Introduction

0.1 Background

It is estimated that, worldwide, up to 1 billion children aged between 2 years to 17 years have been affected by physical, sexual, or emotional violence or neglect.^[¹^] This includes being subjected to physical punishment by caregivers, bullying in school, and physical, emotional, and sexual violence. Every four minutes, a child dies due to violence somewhere in the world. On average, violence claims the lives of approximately 130 000 children and adolescents under the age of 20 every year, with boys facing a higher risk of dying from violence compared to girls.^[²^]

The United Nations Children’s Fund (UNICEF) has estimated that over 1 billion women and men alive in 2024 were subject to sexual violence when they were children. 650 million (1 in 5) girls and women alive today have been subjected to sexual violence as children. Among them, over 370 million (1 in 8) have experienced rape or sexual assault. For boys, between 410 million and 530 million (1 in 7) have been subjected to sexual violence in childhood. This includes 240 million to 310 million (1 in 11) who experienced rape or sexual assault.^[³^]

Furthermore, technology has a significant impact on children’s well-being, offering both opportunities and risks. While the internet facilitates learning, social interaction and creativity, it also exposes children to dangers such as cyberbullying, grooming, and sexual exploitation since perpetrators often exploit social media and online gaming platforms, live-streaming services, and encrypted messaging apps to distribute child sexual abuse material,^[⁴^] solicitate minors, or engage in sexual extortion.

Globally, 1,6 billion children (2 in 3) experience violent punishment by caregivers at home. Among them, over two-thirds are subjected to both physical punishment and psychological aggression, such as screaming and name-calling. Nearly 550 million children (1 in 4 globally) live with mothers who are victims of intimate partner violence, exposing them to additional risks and trauma.^[²^]

“The impact of violence is devastating, immediate and lifelong. Violence against children impairs their brain development, their physical and mental health and their ability to learn”, according to Reference [5]. While the criminal justice process is a priority for most states, child victims and witnesses of violence have the right to a holistic response that supports their full recovery.

The United Nations Convention on the Rights of the Child (UNCRC)^[⁶^] and its Optional Protocol to the Convention on the Rights of the Child on the Sale of children, child prostitution and child pornography^[⁷^] and the Council of Europe Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse (the Lanzarote Convention)^[⁸^] underscore the obligation of state parties to create systems that safeguard children from all forms of violence and abuse and adopt measures to promote their physical and psychological recovery. The United Nations Committee on the Rights of the Child systematically recommends that state parties establish child-friendly, multidisciplinary and interagency services to address violence against children and ensure that children receive timely, effective support.^[⁹^]

Multidisciplinary and interagency (MDIA) response services are a cornerstone of effective child protection systems. MDIA response services provide holistic, child-centred and child-friendly responses to violence and abuse. They bring together child welfare, criminal justice, and medical, therapeutic and legal professionals under one roof to deliver a coordinated and child-centred response.

In many contexts, the lack of integration between these services results in fragmented and inconsistent support for child victims. This often forces children to navigate complex systems alone, reliving their trauma by recounting their experiences multiple times to different professionals. The absence of a child-centred approach exacerbates the difficulty of disclosure, particularly in cases of sexual violence, where feelings of fear, shame, and stigma already act as significant barriers. MDIA response services help reduce re-traumatization for children subjected to sexual exploitation or abuse and child victims and survivors of violence by preventing the repetition of their experiences.^[¹⁰^] These services are part of a broader continuum of child protection mechanisms that address the needs of children and their families throughout the entire process of healing and protection.

