ABSTRACT

Objective:

to map existing evidence in the literature on the impacts of the Covid-19 pandemic on child violence.

Method:

scope review carried out according to the recommendations of the Joanna Briggs Institute and the international guide PRISMA-ScR in the Databases PubMed, CINAHL, Web of Science and LILACS in October 2020. Inclusion criteria were: studies available in full text, online, in the Portuguese, English or Spanish language, published in 2020 and addressing violence against children in the context of the pandemic. The data were submitted to descriptive analysis.

Results:

216 articles were found, of which 26 were kept for review. The results were presented in the form of a table and, for their discussion, were summarized in the following axes: Closing schools, increasing risks and reducing reports of violence; Economic changes, parental stress and increased violence against children; Health professionals, protection services and negligence violence against children.

Conclusion:

he Covid-19 pandemic has had numerous impacts on violence against children. The summary of the findings of this review may contribute to the dissemination of the theme and stimulate actions that favor the identification, notification and monitoring of cases of violence against children as an important part of the responses against the Covid-19 pandemic.

DESCRIPTORS:
Pandemics; Coronavirus infections; Child abuse; Primary health care; Child health; Domestic violence

RESUMEN

Objetivo:

para mapear la evidencia existente en la literatura sobre los impactos de la pandemia Covid-19 en la violencia infantil.

Método:

revisión del alcance realizada de acuerdo con las recomendaciones del Instituto Joanna Briggs y la guía internacional PRISMA-ScR en las bases de datos PubMed, CINAHL, Web of Science y LILACS en octubre de 2020. Los criterios de inclusión fueron: estudios disponibles en texto completo, online, en portugués, Inglés o español, publicado en 2020 y que abordó la violencia infantil en el contexto de la pandemia. Los datos se sometieron a análisis descriptivo.

Resultados:

se encontraron 216 artículos, de los cuales 26 se conservaron para revisión. Los resultados se presentaron en forma de tabla y, para su discusión, se resumieron en los siguientes ejes: cierre de escuelas, aumento de riesgos y disminución de notificaciones de violencia; Cambios económicos, estrés de los padres y aumento de la violencia infantil; Profesionales de la salud, servicios de protección y negligencia por violencia infantil.

Conclusión:

la pandemia de Covid-19 tuvo numerosos impactos con respecto a la violencia infantil. La síntesis de los hallazgos de esta revisión puede contribuir a la difusión del tema y fomentar acciones que favorezcan la identificación, notificación y seguimiento de los casos de violencia infantil como parte importante de las respuestas frente a la pandemia Covid-19.

DESCRIPTORES:
Pandemias; Infecciones por coronavirus; Abuso infantil; Atención Primaria de Salud; Salud Infantil; Violencia doméstica

RESUMO

Objetivo:

mapear evidências existentes na literatura sobre os impactos da pandemia de Covid-19 na violência infantil.

Método:

revisão de escopo realizada conforme as recomendações do Joanna Briggs Institute e do guia internacional PRISMA-ScR nas bases de dados PubMed, CINAHL, Web of Science e LILACS no mês de outubro de 2020. Os critérios de inclusão foram: estudos disponíveis em texto completo, online, nos idiomas português, inglês ou espanhol, publicados em 2020 e que abordassem a violência infantil no contexto da pandemia. Os dados foram submetidos à análise descritiva.

Resultados:

foram encontrados 216 artigos, dos quais 26 foram mantidos para a revisão. Os resultados foram apresentados em forma de quadro e, para a sua discussão, foram sintetizadas nos seguintes eixos: fechamento de escolas, aumento de riscos e diminuição das notificações de violência; Mudanças econômicas, estresse parental e aumento da violência infantil; Profissionais de saúde, serviços de proteção e negligência para com a violência infantil.

Conclusão:

a pandemia de Covid-19 trouxe inúmeros impactos no que concerne à violência infantil. A síntese dos achados desta revisão poderá contribuir para a divulgação do tema e estimular as ações que favoreçam a identificação, a notificação e o acompanhamento dos casos de violência infantil como parte importante das respostas contra a pandemia de Covid-19.

DESCRIPTORS:
Pandemias; Infecções por Coronavírus; Maus-tratos infantis; Atenção primária à saúde; Saúde da criança; Violência doméstica

INTRODUCTION

The World Health Organization (WHO) defines violence as the intentional use of physical force or power, either by threat or in a real way used against oneself, against another person or against a group or community, which enables or results in injury, psychological damage, death, disability or development deprivation. The types of violence are: collective violence, which concerns acts that occur in the social, political and economic spheres; self-inflicted violence, which may present as suicidal or self-abuse (self-harm); and interpersonal violence, subdivided into family violence (domestic) and community violence.11. Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R. World report on violence and health. Geneva(CH): World Health Organization; 2002. [cited 2020 Set 12]; Available from: https://apps.who.int/iris/bitstream/handle/10665/42495/9241545615_eng.pdf?sequence=1)
https://apps.who.int/iris/bitstream/hand...

Domestic violence is that committed mainly at home by family members and/or intimate partners.11. Krug EG, Dahlberg LL, Mercy JA, Zwi AB, Lozano R. World report on violence and health. Geneva(CH): World Health Organization; 2002. [cited 2020 Set 12]; Available from: https://apps.who.int/iris/bitstream/handle/10665/42495/9241545615_eng.pdf?sequence=1)
https://apps.who.int/iris/bitstream/hand... It is important to mention that children living in environments in which domestic violence is a reality are more likely to reproduce violent behaviors in the future.22. Costa ACF, Marcato FT, Chaves LPG, Longo NS, Rezende RS. Domestic violence: from perceptible to imperceptible. IVF Electronic J [Internet]. 2019 [cited 2020 Set 12];11(1):1-23. Available from: https://www.jornaleletronicofivj.com.br/jefvj/article/view/670
https://www.jornaleletronicofivj.com.br/... ^-44. Cerqueira DRC, Moura RL, Pasinato W. Participation in the labor market and domestic violence against women in Brazil. Rio de Janeiro, RJ(BR): IPEA; 2019 [cited 2020 June 22]. Available from: http://repositorio.ipea.gov.br/bitstream/11058/9358/1/td_2501.pdf
http://repositorio.ipea.gov.br/bitstream...

The world is currently experiencing the Covid-19 pandemic55. Guo Y-R, Cao Q-D, Hong Z-S, Tan Y-YT, Chen S-D, Jin H-J, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res [Internet]. 2020 [cited 2020 Set 10];7:11. Available from: https://doi.org/10.1186/s40779-020-00240-0
https://doi.org/10.1186/s40779-020-00240... ^-66. Organização Mundial de Saúde. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 16 March 2020. [Internet]. 2020 [cited 2020 Set 10]. Available from: https://www.who.int/director-general/speeches/detail/who-director general-s-opening-remarks-at-the-media-briefing-on-covid-19---16-march-2020
https://www.who.int/director-general/spe... and numerous measures have been taken so that the virus can be contained, among these, social distancing and isolation, which although important, has consequences mainly for the family relationship, since domestic interaction has become more prolonged and continuous.77. Silva ERA, Oliveira VR. Protection of children and adolescents in the context of the covid-19 pandemic: consequences and measures necessary for coping. Rio de Janeiro, RJ(BR): IPEA; 2020. [cited 2020 June 22]; Available from: http://repositorio.ipea.gov.br/handle/11058/10041
http://repositorio.ipea.gov.br/handle/11...

In view of this, there is a paradox in the Covid-19 pandemic: on the one hand, staying at home is one of the most efficient means for containing the disease; on the other hand, the family environment, which should be a safe and welcoming place, is considered a great facilitator of violent acts.88. Bradbury-Jones C, Isham L. The pandemic paradox: The consequences of COVID-19 on domestic violence. J Clin Nurs [Internet]. 2020 [cited 2020 Oct 30];29(13-14):2047-9. Available from: https://doi.org/10.1111/jocn.15296
https://doi.org/10.1111/jocn.15296...

Violence that occurs in the domestic environment is the one with the highest number of reports of child violence.99. Ministério da Mulher, Família e Direitos Humanos (Brasil) . Crianças e adolescentes: Balanço do Disque 100 aponta mais de 76 mil vítimas [Internet]. Brasília, DF(BR): Ministério da Mulher, Família e Direitos Humanos; 2019 [cited 2020 Set 12]. Available from: https://www.gov.br/mdh/pt-br/assuntos/noticias/2019/junho/criancas-e-adolescentes-balanco-do-disque-100-aponta-mais-de-76-mil-vitimas
https://www.gov.br/mdh/pt-br/assuntos/no... The child's permanence in this hostile and violent environment makes it more difficult to report,1010. Lira MOSC, Rodrigues VP, Rodrigues AD, Couto TM, Gomes NP, Diniz NMF. Abuso sexual na infância e suas repercussões na vida adulta. Texto Contexto Enferm [Internet]. 2017 [cited 2020 Nov 18];26(3):e0080016. Available from: https://doi.org/10.1590/0104-07072017000080016
https://doi.org/10.1590/0104-07072017000... since they are in the presence of its aggressor(s) and/or potential aggressors.77. Silva ERA, Oliveira VR. Protection of children and adolescents in the context of the covid-19 pandemic: consequences and measures necessary for coping. Rio de Janeiro, RJ(BR): IPEA; 2020. [cited 2020 June 22]; Available from: http://repositorio.ipea.gov.br/handle/11058/10041
http://repositorio.ipea.gov.br/handle/11...

