Laboratory of Violence, Vulnerability and Humand Health (LVVH): a proposal to detect, quantify and reduce damage promoted by violence against children and adolescents in São Paulo

Abstract

In the municipality of São Paulo, in 2022, 30.8% of general violence notifications (all types) occurred with victims between 0 and 19 years, 70.2% against female children and adolescents. The residence was the place of violence against children and adolescents (VCA) in 69.8% of all types of violence. Although Law No. 14,247, of December 8, 2006, at the municipal level and coping plans outlined by the São Paulo City Hall, the Understanding of VCA cases is still very high. Most accurate methods for suspected cases detection through secondary data can contribute to a better understanding of the phenomenon, such as the identification of silent health facilities, estimating undernotification and directing the implementation of measures. This proposal aims to contribute to the improvement, updating and complementation of public policies in execution (PEX) of the line of Full Health Care of the Person in Situations of Violence (2015), the Municipal Plan by Early Childhood (2018-2030) and the Municipal Plan to confront sexual violence against children and adolescents (2023), in São Paulo. The research proposal is based on two of the seven strategies to end violence against children - Inspire, WHO (2016). The main objective of the proposal is to reduce the undernotification cases of VCA by detecting suspicious, unmarked cases. To this end, the research will involve analysis of databases, assessment and methodological innovation through the development of the construction of classification rules to predict the likelihood that a child/adolescent has suffered violence based on information from hospital hospitalizations and primary health care and through analysis and spatial modeling. Through linkage procedures, it will be possible to reconstruct the victims' trajectory in public health systems, identifying the passage of each individual in each of the systems. The algorithm should contribute to the detection of suspicious cases to be referred for verification. Spatial analysis from the geocodification of secondary data from various sources will allow the identification of "hot spots" of VCA cases and the design of localized prevention and intervention actions.As a result, it is expected to detect suspicious cases and increase VCA notifications. A pilot project in public and private health services will be developed for testing and assessing the algorithm. Next phase, the Municipal Health Secretariat may implement the algorithm in its routine to track suspicious cases continuously, automatically. In this process is planned the training of servers for the database and algorithm database linking steps. The VCA is related to the violence of the neighborhood of the place of residence of the child and adolescent. In this sense, its confrontation requires an approach that involves sectors necessary to reduce violence in general - urban planning to increase safety in the vicinity, the housing sector to improve housing, among others. Understanding VCA's relationship with the urban environment can contribute to the elaboration of multiserial programs. The identification of VCA Hot Spots will indicate areas that must undergo direct interventions and prevention programs. Additionally, it will be possible to explore the scientific potential of existing databases to understand a phenomenon as complex as VCA. The project will subside implementation in VCA public policy throughout the state of São Paulo, directing actions to be implemented in the other 644 municipalities of the state. The duration of the 4 -year project will allow the intersectoral relationship to be promoted, enabling the mobilization of other areas of the City Hall to contribute to the project. (AU)