MDIA principles can be adapted to a range of resource environments and governance frameworks while maintaining a child-centred approach. The Barnahus (Children’s House) model, developed in Iceland, for instance, integrates child welfare, criminal investigation, and medical and therapeutic services under one roof, minimizing the risk of re-traumatization while ensuring a coordinated response. In 2015, the Committee of the Parties to the Convention for the Protection of Children against Sexual Exploitation and Sexual Abuse (the Lanzarote Committee) recognized the Barnahus (Children’s House) model as a promising practice.^[¹¹^]

Children’s Advocacy Centers in the United States emphasize multidisciplinary collaboration, providing child-friendly environments for interviews, medical examinations, and therapy. In countries with fewer resources, community-based MDIA initiatives demonstrate the flexibility of the model, relying on community involvement to deliver services, ensuring accessibility and cultural relevance.^[⁹^]

The promotion and implementation of MDIA response services align closely with the Sustainable Development Goals (SDGs), particularly Goal 16, which aims to promote peaceful and inclusive societies, provide access to justice for all, and build effective, accountable institutions. Specifically, MDIA response services contribute to Target 16.2, which seeks to end abuse, exploitation, trafficking, and all forms of violence against children, as well as Target 16.3, which focuses on promoting the rule of law and ensuring equal access to justice. By fostering coordinated, child-centred responses, MDIA response services also intersect with SDG 5, which aims to achieve gender equality and empower all women and girls, by addressing the gendered dimensions of violence and supporting survivors, as well as with other SDG targets related to violence against children.

Efforts to establish and expand MDIA response services have been supported by a range of international and regional organizations.

The United Nations Committee on the Rights of the Child recommends that state parties establish MDIA response services.

As part of its core commitment to strengthening comprehensive child protection systems, UNICEF has consistently promoted child-friendly, integrated, and multidisciplinary services for child victims and witnesses of violence worldwide. These efforts are designed to foster coordinated, child-centred approaches that address the complex needs of children in a holistic manner.

The European Union in its Strategy for the Rights of the Child^[¹²^] has also emphasized the urgency to present an initiative aimed at supporting the development and strengthening of integrated child protection systems, which will encourage all relevant authorities and services to better work together, in a system that puts the child at the centre.

The Council of Europe has promoted the Barnahus (Children’s House) model since 2015 and has been assisting its member states in establishing and expanding the existing services with a view to providing children with access to child-friendly justice.^[¹³^]

The Council of the Baltic Sea States has advanced the Barnahus (Children’s House) model since 2015, focusing on capacity building, standard development, and international cooperation to enhance child-friendly, multidisciplinary approaches to child abuse cases. These efforts led to the creation of the Barnahus Quality Standards^[¹⁴^] and formalized the Barnahus Network,^[¹⁵^] a member-led platform connecting professionals and policymakers across Europe. The network supports the establishment and operation of the Barnahus (Children’s House) model, promotes best practices, facilitates training, and fosters cross-border collaboration to strengthen MDIA response services globally.

This document recognizes the contributions of all these organizations and others that have supported and promoted MDIA response services globally, while underscoring the need for continued collaboration to expand MDIA response services globally.

0.2 Use of this document

This document is intended to establish a consistent global baseline in the establishment and provision of MDIA response services, based on a consensus of key experts and organizations involved in their drafting and good practices worldwide. It can be used alongside relevant United Nations standards in addition to local, regional or global standards.

This document is designed to ensure equality and fairness in the provision of MDIA response services worldwide. While they form a universally applicable foundation, this document also recognizes the need for adaptability, allowing governments and stakeholders to contextualize the model to suit specific legal, cultural, and social environments. Beyond this baseline, states and other actors are encouraged to innovate and expand upon these requirements and recommendations to achieve the highest levels of service quality and effectiveness.

The aim of this document is global application, ensuring that the requirements and recommendations outlined are relevant and applicable to diverse geographical contexts, from high-resource settings to those with more limited capacities.

This document serves as a resource for collaborative efforts, whether led solely by governmental organizations or in partnership with non-governmental organizations. It is also intended for use by international organizations, monitoring bodies, stakeholders and agencies or service providers for child victims of violence.

See Annex B for information regarding workshop contributors for this document.

PD ISO IWA 49:2025

Child-friendly multidisciplinary and interagency response services for children who are victims of violence. Requirements and recommendations

Current

Published:

31 Mar 2025