The pandemic has had negative impacts on the mental, physical and mental development of children who, although less biologically affected by Covid-19, are predisposed to the emergence and/or increase of the vulnerabilities of their rights and greater exposure to their violation.77. Silva ERA, Oliveira VR. Protection of children and adolescents in the context of the covid-19 pandemic: consequences and measures necessary for coping. Rio de Janeiro, RJ(BR): IPEA; 2020. [cited 2020 June 22]; Available from: http://repositorio.ipea.gov.br/handle/11058/10041
http://repositorio.ipea.gov.br/handle/11...

In March 2020, reports of sexual violence against children in Brazil increased by 85% compared to the same period in the previous year. In April 2020, there were 19,663 complaints, approximately 10% less than the previous month. Despite the high number, this decrease is associated with the suspension of classes, exposure to continuous contact with aggressors and distancing from protective adults.1111. Ministério da Mulher, Família e Direitos Humanos (Brasil). Comparativo revela queda no número de denúncias de violência sexual contra crianças e adolescentes em abril [Internet]. Brasília, DF(BR): Ministério da Mulher, Família e Direitos Humanos; 2020 [cited 2020 Set 12]. Available from: https://www.gov.br/mdh/pt-br/assuntos/noticias/2020-2/maio/comparativo-revela-queda-no-numero-de-denuncias-de-violencia-sexual-contra-criancas-e-adolescentes-em-abril
https://www.gov.br/mdh/pt-br/assuntos/no... ^,1212. Farfan T. Dial 100 records a 47% increase in reports of sexual violence to minors. CNN Brazil; 2020 [cited 2020 Sept 12]. Available from: https://www.cnnbrasil.com.br/nacional/2020/05/18/disque-100-registra-aumento-de-47-em-denuncias-de-violencia-sexual-menores
https://www.cnnbrasil.com.br/nacional/20...

During the pandemic, there was an increase in child abuse in Brazil and worldwide,1313. United Nations Children’s Fund (UNICEF). Children and adolescents are more exposed to domestic violence during the pandemic [Internet]. Brasília, DF(BR): Unicef Representation Office in Brazil; 2020 [cited 2020 Set 12]. Available from: https://www.unicef.org/brazil/comunicados-de-imprensa/criancas-e-adolescentes-estao-mais-expostos-a-violencia-domestica-durante-pandemia
https://www.unicef.org/brazil/comunicado... ^-1515. World Health Organization. Global status report on preventing violence against children 2020 [Internet]. Geneva(CH): World Health Organization. 2020 [cited 2020 Oct 30]. Available from: https://www.who.int/teams/social-determinants-of-health/violence-prevention/global-status-report-on-violence-against-children-2020
https://www.who.int/teams/social-determi... which intensified the urgency of discussing the confrontation of this problem, since behind the health crisis brought by the pandemic, another obstacle grows: the violation of the rights of children and adolescents.1111. Ministério da Mulher, Família e Direitos Humanos (Brasil). Comparativo revela queda no número de denúncias de violência sexual contra crianças e adolescentes em abril [Internet]. Brasília, DF(BR): Ministério da Mulher, Família e Direitos Humanos; 2020 [cited 2020 Set 12]. Available from: https://www.gov.br/mdh/pt-br/assuntos/noticias/2020-2/maio/comparativo-revela-queda-no-numero-de-denuncias-de-violencia-sexual-contra-criancas-e-adolescentes-em-abril
https://www.gov.br/mdh/pt-br/assuntos/no... ^,1515. World Health Organization. Global status report on preventing violence against children 2020 [Internet]. Geneva(CH): World Health Organization. 2020 [cited 2020 Oct 30]. Available from: https://www.who.int/teams/social-determinants-of-health/violence-prevention/global-status-report-on-violence-against-children-2020
https://www.who.int/teams/social-determi...

Based on the above, the importance of this research for the production of knowledge and for the dissemination of information regarding the impacts that the pandemic has caused on child violence is justified. The methodological option adopted - scoping review1616. Peters MD, Godfrey C, McInerney P, Munn Z, Tricco A, Khalil H. Chapter 11: Scoping reviews (2020 version). In: Aromataris E, Munn Z, eds. Joanna Briggs Institute Reviewer’s Manual JBI; 2017 [cited 2020 Nov 30]; Available from: https://doi.org/10.46658/JBIMES-20-12
https://doi.org/10.46658/JBIMES-20-12... - gathers existing evidence on the theme in a clear and direct way, so that health professionals can have an expanded perception of existing problems and a greater clarity when planning, implementing and making decisions.

Therefore, the aim of this research is to map existing evidence in the literature on the impacts of the Covid-19 pandemic on child violence.

METHOD

This is a scoping review, developed from the recommendations of the Joanna Briggs Institute (JBI)1616. Peters MD, Godfrey C, McInerney P, Munn Z, Tricco A, Khalil H. Chapter 11: Scoping reviews (2020 version). In: Aromataris E, Munn Z, eds. Joanna Briggs Institute Reviewer’s Manual JBI; 2017 [cited 2020 Nov 30]; Available from: https://doi.org/10.46658/JBIMES-20-12
https://doi.org/10.46658/JBIMES-20-12... and preferred reporting items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).1717. Tricco A, Lillie E, Zarin W, O’Brien K, Colquhoun H, Levac D. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation [Internet]. Ann Inter Med. 2020 [cited 2020 Sept 12];169(7):467-73. Available from: https://doi.org/10.7326/M18-0850
https://doi.org/10.7326/M18-0850... This choice is anchored in its potential to identify and analyze knowledge gaps, clarify the main concepts/definitions, as well as the main characteristics or factors related to a concept.1616. Peters MD, Godfrey C, McInerney P, Munn Z, Tricco A, Khalil H. Chapter 11: Scoping reviews (2020 version). In: Aromataris E, Munn Z, eds. Joanna Briggs Institute Reviewer’s Manual JBI; 2017 [cited 2020 Nov 30]; Available from: https://doi.org/10.46658/JBIMES-20-12
https://doi.org/10.46658/JBIMES-20-12...

The title of the review was recorded in Open Science (https://osf.io/dashboard), in the profile of one of the authors. In order to formulate the research question, the mnemonic PCC was used, in which the (P) concerns the "population", (C) the "context" and (C) the "concept". 1616. Peters MD, Godfrey C, McInerney P, Munn Z, Tricco A, Khalil H. Chapter 11: Scoping reviews (2020 version). In: Aromataris E, Munn Z, eds. Joanna Briggs Institute Reviewer’s Manual JBI; 2017 [cited 2020 Nov 30]; Available from: https://doi.org/10.46658/JBIMES-20-12
https://doi.org/10.46658/JBIMES-20-12... The following elements were defined: P (children); C (pandemic) and C (child violence). Based on this, the following question was elaborated: what evidence is there in the literature on the impacts of the Covid-19 pandemic on child violence?

It is emphasized that, for the MESH vocabulary,1818. MeSH. Medical Subject Headings. Bethesda:US National Library of Medicine. 2005 [cited 2021 Apr 24]. Available from: https://meshb.nlm.nih.gov/record/ui?ui=D002648
https://meshb.nlm.nih.gov/record/ui?ui=D... the descriptor "child" refers to the person from 6 to 12 years of age. The term child violence is an alternative term for the descriptor "Child Abuse", adopted in the search. The pandemic is defined in this vocabulary as an epidemic of infectious disease that has spread to several countries, often in more than one continent and which generally affects a large number of people.

In order to be included in the review, the studies should be available in full text, online, in the Portuguese, English or Spanish language, published in 2020 and addressing, in their title and/or summary, child violence in the context of the pandemic. Studies which when read in full, did not have evidence related to the theme were excluded. Repeated articles were also excluded and considered only the first time.

The construction of search strategies was performed from combinations of descriptors combined by the Boolean operators "AND" and "OR". Each strategy was adapted to the respective databases with the help of a librarian, as shown in Chart 1.

The search and selection of the studies occurred in October 2020, by two reviewers and, in case of divergences, a third reviewer participated as a judge in order to strengthen the quality of the study.

Data extraction was performed through the use of an instrument based on JBI1616. Peters MD, Godfrey C, McInerney P, Munn Z, Tricco A, Khalil H. Chapter 11: Scoping reviews (2020 version). In: Aromataris E, Munn Z, eds. Joanna Briggs Institute Reviewer’s Manual JBI; 2017 [cited 2020 Nov 30]; Available from: https://doi.org/10.46658/JBIMES-20-12
https://doi.org/10.46658/JBIMES-20-12... recommendations and adapted by the reviewers, containing the following information: Study Title, Year, Authorship, Journal, Title, Country of Study and Main Reported Evidence.

After reading and evaluating the texts in full, the extracted data were submitted to descriptive analysis, based on the design of the research according to the adopted reference.1616. Peters MD, Godfrey C, McInerney P, Munn Z, Tricco A, Khalil H. Chapter 11: Scoping reviews (2020 version). In: Aromataris E, Munn Z, eds. Joanna Briggs Institute Reviewer’s Manual JBI; 2017 [cited 2020 Nov 30]; Available from: https://doi.org/10.46658/JBIMES-20-12
https://doi.org/10.46658/JBIMES-20-12...

The databases consulted were the Medical Literature Analysis AND Retrieval System Online via The National Library of Medicine (MEDLINE/PubMed), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Literature in Health Sciences (LILACS) and Web of Science (WOS). Figure 1 shows the process of searching, deleting and selecting the studies found. The selected studies were exported to Mendeley ®, the reference manager software.

