Improving access to care by establishing a national hospital-based child protection service

Qatar, a country of approximately 2.9 million, lacked a robust system for reporting and caring for victims of suspected child abuse We describe the development in four phases of a nationwide hospital-based child protection service The first phase focused on skill building around detecting and reporting child maltreatment. The second phase dealt with building multisectoral response while in the third phase we formalized structures to support detection, reporting and response. In the fourth phase we concentrated on data monitoring and evaluation. After phases 1 and 2 made reporting of suspected child abuse mandatory, reports increased from seven to eight per year (all confirmed) to 20–22 per year, where the number plateaued for several years. Of these, 80% were considered confirmed cases during phases 1 and 2, requiring referral to stakeholders outside the hospital. However, after the establishment of the dedicated national child abuse service in phase 3 and awareness promotion in phase 4, the number of referrals for child abuse rapidly increased to an average of 250/year, where it remained during Covid years and showing a steady increase again in last 2 years. Approximately 25% cases per year are considered confirmed from 2019-2024. Step-wise establishment of a child protection service in a small country over several years resulted in over 30-fold increase in suspect reports. For the past six years, approximately one-fourth of reported cases are considered confirmed. • This article is a first of its kind from Qatar. • It explains how a child abuse service was developed in phases by engaging stakeholders from different fields • Its practical bottom-up approach of increasing awareness about child abuse in both practitioners as well as service users has practice implications and could work better in certain societies than policy-legislation (top-down approach)