The WHO Guidelines on Violence and Injury Prevention

The Summary and Recommendation of the Guidelines are given below:-

1. The dynamics of child sexual abuse differ from those of adult sexual abuse. In particular, children rarely disclose sexual abuse immediately after the event. Moreover, disclosure tends to be a process rather than a single episode and is often initiated following a physical complaint or a change in behaviour.
2. The evaluation of children requires special skills and techniques in history taking, forensic interviewing and examination; the examiner may also need to address specific issues related to consent and reporting of child sexual abuse.
3. Definitive signs of genital trauma are seldom seen in cases of child sexual abuse, as physical force is rarely involved. The accurate interpretation of genital findings in children requires specialist training and wherever possible, experts in this field should be consulted.
4. Decisions about STI testing in children should be made on a case-by-case basis. If testing is warranted, age-appropriate diagnostic tests should be used. Presumptive treatment of children for STIs is not generally recommended.
5. A follow-up consultation is strongly recommended. Although a physical examination may not be necessary, a follow-up consultation provides an opportunity to assess any psychological problems that may have since arisen and to ensure that the child and his/her caregiver are receiving adequate social support and counselling

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