RESULTS

Twenty-six studies were selected, published in 16 different journals, 9 of which were publications (34.6%) carried out by the Child Abuse & Neglect,2525. Katz C, Cohen N. Invisible children and non-essential workers: Child protection during COVID-19 in Israel according to policy documents and media coverage. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104770; Available from: https://doi.org/10.1016/j.chiabu.2020.104770
https://doi.org/10.1016/j.chiabu.2020.10... ^,2727. Racine N, Hartwick C, Collin-Vézina D, Madigan S. Telemental health for child trauma treatment during and post-COVID-19: Limitations and considerations. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 31];110(Pt 2):104698. Available from: https://doi.org/10.1016/j.chiabu.2020.104698
https://doi.org/10.1016/j.chiabu.2020.10... ^-2828. Baginsky M, Manthorpe J. The impact of COVID-19 on Children’s Social Care in England. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104739. Available from: https://doi.org/10.1016/j.chiabu.2020.104739
https://doi.org/10.1016/j.chiabu.2020.10... ^,3131. Barboza GE, Schiamberg LB, Pachl L. A spatiotemporal analysis of the impact of COVID-19 on child abuse and neglect in the city of Los Angeles, California. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104740. Available from: https://doi.org/10.1016/j.chiabu.2020.104740
https://doi.org/10.1016/j.chiabu.2020.10... ^-3232. Lawson M, Piel MH, Simon M. Child maltreatment during the COVID-19 pandemic: consequences of parental job loss on psychological and physical abuse towards children. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104709. Available from: https://doi.org/10.1016/j.chiabu.2020.104709
https://doi.org/10.1016/j.chiabu.2020.10... ^,3535. Kovler ML, Ziegfeld S, Ryan LM, Goldstein MA, Gardner R, Garcia AV, et al. Increased proportion of physical child abuse injuries at a level I pediatric trauma center during the Covid-19 pandemic. Child Abuse Negl [Internet]. 2021 [cited 2020 Nov 1];116(Pt 2):104756. Available from: https://doi.org/10.1016/j.chiabu.2020.104756
https://doi.org/10.1016/j.chiabu.2020.10... ^,3939. Levine DT, Morton J, O’Reilly M. Child safety, protection, and safeguarding in the time of COVID-19 in Great Britain: Proposing a conceptual framework. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104668. Available from: https://doi.org/10.1016/j.chiabu.2020.104668
https://doi.org/10.1016/j.chiabu.2020.10... ^,4141. Brown SM, Doom JR, Lechuga-Peña S, Watamura SE, Koppels T. Stress and parenting during the global COVID-19 pandemic. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 31];110(Pt 2):104699. Available from: https://doi.org/10.1016/j.chiabu.2020.104699
https://doi.org/10.1016/j.chiabu.2020.10... ^-4242. Jentsch B, Schnock B. Child welfare in the midst of the coronavirus pandemic-emerging evidence from Germany. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104716. Available from: https://doi.org/10.1016/j.chiabu.2020.104716
https://doi.org/10.1016/j.chiabu.2020.10... journal highlighted in this review. Regarding the method adopted, 9 were reviews (34.6%),2020. Bhatia A, Fabbri C, Cerna-Turoff I, Tanton C, Knight L, Turner E, et al. COVID-19 response measures and violence against children. Bull World Health Organ [Internet]. 2020 [cited 2020 Oct 30];98(9):583. Available from: https://doi.org10.2471/BLT.20.263467
https://doi.org10.2471/BLT.20.263467... ^,2525. Katz C, Cohen N. Invisible children and non-essential workers: Child protection during COVID-19 in Israel according to policy documents and media coverage. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104770; Available from: https://doi.org/10.1016/j.chiabu.2020.104770
https://doi.org/10.1016/j.chiabu.2020.10... ^,2727. Racine N, Hartwick C, Collin-Vézina D, Madigan S. Telemental health for child trauma treatment during and post-COVID-19: Limitations and considerations. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 31];110(Pt 2):104698. Available from: https://doi.org/10.1016/j.chiabu.2020.104698
https://doi.org/10.1016/j.chiabu.2020.10... ^,3030. Griffith AK. Parental Burnout and Child Maltreatment During the COVID-19 Pandemic. J Fam Violence [Internet]. 2020 [cited 2020 Oct 31];ahead of print. Available from: https://doi.org/10.1007/s10896-020-00172-2
https://doi.org/10.1007/s10896-020-00172... ^,3333. Posick C, Schueths AA, Christian C, Grubb JA, Christian SE. Child Victim services in the time of COVID-19: new challenges and innovative solutions. Am J Crim Just [Internet]. 2020 [cited 2020 Oct 31];45(4):680-9. Available from: https://doi.org/10.1007/s12103-020-09543-3
https://doi.org/10.1007/s12103-020-09543... ^,3535. Kovler ML, Ziegfeld S, Ryan LM, Goldstein MA, Gardner R, Garcia AV, et al. Increased proportion of physical child abuse injuries at a level I pediatric trauma center during the Covid-19 pandemic. Child Abuse Negl [Internet]. 2021 [cited 2020 Nov 1];116(Pt 2):104756. Available from: https://doi.org/10.1016/j.chiabu.2020.104756
https://doi.org/10.1016/j.chiabu.2020.10... ^-3636. Ghosh R, Dubey MJ, Chatterjee S, Dubey S. Impact of COVID-19 on children: Special focus on the psychosocial aspect. Minerva Pediatr [Internet]. 2020 [cited 2020 Nov 1];72(3):226-35. Available from: https://doi.org/10.23736/s0026-4946.20.05887-9
https://doi.org/10.23736/s0026-4946.20.0... ^,3838. Bryce I. Responding to the accumulation of adverse childhood experiences in the wake of the COVID-19 pandemic: implications for practice. Child Aust [Internet]. 2020 [cited 2020 Oct 31];45(2):80-7. Available from: https://doi.org/10.1017/cha.2020.27
https://doi.org/10.1017/cha.2020.27... ^,4242. Jentsch B, Schnock B. Child welfare in the midst of the coronavirus pandemic-emerging evidence from Germany. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104716. Available from: https://doi.org/10.1016/j.chiabu.2020.104716
https://doi.org/10.1016/j.chiabu.2020.10... 3 were qualitative studies (11.5%),2828. Baginsky M, Manthorpe J. The impact of COVID-19 on Children’s Social Care in England. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104739. Available from: https://doi.org/10.1016/j.chiabu.2020.104739
https://doi.org/10.1016/j.chiabu.2020.10... ^-3030. Griffith AK. Parental Burnout and Child Maltreatment During the COVID-19 Pandemic. J Fam Violence [Internet]. 2020 [cited 2020 Oct 31];ahead of print. Available from: https://doi.org/10.1007/s10896-020-00172-2
https://doi.org/10.1007/s10896-020-00172... 2 were letters to the editor (7.6%),2121. Parks A, Sparre C, Söderquist E, Arver S, Andersson G, Kaldo V, et al. Illegal online sexual behavior during the COVID-19 pandemic: a call for action based on experiences from the ongoing prevent it research study. Arch Sex Behav [Internet]. 2020 [cited 2020 Oct 30];49(5):1433-5. Available from: https://doi.org/10.1007/s10508-020-01750-7
https://doi.org/10.1007/s10508-020-01750... ^,3737. Perks B, Cluver LD. The parenting ‘vaccine’. Nat Hum Behav [Internet]. 2020 [cited 2021 Apr 25];4(10):985. Available from: https://doi.org/10.1038/s41562-020-0932-8
https://doi.org/10.1038/s41562-020-0932-... 2 were editorial (7.6%),88. Bradbury-Jones C, Isham L. The pandemic paradox: The consequences of COVID-19 on domestic violence. J Clin Nurs [Internet]. 2020 [cited 2020 Oct 30];29(13-14):2047-9. Available from: https://doi.org/10.1111/jocn.15296
https://doi.org/10.1111/jocn.15296... ^,2323. Honda C, Yoshioka-Maeda K, Iwasaki-Motegi R. Child abuse and neglect prevention by public health nurses during the COVID-19 pandemic in Japan. J Adv Nurs [Internet]. 2020 [cited 2020 Oct 30];76(11):2792-3. Available from: ttps://doi.org/10.1111/jan.14526
ttps://doi.org/10.1111/jan.14526... 2 were comments (7.6),2222. Hoffman JA, Miller EA. Addressing the consequences of school closure due to covid-19 on children’s physical and mental well-being. World Medical Health Policy [Internet]. 2020 [cited 2020 Oct 30];12(3):300-10. Available from: https://doi.org/10.1002/wmh3.365
https://doi.org/10.1002/wmh3.365... ^,2626. Dahal M, Khanal P, Maharjan S, Panthi B, Nepal S. Mitigating violence against women and young girls during COVID-19 induced lockdown in Nepal: a wake-up call. Global Health [Internet]. 2020 [cited 2020 Oct 31];16(1):84. Available from: https://doi.org/10.1186/s12992-020-00616 2 were cross-sectional study (7.6%),4141. Brown SM, Doom JR, Lechuga-Peña S, Watamura SE, Koppels T. Stress and parenting during the global COVID-19 pandemic. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 31];110(Pt 2):104699. Available from: https://doi.org/10.1016/j.chiabu.2020.104699
https://doi.org/10.1016/j.chiabu.2020.10... ^,4343. Chung G, Lanier P, Wong PYJ. Mediating effects of parental stress on harsh parenting and parent-child relationship during coronavirus (COVID-19) pandemic in Singapore. J Fam Violence [Internet]. 2020 [cited 2020 Oct 30];ahead of print. Available from: https://doi.org/10.1007/s10896-020-00200-1
https://doi.org/10.1007/s10896-020-00200... 2 were opinion articles1919. Rosenthal CM, Thompson LA. Child abuse awareness month during the coronavirus disease 2019 pandemic. JAMA Pediatr [Internet]. 2020 [cited 2020 Oct 30];174(8):812. Available from: https://doi.org/10.1001/jamapediatrics.2020.1459
https://doi.org/10.1001/jamapediatrics.2... ^,2424. Teo SSS, Griffiths G. Child protection in the time of COVID-19. J Paediatr Child Health [Internet] 2020 [cited 2020 Oct 31];56(6):838-40. Available from: https://doi.org/10.1111/jpc.14916
https://doi.org/10.1111/jpc.14916... and the other was an ecological study,2929. Baron EJ, Goldstein EG, Wallace CT. Suffering in silence: how COVID-19 school closures inhibit the reporting of child maltreatment. J Public Econ [Internet]. 2020 [cited 2020 Oct 31];190:104258. Available from: https://doi.org/10.1016/j.jpubeco.2020.104258
https://doi.org/10.1016/j.jpubeco.2020.1... behavioral study,3232. Lawson M, Piel MH, Simon M. Child maltreatment during the COVID-19 pandemic: consequences of parental job loss on psychological and physical abuse towards children. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104709. Available from: https://doi.org/10.1016/j.chiabu.2020.104709
https://doi.org/10.1016/j.chiabu.2020.10... observational study3434. Garstang J, Debelle G, Anand I, Armstrong J, Botcher E, Chaplin H, et al. Effect of COVID-19 lockdown on child protection medical assessments: a retrospective observational study in Birmingham, UK. BMJ Open [Internet]. 2020 [cited 2020 Oct 31];10(9):e042867. Available from: https://doi.org/10.1136/bmjopen-2020-042867
https://doi.org/10.1136/bmjopen-2020-042... and one spatiotemporal analysis.3131. Barboza GE, Schiamberg LB, Pachl L. A spatiotemporal analysis of the impact of COVID-19 on child abuse and neglect in the city of Los Angeles, California. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104740. Available from: https://doi.org/10.1016/j.chiabu.2020.104740
https://doi.org/10.1016/j.chiabu.2020.10...

Regarding the country of origin, 10 studies were conducted in the United States (38.4%),1919. Rosenthal CM, Thompson LA. Child abuse awareness month during the coronavirus disease 2019 pandemic. JAMA Pediatr [Internet]. 2020 [cited 2020 Oct 30];174(8):812. Available from: https://doi.org/10.1001/jamapediatrics.2020.1459
https://doi.org/10.1001/jamapediatrics.2... ^-2020. Bhatia A, Fabbri C, Cerna-Turoff I, Tanton C, Knight L, Turner E, et al. COVID-19 response measures and violence against children. Bull World Health Organ [Internet]. 2020 [cited 2020 Oct 30];98(9):583. Available from: https://doi.org10.2471/BLT.20.263467
https://doi.org10.2471/BLT.20.263467... ^,2323. Honda C, Yoshioka-Maeda K, Iwasaki-Motegi R. Child abuse and neglect prevention by public health nurses during the COVID-19 pandemic in Japan. J Adv Nurs [Internet]. 2020 [cited 2020 Oct 30];76(11):2792-3. Available from: ttps://doi.org/10.1111/jan.14526
ttps://doi.org/10.1111/jan.14526... ^,3030. Griffith AK. Parental Burnout and Child Maltreatment During the COVID-19 Pandemic. J Fam Violence [Internet]. 2020 [cited 2020 Oct 31];ahead of print. Available from: https://doi.org/10.1007/s10896-020-00172-2
https://doi.org/10.1007/s10896-020-00172... ^-3434. Garstang J, Debelle G, Anand I, Armstrong J, Botcher E, Chaplin H, et al. Effect of COVID-19 lockdown on child protection medical assessments: a retrospective observational study in Birmingham, UK. BMJ Open [Internet]. 2020 [cited 2020 Oct 31];10(9):e042867. Available from: https://doi.org/10.1136/bmjopen-2020-042867
https://doi.org/10.1136/bmjopen-2020-042... ^,3636. Ghosh R, Dubey MJ, Chatterjee S, Dubey S. Impact of COVID-19 on children: Special focus on the psychosocial aspect. Minerva Pediatr [Internet]. 2020 [cited 2020 Nov 1];72(3):226-35. Available from: https://doi.org/10.23736/s0026-4946.20.05887-9
https://doi.org/10.23736/s0026-4946.20.0... ^,4242. Jentsch B, Schnock B. Child welfare in the midst of the coronavirus pandemic-emerging evidence from Germany. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104716. Available from: https://doi.org/10.1016/j.chiabu.2020.104716
https://doi.org/10.1016/j.chiabu.2020.10... 3 in the United Kingdom (11.5%),88. Bradbury-Jones C, Isham L. The pandemic paradox: The consequences of COVID-19 on domestic violence. J Clin Nurs [Internet]. 2020 [cited 2020 Oct 30];29(13-14):2047-9. Available from: https://doi.org/10.1111/jocn.15296
https://doi.org/10.1111/jocn.15296... ^,3434. Garstang J, Debelle G, Anand I, Armstrong J, Botcher E, Chaplin H, et al. Effect of COVID-19 lockdown on child protection medical assessments: a retrospective observational study in Birmingham, UK. BMJ Open [Internet]. 2020 [cited 2020 Oct 31];10(9):e042867. Available from: https://doi.org/10.1136/bmjopen-2020-042867
https://doi.org/10.1136/bmjopen-2020-042... ^,3939. Levine DT, Morton J, O’Reilly M. Child safety, protection, and safeguarding in the time of COVID-19 in Great Britain: Proposing a conceptual framework. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104668. Available from: https://doi.org/10.1016/j.chiabu.2020.104668
https://doi.org/10.1016/j.chiabu.2020.10... 2 in Canada (7.6%)2727. Racine N, Hartwick C, Collin-Vézina D, Madigan S. Telemental health for child trauma treatment during and post-COVID-19: Limitations and considerations. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 31];110(Pt 2):104698. Available from: https://doi.org/10.1016/j.chiabu.2020.104698
https://doi.org/10.1016/j.chiabu.2020.10... ^-2828. Baginsky M, Manthorpe J. The impact of COVID-19 on Children’s Social Care in England. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104739. Available from: https://doi.org/10.1016/j.chiabu.2020.104739
https://doi.org/10.1016/j.chiabu.2020.10... , 2 in Australia (7.6%)2424. Teo SSS, Griffiths G. Child protection in the time of COVID-19. J Paediatr Child Health [Internet] 2020 [cited 2020 Oct 31];56(6):838-40. Available from: https://doi.org/10.1111/jpc.14916
https://doi.org/10.1111/jpc.14916... ^,3838. Bryce I. Responding to the accumulation of adverse childhood experiences in the wake of the COVID-19 pandemic: implications for practice. Child Aust [Internet]. 2020 [cited 2020 Oct 31];45(2):80-7. Available from: https://doi.org/10.1017/cha.2020.27
https://doi.org/10.1017/cha.2020.27... and the others in Sweden,2121. Parks A, Sparre C, Söderquist E, Arver S, Andersson G, Kaldo V, et al. Illegal online sexual behavior during the COVID-19 pandemic: a call for action based on experiences from the ongoing prevent it research study. Arch Sex Behav [Internet]. 2020 [cited 2020 Oct 30];49(5):1433-5. Available from: https://doi.org/10.1007/s10508-020-01750-7
https://doi.org/10.1007/s10508-020-01750... Israel,2525. Katz C, Cohen N. Invisible children and non-essential workers: Child protection during COVID-19 in Israel according to policy documents and media coverage. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104770; Available from: https://doi.org/10.1016/j.chiabu.2020.104770
https://doi.org/10.1016/j.chiabu.2020.10... Singapore,4343. Chung G, Lanier P, Wong PYJ. Mediating effects of parental stress on harsh parenting and parent-child relationship during coronavirus (COVID-19) pandemic in Singapore. J Fam Violence [Internet]. 2020 [cited 2020 Oct 30];ahead of print. Available from: https://doi.org/10.1007/s10896-020-00200-1
https://doi.org/10.1007/s10896-020-00200... Spain,4040. Roca E, Melgar P, Gairal-Casadó R, Pulido-Rodríguez MA. Schools that “open doors” to prevent child abuse in confinement by COVID-19. Sustain [Internet]. 2020 [cited 2020 Oct 31];12(11):4685. Available from: https://doi.org/10.3390/su12114685
https://doi.org/10.3390/su12114685... Japan,2323. Honda C, Yoshioka-Maeda K, Iwasaki-Motegi R. Child abuse and neglect prevention by public health nurses during the COVID-19 pandemic in Japan. J Adv Nurs [Internet]. 2020 [cited 2020 Oct 30];76(11):2792-3. Available from: ttps://doi.org/10.1111/jan.14526
ttps://doi.org/10.1111/jan.14526... Nepal,2626. Dahal M, Khanal P, Maharjan S, Panthi B, Nepal S. Mitigating violence against women and young girls during COVID-19 induced lockdown in Nepal: a wake-up call. Global Health [Internet]. 2020 [cited 2020 Oct 31];16(1):84. Available from: https://doi.org/10.1186/s12992-020-00616 India3636. Ghosh R, Dubey MJ, Chatterjee S, Dubey S. Impact of COVID-19 on children: Special focus on the psychosocial aspect. Minerva Pediatr [Internet]. 2020 [cited 2020 Nov 1];72(3):226-35. Available from: https://doi.org/10.23736/s0026-4946.20.05887-9
https://doi.org/10.23736/s0026-4946.20.0... and Germany.4343. Chung G, Lanier P, Wong PYJ. Mediating effects of parental stress on harsh parenting and parent-child relationship during coronavirus (COVID-19) pandemic in Singapore. J Fam Violence [Internet]. 2020 [cited 2020 Oct 30];ahead of print. Available from: https://doi.org/10.1007/s10896-020-00200-1
https://doi.org/10.1007/s10896-020-00200...

For the characterization of the included studies, data were extracted regarding the identification, authors and year of publication, as well as the journal and the country in which the study was conducted. Chart 2 is available below.

Regarding the consequences of the Covid-19 pandemic in child violence, the studies indicated 10 main impacts, as it shows Chart 3, among which stand out are: decrease in reports of violence and decrease in confirmed cases (30%),2020. Bhatia A, Fabbri C, Cerna-Turoff I, Tanton C, Knight L, Turner E, et al. COVID-19 response measures and violence against children. Bull World Health Organ [Internet]. 2020 [cited 2020 Oct 30];98(9):583. Available from: https://doi.org10.2471/BLT.20.263467
https://doi.org10.2471/BLT.20.263467... ^-2121. Parks A, Sparre C, Söderquist E, Arver S, Andersson G, Kaldo V, et al. Illegal online sexual behavior during the COVID-19 pandemic: a call for action based on experiences from the ongoing prevent it research study. Arch Sex Behav [Internet]. 2020 [cited 2020 Oct 30];49(5):1433-5. Available from: https://doi.org/10.1007/s10508-020-01750-7
https://doi.org/10.1007/s10508-020-01750... ^,2828. Baginsky M, Manthorpe J. The impact of COVID-19 on Children’s Social Care in England. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104739. Available from: https://doi.org/10.1016/j.chiabu.2020.104739
https://doi.org/10.1016/j.chiabu.2020.10... ^,2929. Baron EJ, Goldstein EG, Wallace CT. Suffering in silence: how COVID-19 school closures inhibit the reporting of child maltreatment. J Public Econ [Internet]. 2020 [cited 2020 Oct 31];190:104258. Available from: https://doi.org/10.1016/j.jpubeco.2020.104258
https://doi.org/10.1016/j.jpubeco.2020.1... ^,3131. Barboza GE, Schiamberg LB, Pachl L. A spatiotemporal analysis of the impact of COVID-19 on child abuse and neglect in the city of Los Angeles, California. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104740. Available from: https://doi.org/10.1016/j.chiabu.2020.104740
https://doi.org/10.1016/j.chiabu.2020.10... ^,3434. Garstang J, Debelle G, Anand I, Armstrong J, Botcher E, Chaplin H, et al. Effect of COVID-19 lockdown on child protection medical assessments: a retrospective observational study in Birmingham, UK. BMJ Open [Internet]. 2020 [cited 2020 Oct 31];10(9):e042867. Available from: https://doi.org/10.1136/bmjopen-2020-042867
https://doi.org/10.1136/bmjopen-2020-042... ^,4242. Jentsch B, Schnock B. Child welfare in the midst of the coronavirus pandemic-emerging evidence from Germany. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104716. Available from: https://doi.org/10.1016/j.chiabu.2020.104716
https://doi.org/10.1016/j.chiabu.2020.10... increase in abuse, neglect, psychological abuse and child exploitation (30%),1919. Rosenthal CM, Thompson LA. Child abuse awareness month during the coronavirus disease 2019 pandemic. JAMA Pediatr [Internet]. 2020 [cited 2020 Oct 30];174(8):812. Available from: https://doi.org/10.1001/jamapediatrics.2020.1459
https://doi.org/10.1001/jamapediatrics.2... ^-2020. Bhatia A, Fabbri C, Cerna-Turoff I, Tanton C, Knight L, Turner E, et al. COVID-19 response measures and violence against children. Bull World Health Organ [Internet]. 2020 [cited 2020 Oct 30];98(9):583. Available from: https://doi.org10.2471/BLT.20.263467
https://doi.org10.2471/BLT.20.263467... ^,88. Bradbury-Jones C, Isham L. The pandemic paradox: The consequences of COVID-19 on domestic violence. J Clin Nurs [Internet]. 2020 [cited 2020 Oct 30];29(13-14):2047-9. Available from: https://doi.org/10.1111/jocn.15296
https://doi.org/10.1111/jocn.15296... ^,2626. Dahal M, Khanal P, Maharjan S, Panthi B, Nepal S. Mitigating violence against women and young girls during COVID-19 induced lockdown in Nepal: a wake-up call. Global Health [Internet]. 2020 [cited 2020 Oct 31];16(1):84. Available from: https://doi.org/10.1186/s12992-020-00616^,3232. Lawson M, Piel MH, Simon M. Child maltreatment during the COVID-19 pandemic: consequences of parental job loss on psychological and physical abuse towards children. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104709. Available from: https://doi.org/10.1016/j.chiabu.2020.104709
https://doi.org/10.1016/j.chiabu.2020.10... ^,3434. Garstang J, Debelle G, Anand I, Armstrong J, Botcher E, Chaplin H, et al. Effect of COVID-19 lockdown on child protection medical assessments: a retrospective observational study in Birmingham, UK. BMJ Open [Internet]. 2020 [cited 2020 Oct 31];10(9):e042867. Available from: https://doi.org/10.1136/bmjopen-2020-042867
https://doi.org/10.1136/bmjopen-2020-042... ^,3636. Ghosh R, Dubey MJ, Chatterjee S, Dubey S. Impact of COVID-19 on children: Special focus on the psychosocial aspect. Minerva Pediatr [Internet]. 2020 [cited 2020 Nov 1];72(3):226-35. Available from: https://doi.org/10.23736/s0026-4946.20.05887-9
https://doi.org/10.23736/s0026-4946.20.0... increased risks of child violence (23%),88. Bradbury-Jones C, Isham L. The pandemic paradox: The consequences of COVID-19 on domestic violence. J Clin Nurs [Internet]. 2020 [cited 2020 Oct 30];29(13-14):2047-9. Available from: https://doi.org/10.1111/jocn.15296
https://doi.org/10.1111/jocn.15296... ^,2525. Katz C, Cohen N. Invisible children and non-essential workers: Child protection during COVID-19 in Israel according to policy documents and media coverage. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104770; Available from: https://doi.org/10.1016/j.chiabu.2020.104770
https://doi.org/10.1016/j.chiabu.2020.10... ^,2626. Dahal M, Khanal P, Maharjan S, Panthi B, Nepal S. Mitigating violence against women and young girls during COVID-19 induced lockdown in Nepal: a wake-up call. Global Health [Internet]. 2020 [cited 2020 Oct 31];16(1):84. Available from: https://doi.org/10.1186/s12992-020-00616^,3030. Griffith AK. Parental Burnout and Child Maltreatment During the COVID-19 Pandemic. J Fam Violence [Internet]. 2020 [cited 2020 Oct 31];ahead of print. Available from: https://doi.org/10.1007/s10896-020-00172-2
https://doi.org/10.1007/s10896-020-00172... ^,3232. Lawson M, Piel MH, Simon M. Child maltreatment during the COVID-19 pandemic: consequences of parental job loss on psychological and physical abuse towards children. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104709. Available from: https://doi.org/10.1016/j.chiabu.2020.104709
https://doi.org/10.1016/j.chiabu.2020.10... ^,3737. Perks B, Cluver LD. The parenting ‘vaccine’. Nat Hum Behav [Internet]. 2020 [cited 2021 Apr 25];4(10):985. Available from: https://doi.org/10.1038/s41562-020-0932-8
https://doi.org/10.1038/s41562-020-0932-... and increased difficulty in identifying and reporting cases (19%).88. Bradbury-Jones C, Isham L. The pandemic paradox: The consequences of COVID-19 on domestic violence. J Clin Nurs [Internet]. 2020 [cited 2020 Oct 30];29(13-14):2047-9. Available from: https://doi.org/10.1111/jocn.15296
https://doi.org/10.1111/jocn.15296... ^,2222. Hoffman JA, Miller EA. Addressing the consequences of school closure due to covid-19 on children’s physical and mental well-being. World Medical Health Policy [Internet]. 2020 [cited 2020 Oct 30];12(3):300-10. Available from: https://doi.org/10.1002/wmh3.365
https://doi.org/10.1002/wmh3.365... ^-2424. Teo SSS, Griffiths G. Child protection in the time of COVID-19. J Paediatr Child Health [Internet] 2020 [cited 2020 Oct 31];56(6):838-40. Available from: https://doi.org/10.1111/jpc.14916
https://doi.org/10.1111/jpc.14916... ^,3333. Posick C, Schueths AA, Christian C, Grubb JA, Christian SE. Child Victim services in the time of COVID-19: new challenges and innovative solutions. Am J Crim Just [Internet]. 2020 [cited 2020 Oct 31];45(4):680-9. Available from: https://doi.org/10.1007/s12103-020-09543-3
https://doi.org/10.1007/s12103-020-09543...

