for many children violence is routine, a part of their daily reality. Although much violence remains hidden or unreported, and figures therefore often underestimate the scope of the problem, the statistics in the report reveal a startling picture. For example: Although the consequences may vary according to the nature and severity of the violence inflicted, the short- and long-term repercussions for children are very often grave and damaging. The physical, emotional and psychological scars of violence can have severe implications for a child's development, health and ability to learn. Studies have shown that experiencing violence in childhood is strongly associated with health risk behaviours later in life such as smoking, alcohol and drug abuse, physical inactivity and obesity. In turn, these behaviours contribute to some of the leading causes of disease and death, including cancers, depression, suicide and cardiovascular disorders. "No matter whether it occurs in the family, school, community, institution or workplace, health workers are the front line for responding to violence against children," says Dr. Anders Nordström, WHO Acting Director-General. "We must make our contribution to ensuring that such violence is prevented from occurring in the first place, and that where it does occur children receive the best possible services to reduce its harmful effects. States should pursue evidence-based policies and programmes which address factors that give rise to such violence, and ensure that resources are allocated to address its underlying causes and monitor the response to these efforts." "Violence against children is a violation of their human rights, a disturbing reality of our societies," says Louise Arbour, United Nations High Commissioner for Human Rights. "It can never be justified whether for disciplinary reasons or cultural tradition. No such thing as a 'reasonable' level of violence is acceptable. Legalized violence against children in one context risks tolerance of violence against children generally." "Violence has a lasting affect not just on children and their families, but also on communities and nations," says UNICEF Executive Director Ann M. Veneman. "We welcome this comprehensive study on the impact of violence against children." The report to the General Assembly calls for a wide range of actions to be taken to prevent and respond to violence against children across all the settings where it occurs. Twelve overarching recommendations address areas such as national strategies and systems, data collection and ensuring accountability. At a global level, the report calls for the appointment of a Special Representative on Violence against Children, with an initial mandate of four years, to act as a high-profile global advocate to promote prevention and elimination of all violence against children and to encourage cooperation and follow-up. About the United Nations Secretary-General's Study on Violence against Children In 2001 the General Assembly requested the Secretary-General to conduct 'an in-depth study on the question of violence against children'. Independent Expert Professor Paulo Sérgio Pinheiro was later appointed to lead the Study, in collaboration with the Office of the High Commissioner for Human Rights (OHCHR), the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO).