Child homicide—speaking of the unspeakable

New estimates published in PLOS Medicine suggest that homicide could be responsible for just over 1% of all neonatal deaths in South Africa. Together with other studies reporting on child homicide from other countries, these findings emphasize the importance of child protection, and highlight a need for cross-sector services to support vulnerable mothers.

In the research, Naeemah Abrahams of the South African Medical Research Council, Cape Town, South Africa, and colleagues studied medical and legal data, from a random sample of urban and rural settings across the country, for 2009. The researchers estimated that 454 children (95% Confidence Interval 366-541) under the age of 5 years were killed. Most deaths were in infants aged 0-6 days, with abandonment being the most common method of homicide in this age group.

Obtaining accurate estimates of the occurrence of child homicide is challenging, because causes of deaths may be hard to determine. In an accompanying Perspective, written by authors independent of the research team, Delan Devakumar and David Osrin of University College London, UK note that Abrahams and colleagues used the best methods available to them, culminating in estimates of child homicide that are "substantial". Devakumar and Osrin note that "protecting vulnerable children is a priority" and that primary prevention should be strengthened by work "with adolescent women to provide advice and support on sexual health, contraception, and childbirth".