These impacts permeate and are permeated by broader issues that have been summarized around three axes: school closures, increased risks and decreased reports of violence; economic changes, parental stress and increased violence against children; health professionals, protection services and negligence in the area of violence against children.

DISCUSSION

The mapping shows important evidence regarding the impacts of the Covid-19 pandemic on violence against children and its most varied causes.88. Bradbury-Jones C, Isham L. The pandemic paradox: The consequences of COVID-19 on domestic violence. J Clin Nurs [Internet]. 2020 [cited 2020 Oct 30];29(13-14):2047-9. Available from: https://doi.org/10.1111/jocn.15296
https://doi.org/10.1111/jocn.15296... ^,1919. Rosenthal CM, Thompson LA. Child abuse awareness month during the coronavirus disease 2019 pandemic. JAMA Pediatr [Internet]. 2020 [cited 2020 Oct 30];174(8):812. Available from: https://doi.org/10.1001/jamapediatrics.2020.1459
https://doi.org/10.1001/jamapediatrics.2... ^-4343. Chung G, Lanier P, Wong PYJ. Mediating effects of parental stress on harsh parenting and parent-child relationship during coronavirus (COVID-19) pandemic in Singapore. J Fam Violence [Internet]. 2020 [cited 2020 Oct 30];ahead of print. Available from: https://doi.org/10.1007/s10896-020-00200-1
https://doi.org/10.1007/s10896-020-00200... The discussion took place by means of the following three axes.

School closures, increased risks and decreased reports of violence

School is an important environment for the physical, mental and social development of children and adolescents and is characterized as part of the protection network.2222. Hoffman JA, Miller EA. Addressing the consequences of school closure due to covid-19 on children’s physical and mental well-being. World Medical Health Policy [Internet]. 2020 [cited 2020 Oct 30];12(3):300-10. Available from: https://doi.org/10.1002/wmh3.365
https://doi.org/10.1002/wmh3.365... ^,2424. Teo SSS, Griffiths G. Child protection in the time of COVID-19. J Paediatr Child Health [Internet] 2020 [cited 2020 Oct 31];56(6):838-40. Available from: https://doi.org/10.1111/jpc.14916
https://doi.org/10.1111/jpc.14916... In March 2020, numerous states in Brazil decreed the closure of schools and day care centers as one of the containment measures of the new Coronavirus, causing children and adolescents to take online classes and interrupt their face-to-face contact with teachers and other school professionals.

According to Art. 245 of the Statute of the Child and Adolescent (ECA),4444. Brasil. Lei n. 8069, de 13 de julho de 1990: Dispõe sobre o Estatuto da Criança e do Adolescente e dá outras providências; 1990 [cited 2020 Sept 12]. Available from: http://www.planalto.gov.br/ccivil_03/Leis/L8069.htm
http://www.planalto.gov.br/ccivil_03/Lei... teachers are obliged to notify suspected or confirmed cases of violence. Thus, teachers are part of the main whistleblowers of cases of violence against children,2828. Baginsky M, Manthorpe J. The impact of COVID-19 on Children’s Social Care in England. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104739. Available from: https://doi.org/10.1016/j.chiabu.2020.104739
https://doi.org/10.1016/j.chiabu.2020.10... and the contact between these protective adults and children during the school period is essential for notification and protection against violence.

According to studies conducted in the USA1919. Rosenthal CM, Thompson LA. Child abuse awareness month during the coronavirus disease 2019 pandemic. JAMA Pediatr [Internet]. 2020 [cited 2020 Oct 30];174(8):812. Available from: https://doi.org/10.1001/jamapediatrics.2020.1459
https://doi.org/10.1001/jamapediatrics.2... ^,2929. Baron EJ, Goldstein EG, Wallace CT. Suffering in silence: how COVID-19 school closures inhibit the reporting of child maltreatment. J Public Econ [Internet]. 2020 [cited 2020 Oct 31];190:104258. Available from: https://doi.org/10.1016/j.jpubeco.2020.104258
https://doi.org/10.1016/j.jpubeco.2020.1... and Australia,3838. Bryce I. Responding to the accumulation of adverse childhood experiences in the wake of the COVID-19 pandemic: implications for practice. Child Aust [Internet]. 2020 [cited 2020 Oct 31];45(2):80-7. Available from: https://doi.org/10.1017/cha.2020.27
https://doi.org/10.1017/cha.2020.27... it is quite common to notice a reduction in the number of reports of violence against children during the school holidays and in situations of natural disasters, which usually increases soon after school return; these findings strengthen the idea that, during the Covid-19 pandemic, child abuse may have increased, although many of them will not be reported due to the increased difficulty in identifying and reporting cases.88. Bradbury-Jones C, Isham L. The pandemic paradox: The consequences of COVID-19 on domestic violence. J Clin Nurs [Internet]. 2020 [cited 2020 Oct 30];29(13-14):2047-9. Available from: https://doi.org/10.1111/jocn.15296
https://doi.org/10.1111/jocn.15296... ^,2222. Hoffman JA, Miller EA. Addressing the consequences of school closure due to covid-19 on children’s physical and mental well-being. World Medical Health Policy [Internet]. 2020 [cited 2020 Oct 30];12(3):300-10. Available from: https://doi.org/10.1002/wmh3.365
https://doi.org/10.1002/wmh3.365... ^-2424. Teo SSS, Griffiths G. Child protection in the time of COVID-19. J Paediatr Child Health [Internet] 2020 [cited 2020 Oct 31];56(6):838-40. Available from: https://doi.org/10.1111/jpc.14916
https://doi.org/10.1111/jpc.14916... ^,3333. Posick C, Schueths AA, Christian C, Grubb JA, Christian SE. Child Victim services in the time of COVID-19: new challenges and innovative solutions. Am J Crim Just [Internet]. 2020 [cited 2020 Oct 31];45(4):680-9. Available from: https://doi.org/10.1007/s12103-020-09543-3
https://doi.org/10.1007/s12103-020-09543...

In Brazil, April 2020 showed a 19% decrease in the number of reports of child sexual violence compared to the same period in the previous year. 1111. Ministério da Mulher, Família e Direitos Humanos (Brasil). Comparativo revela queda no número de denúncias de violência sexual contra crianças e adolescentes em abril [Internet]. Brasília, DF(BR): Ministério da Mulher, Família e Direitos Humanos; 2020 [cited 2020 Set 12]. Available from: https://www.gov.br/mdh/pt-br/assuntos/noticias/2020-2/maio/comparativo-revela-queda-no-numero-de-denuncias-de-violencia-sexual-contra-criancas-e-adolescentes-em-abril
https://www.gov.br/mdh/pt-br/assuntos/no... In the US, it is estimated that, in Florida alone, around 40,000 cases of violence against children have not been confirmed due to the closing of schools. It is noteworthy that the decrease in notifications and complaints was strongly reported as the main impact of the pandemic on violence against children.1919. Rosenthal CM, Thompson LA. Child abuse awareness month during the coronavirus disease 2019 pandemic. JAMA Pediatr [Internet]. 2020 [cited 2020 Oct 30];174(8):812. Available from: https://doi.org/10.1001/jamapediatrics.2020.1459
https://doi.org/10.1001/jamapediatrics.2... ^-2020. Bhatia A, Fabbri C, Cerna-Turoff I, Tanton C, Knight L, Turner E, et al. COVID-19 response measures and violence against children. Bull World Health Organ [Internet]. 2020 [cited 2020 Oct 30];98(9):583. Available from: https://doi.org10.2471/BLT.20.263467
https://doi.org10.2471/BLT.20.263467... ^,2828. Baginsky M, Manthorpe J. The impact of COVID-19 on Children’s Social Care in England. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104739. Available from: https://doi.org/10.1016/j.chiabu.2020.104739
https://doi.org/10.1016/j.chiabu.2020.10... ^-2929. Baron EJ, Goldstein EG, Wallace CT. Suffering in silence: how COVID-19 school closures inhibit the reporting of child maltreatment. J Public Econ [Internet]. 2020 [cited 2020 Oct 31];190:104258. Available from: https://doi.org/10.1016/j.jpubeco.2020.104258
https://doi.org/10.1016/j.jpubeco.2020.1... For children at risk or in situations of violence, the constant and daily presence of their aggressors ends up reducing escape routes and the possibilities of asking for help, as well as increasing the risk of violence.88. Bradbury-Jones C, Isham L. The pandemic paradox: The consequences of COVID-19 on domestic violence. J Clin Nurs [Internet]. 2020 [cited 2020 Oct 30];29(13-14):2047-9. Available from: https://doi.org/10.1111/jocn.15296
https://doi.org/10.1111/jocn.15296... ^,2626. Dahal M, Khanal P, Maharjan S, Panthi B, Nepal S. Mitigating violence against women and young girls during COVID-19 induced lockdown in Nepal: a wake-up call. Global Health [Internet]. 2020 [cited 2020 Oct 31];16(1):84. Available from: https://doi.org/10.1186/s12992-020-00616

In addition, another fact that deserves to be highlighted is that the closure of schools and longer time at home caused children to spend more time on the Internet, both for the monitoring of school activities and for other types of use, generating greater exposure of them to online sexual crimes,2121. Parks A, Sparre C, Söderquist E, Arver S, Andersson G, Kaldo V, et al. Illegal online sexual behavior during the COVID-19 pandemic: a call for action based on experiences from the ongoing prevent it research study. Arch Sex Behav [Internet]. 2020 [cited 2020 Oct 30];49(5):1433-5. Available from: https://doi.org/10.1007/s10508-020-01750-7
https://doi.org/10.1007/s10508-020-01750... ^,3636. Ghosh R, Dubey MJ, Chatterjee S, Dubey S. Impact of COVID-19 on children: Special focus on the psychosocial aspect. Minerva Pediatr [Internet]. 2020 [cited 2020 Nov 1];72(3):226-35. Available from: https://doi.org/10.23736/s0026-4946.20.05887-9
https://doi.org/10.23736/s0026-4946.20.0... ^,3838. Bryce I. Responding to the accumulation of adverse childhood experiences in the wake of the COVID-19 pandemic: implications for practice. Child Aust [Internet]. 2020 [cited 2020 Oct 31];45(2):80-7. Available from: https://doi.org/10.1017/cha.2020.27
https://doi.org/10.1017/cha.2020.27... and, due to the home office and the accumulation of parents' domestic responsibilities, many do not have adequate supervision.3737. Perks B, Cluver LD. The parenting ‘vaccine’. Nat Hum Behav [Internet]. 2020 [cited 2021 Apr 25];4(10):985. Available from: https://doi.org/10.1038/s41562-020-0932-8
https://doi.org/10.1038/s41562-020-0932-...

During the period of social distancing, there was an increase in the search for child sexual material, as well as the exchange of information on how to have access to children for the production of sexual material. 2121. Parks A, Sparre C, Söderquist E, Arver S, Andersson G, Kaldo V, et al. Illegal online sexual behavior during the COVID-19 pandemic: a call for action based on experiences from the ongoing prevent it research study. Arch Sex Behav [Internet]. 2020 [cited 2020 Oct 30];49(5):1433-5. Available from: https://doi.org/10.1007/s10508-020-01750-7
https://doi.org/10.1007/s10508-020-01750... Although all children are possible victims and risk suffering online sexual violence, those with a history of abuse and neglect are even more vulnerable.3838. Bryce I. Responding to the accumulation of adverse childhood experiences in the wake of the COVID-19 pandemic: implications for practice. Child Aust [Internet]. 2020 [cited 2020 Oct 31];45(2):80-7. Available from: https://doi.org/10.1017/cha.2020.27
https://doi.org/10.1017/cha.2020.27...

Economic change, parental stress and increased violence against children

The pandemic brought about the emergence/intensification of the economic crisis, the loss of jobs and work adaptations.1919. Rosenthal CM, Thompson LA. Child abuse awareness month during the coronavirus disease 2019 pandemic. JAMA Pediatr [Internet]. 2020 [cited 2020 Oct 30];174(8):812. Available from: https://doi.org/10.1001/jamapediatrics.2020.1459
https://doi.org/10.1001/jamapediatrics.2... ^,2222. Hoffman JA, Miller EA. Addressing the consequences of school closure due to covid-19 on children’s physical and mental well-being. World Medical Health Policy [Internet]. 2020 [cited 2020 Oct 30];12(3):300-10. Available from: https://doi.org/10.1002/wmh3.365
https://doi.org/10.1002/wmh3.365... ^,2424. Teo SSS, Griffiths G. Child protection in the time of COVID-19. J Paediatr Child Health [Internet] 2020 [cited 2020 Oct 31];56(6):838-40. Available from: https://doi.org/10.1111/jpc.14916
https://doi.org/10.1111/jpc.14916... The economic changes brought about by social distancing mainly impacted parents who lost their jobs or were already unemployed. This has resulted in increased parental stress and anxiety which, as a result, increase the risks of physical and psychological abuse, sexual exploitation and neglect.2020. Bhatia A, Fabbri C, Cerna-Turoff I, Tanton C, Knight L, Turner E, et al. COVID-19 response measures and violence against children. Bull World Health Organ [Internet]. 2020 [cited 2020 Oct 30];98(9):583. Available from: https://doi.org10.2471/BLT.20.263467
https://doi.org10.2471/BLT.20.263467... ^,2222. Hoffman JA, Miller EA. Addressing the consequences of school closure due to covid-19 on children’s physical and mental well-being. World Medical Health Policy [Internet]. 2020 [cited 2020 Oct 30];12(3):300-10. Available from: https://doi.org/10.1002/wmh3.365
https://doi.org/10.1002/wmh3.365... ^,2525. Katz C, Cohen N. Invisible children and non-essential workers: Child protection during COVID-19 in Israel according to policy documents and media coverage. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104770; Available from: https://doi.org/10.1016/j.chiabu.2020.104770
https://doi.org/10.1016/j.chiabu.2020.10... ^,3030. Griffith AK. Parental Burnout and Child Maltreatment During the COVID-19 Pandemic. J Fam Violence [Internet]. 2020 [cited 2020 Oct 31];ahead of print. Available from: https://doi.org/10.1007/s10896-020-00172-2
https://doi.org/10.1007/s10896-020-00172... ^-3131. Barboza GE, Schiamberg LB, Pachl L. A spatiotemporal analysis of the impact of COVID-19 on child abuse and neglect in the city of Los Angeles, California. Child Abuse Negl [Internet]. 2021 [cited 2020 Oct 31];116(Pt 2):104740. Available from: https://doi.org/10.1016/j.chiabu.2020.104740
https://doi.org/10.1016/j.chiabu.2020.10...

Feelings generated by job loss are related to physical violence among family members, especially children.4242. Jentsch B, Schnock B. Child welfare in the midst of the coronavirus pandemic-emerging evidence from Germany. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104716. Available from: https://doi.org/10.1016/j.chiabu.2020.104716
https://doi.org/10.1016/j.chiabu.2020.10... Concerns about financial insecurity, economic crisis and health, as well as toxic stress are the main factors of increased risk of child abuse.3636. Ghosh R, Dubey MJ, Chatterjee S, Dubey S. Impact of COVID-19 on children: Special focus on the psychosocial aspect. Minerva Pediatr [Internet]. 2020 [cited 2020 Nov 1];72(3):226-35. Available from: https://doi.org/10.23736/s0026-4946.20.05887-9
https://doi.org/10.23736/s0026-4946.20.0... ^-3737. Perks B, Cluver LD. The parenting ‘vaccine’. Nat Hum Behav [Internet]. 2020 [cited 2021 Apr 25];4(10):985. Available from: https://doi.org/10.1038/s41562-020-0932-8
https://doi.org/10.1038/s41562-020-0932-... In addition, changes in working conditions (home office), domestic responsibilities and the closure of schools intensified the emergence of parental stress and, consequently, presented an increased risk of violence.2020. Bhatia A, Fabbri C, Cerna-Turoff I, Tanton C, Knight L, Turner E, et al. COVID-19 response measures and violence against children. Bull World Health Organ [Internet]. 2020 [cited 2020 Oct 30];98(9):583. Available from: https://doi.org10.2471/BLT.20.263467
https://doi.org10.2471/BLT.20.263467... ^,2424. Teo SSS, Griffiths G. Child protection in the time of COVID-19. J Paediatr Child Health [Internet] 2020 [cited 2020 Oct 31];56(6):838-40. Available from: https://doi.org/10.1111/jpc.14916
https://doi.org/10.1111/jpc.14916... ^,3838. Bryce I. Responding to the accumulation of adverse childhood experiences in the wake of the COVID-19 pandemic: implications for practice. Child Aust [Internet]. 2020 [cited 2020 Oct 31];45(2):80-7. Available from: https://doi.org/10.1017/cha.2020.27
https://doi.org/10.1017/cha.2020.27...

The increase in parental stress also stems from restrictions in contact with family members who usually offered support in home care and with children. Many grandparents and grandfathers had to discontinue contact with children as a measure of protection against the disease, thus reducing social support for families.3333. Posick C, Schueths AA, Christian C, Grubb JA, Christian SE. Child Victim services in the time of COVID-19: new challenges and innovative solutions. Am J Crim Just [Internet]. 2020 [cited 2020 Oct 31];45(4):680-9. Available from: https://doi.org/10.1007/s12103-020-09543-3
https://doi.org/10.1007/s12103-020-09543...

Sexual exploitation and child marriage also increased during the pandemic, and this growth is mainly linked to the economic crisis. Many parents resort to planning child marriage or sexual exploitation to lower household expenses and alleviate the economic impacts brought by the pandemic.2626. Dahal M, Khanal P, Maharjan S, Panthi B, Nepal S. Mitigating violence against women and young girls during COVID-19 induced lockdown in Nepal: a wake-up call. Global Health [Internet]. 2020 [cited 2020 Oct 31];16(1):84. Available from: https://doi.org/10.1186/s12992-020-00616^,3636. Ghosh R, Dubey MJ, Chatterjee S, Dubey S. Impact of COVID-19 on children: Special focus on the psychosocial aspect. Minerva Pediatr [Internet]. 2020 [cited 2020 Nov 1];72(3):226-35. Available from: https://doi.org/10.23736/s0026-4946.20.05887-9
https://doi.org/10.23736/s0026-4946.20.0...

In Brazil, the unemployment rate reached 14.4% with the number of unemployed at 13.8 million.4545. Instituto Brasileiro de Geografia e Estatística. Desemprego chega a 14,4% no trimestre encerrado em agosto [Internet]. Rio de Janeiro, RJ(BR): IBGE; 2020 [cited 2020 Oct 30]. Available from: https://agenciadenoticias.ibge.gov.br/agencia-noticias/2012-agencia-de-noticias/noticias/29321-desemprego-chega-a-14-4-no-trimestre-encerrado-em-agosto
https://agenciadenoticias.ibge.gov.br/ag... Also in this context, it is emphasized that it is possible that most students have been left hungry due to the absence of school meals during the pandemic.77. Silva ERA, Oliveira VR. Protection of children and adolescents in the context of the covid-19 pandemic: consequences and measures necessary for coping. Rio de Janeiro, RJ(BR): IPEA; 2020. [cited 2020 June 22]; Available from: http://repositorio.ipea.gov.br/handle/11058/10041
http://repositorio.ipea.gov.br/handle/11... Although no Brazilian studies on the subject have been found, with the coexistence of the two factors exposed, it is possible to assume that, for Brazilian children and adolescents, the risks of sexual exploitation and forced labor for the supply of family economic expenses are real, dangerous and need to be modified.

Health professionals, protection services and neglect with violence against children

According to Art. 11 of the ECA, comprehensive health care for children and adolescents must be ensured by the Unified Health System (SUS), in order to guarantee universal and equal access in health protection, promotion and recovery actions.4444. Brasil. Lei n. 8069, de 13 de julho de 1990: Dispõe sobre o Estatuto da Criança e do Adolescente e dá outras providências; 1990 [cited 2020 Sept 12]. Available from: http://www.planalto.gov.br/ccivil_03/Leis/L8069.htm
http://www.planalto.gov.br/ccivil_03/Lei... During the pandemic scenario, there was an intensification in the inequality of access to health services, impacting on the increased risks of violence and vulnerability of children2020. Bhatia A, Fabbri C, Cerna-Turoff I, Tanton C, Knight L, Turner E, et al. COVID-19 response measures and violence against children. Bull World Health Organ [Internet]. 2020 [cited 2020 Oct 30];98(9):583. Available from: https://doi.org10.2471/BLT.20.263467
https://doi.org10.2471/BLT.20.263467... and hindering their protection. This inequality will have immediate and long-term impacts post-pandemic.88. Bradbury-Jones C, Isham L. The pandemic paradox: The consequences of COVID-19 on domestic violence. J Clin Nurs [Internet]. 2020 [cited 2020 Oct 30];29(13-14):2047-9. Available from: https://doi.org/10.1111/jocn.15296
https://doi.org/10.1111/jocn.15296...

Ordinance No. 115 of March 20, 2017, in its Art. 65, Item I, says that it is the responsibility of the Department of Special Protection to plan, organize, regulate and perform services and programs for cases of violence, exploitation and sexual abuse. 4646. Almeida DRMM, Vargas DP, Gomes GMR. Protocol of the flow of intersectoral and interinstitutional care in coping with violence against children and adolescents [Internet]. Birigui, SP(BR): Prefeitura Municipal de Birigui; 2018 [cited 2021 Apr 24]. Available from: https://static.fecam.net.br/uploads/1521/arquivos/1664723_cmdca.pdf
https://static.fecam.net.br/uploads/1521... The flow of care for cases of suspected or confirmed cases of violence is organized from the reality of each state/municipality, but there are services that are integrated into the protection network, common throughout Brazil: Specialized Reference Center for Social Assistance (CREAS), Reference Center for Social Assistance (CRAS), Hospital, Schools, Guardianship Council, Police Stations and Public Prosecutor's Office.4646. Almeida DRMM, Vargas DP, Gomes GMR. Protocol of the flow of intersectoral and interinstitutional care in coping with violence against children and adolescents [Internet]. Birigui, SP(BR): Prefeitura Municipal de Birigui; 2018 [cited 2021 Apr 24]. Available from: https://static.fecam.net.br/uploads/1521/arquivos/1664723_cmdca.pdf
https://static.fecam.net.br/uploads/1521... ^-4747. Ministério do Desenvolvimento Social e Combate à Fome (BR). Orientações Técnicas: Centro de Referência Especializado de Assistência Social - CREAS [Internet] Brasília, DF(BR): MDS; 2011 [cited 2021 Apr 24]. Available from: http://aplicacoes.mds.gov.br/snas/documentos/04-caderno-creas-final-dez.pdf
http://aplicacoes.mds.gov.br/snas/docume...

Before the pandemic, the flow of care, in general, involved the identifying unit (Basic Health Unit, hospitals, schools, day care centers), which was responsible for performing childcare and notification to the Guardianship Council.4646. Almeida DRMM, Vargas DP, Gomes GMR. Protocol of the flow of intersectoral and interinstitutional care in coping with violence against children and adolescents [Internet]. Birigui, SP(BR): Prefeitura Municipal de Birigui; 2018 [cited 2021 Apr 24]. Available from: https://static.fecam.net.br/uploads/1521/arquivos/1664723_cmdca.pdf
https://static.fecam.net.br/uploads/1521... ^-4747. Ministério do Desenvolvimento Social e Combate à Fome (BR). Orientações Técnicas: Centro de Referência Especializado de Assistência Social - CREAS [Internet] Brasília, DF(BR): MDS; 2011 [cited 2021 Apr 24]. Available from: http://aplicacoes.mds.gov.br/snas/documentos/04-caderno-creas-final-dez.pdf
http://aplicacoes.mds.gov.br/snas/docume... The path to be followed later in the protection network varied according to the needs of victims, family members and the severity of risk factors and violations.4747. Ministério do Desenvolvimento Social e Combate à Fome (BR). Orientações Técnicas: Centro de Referência Especializado de Assistência Social - CREAS [Internet] Brasília, DF(BR): MDS; 2011 [cited 2021 Apr 24]. Available from: http://aplicacoes.mds.gov.br/snas/documentos/04-caderno-creas-final-dez.pdf
http://aplicacoes.mds.gov.br/snas/docume...

During this period, the protection services remained the same, but there was a reorganization of flows and face-to-face functioning. Each State and municipality carried out their decrees and determined whether the protection services would be opened or closed, culminating in different realities of care and strategies to combat child violence in the country.4848. Brasil. Ministério da Cidadania. Secretaria Nacional de Assistência Social. Portaria nº 100, de 14 de julho de 2020. Dispõe sobre medidas para o enfrentamento da pandemia no âmbito do SUAS; 2020 [cited 2021 Apr 25]. Available from: https://www.in.gov.br/web/dou/-/portaria-n-100-de-14-de-julho-de-2020-267031342?fbclid=IwAR0MnJ-fGY2Y
https://www.in.gov.br/web/dou/-/portaria...

Among the strategies designed to combat violence against children during the pandemic are: prioritizing care and remote care follow-up for risk cases; reorganize face-to-face care in a decentralized manner where there is greater demand to avoid agglomerations; conduct, remotely, appropriate awareness for different genders and ages.4848. Brasil. Ministério da Cidadania. Secretaria Nacional de Assistência Social. Portaria nº 100, de 14 de julho de 2020. Dispõe sobre medidas para o enfrentamento da pandemia no âmbito do SUAS; 2020 [cited 2021 Apr 25]. Available from: https://www.in.gov.br/web/dou/-/portaria-n-100-de-14-de-julho-de-2020-267031342?fbclid=IwAR0MnJ-fGY2Y
https://www.in.gov.br/web/dou/-/portaria... ^-5151. Fernandes Figueira Institute. Covid-19 and Child and Adolescent Health [Internet] Rio de Janeiro, RJ(BR): FIOCRUZ; 2020 [cited 2021 Apr 25]. Available from: http://www.iff.fiocruz.br/pdf/covid19_saude_crianca_adolescente.pdf
http://www.iff.fiocruz.br/pdf/covid19_sa...

Among the studies included in the review, only two brought suggestions for protection and confrontation of violence against children, in order to place the child at the center of the actions,3939. Levine DT, Morton J, O’Reilly M. Child safety, protection, and safeguarding in the time of COVID-19 in Great Britain: Proposing a conceptual framework. Child Abuse Negl [Internet]. 2020 [cited 2020 Oct 30];110(Pt 2):104668. Available from: https://doi.org/10.1016/j.chiabu.2020.104668
https://doi.org/10.1016/j.chiabu.2020.10... ^-4040. Roca E, Melgar P, Gairal-Casadó R, Pulido-Rodríguez MA. Schools that “open doors” to prevent child abuse in confinement by COVID-19. Sustain [Internet]. 2020 [cited 2020 Oct 31];12(11):4685. Available from: https://doi.org/10.3390/su12114685
https://doi.org/10.3390/su12114685... in other words, working from the perspective of prevention, educating children to identify signs of abuse and guiding ways to ask for help quickly and efficiently.

CONCLUSION

It is concluded that the Covid-19 pandemic has had numerous impacts on violence against children. The need for social distancing demanded the closure of schools, with consequent reduction of escape routes and calls for help. The interruption of monitoring by the child protection services was followed by the increase in unconfirmed cases and the difficulty in identifying and reporting cases of violence with a consequent decrease in complaints. It is also important to mention the increase of the following factors: maltreatment; negligence; psychological abuse and exploitation; trauma and cranial trauma due to physical child abuse; child online sexual exploitation; number of child rapes perpetrated by family members; in addition to the reduction of the most serious forms of injuries from the use of firearms and cold weapons.

In addition to contributing to the research area, this study is expected to contribute to the dissemination of the theme and encourage actions that favor the identification, notification and monitoring of cases of child abuse as an important part of the responses against the Covid-19 pandemic. This problem must be an ethical and political commitment of the whole society.

The study is limited due to the absence of Brazilian research on the composition of the sample, raising doubts about the political and scientific involvement with the theme in this country. Future research with other methodological designs is suggested to explore different dimensions of this theme.

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