Article Text

Download PDFPDF

Original article
Who perpetrates violence against children? A systematic analysis of age-specific and sex-specific data
  1. Karen Devries1,
  2. Louise Knight1,
  3. Max Petzold2,
  4. Katherine G Merrill3,
  5. Lauren Maxwell4,
  6. Abigail Williams5,
  7. Claudia Cappa6,
  8. Ko Ling Chan7,
  9. Claudia Garcia-Moreno8,
  10. NaTasha Hollis9,
  11. Howard Kress9,
  12. Amber Peterman10,
  13. Sophie D Walsh11,
  14. Sunita Kishor12,
  15. Alessandra Guedes13,
  16. Sarah Bott14,
  17. Betzabe C Butron Riveros13,
  18. Charlotte Watts1,
  19. Naeemah Abrahams15
  1. 1 Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
  2. 2 Health Metrics at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  3. 3 Johns Hopkins Bloomberg School of Public Health, Departmentof International Health, Johns Hopkins University, Baltimore, Maryland, USA
  4. 4 McGill University, Montreal, Quebec, Canada
  5. 5 Brunel University, Uxbridge, UK
  6. 6 Data and Analytics Section, Division of Data, Research and Policy, UNICEF, New York, USA
  7. 7 Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong
  8. 8 World Health Organization, Geneva, Switzerland
  9. 9 National Center for Injury Prevention and Control, US Centers for Disease Control, Atlanta, Georgia, USA
  10. 10 UNICEF Office of Research-Innocenti, Florence, Toscana, Italy
  11. 11 Department of Criminology, Health Behaviors of School Aged children violence and injuries focus group, Bar Ian University, Israel
  12. 12 The Demographic and Health Program, International Health Division, ICF, Rockville, Maryland, USA
  13. 13 Department of Family, Gender and Life Course, Pan American Health Organization/World Health Organization Regional Office for the Americas, Washington, USA
  14. 14 International Consultant
  15. 15 Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa
  1. Correspondence to Louise Knight; louise.knight{at}


Objective The epidemiology of violence against children is likely to differ substantially by sex and age of the victim and the perpetrator. Thus far, investment in effective prevention strategies has been hindered by lack of clarity in the burden of childhood violence across these dimensions. We produced the first age-specific and sex-specific prevalence estimates by perpetrator type for physical, sexual and emotional violence against children globally.

Design We used random effects meta-regression to estimate prevalence. Estimates were adjusted for relevant quality covariates, variation in definitions of violence and weighted by region-specific, age-specific and sex-specific population data to ensure estimates reflect country population structures.

Data sources Secondary data from 600 population or school-based representative datasets and 43 publications obtained via systematic literature review, representing 13 830 estimates from 171 countries.

Eligibility criteria for selecting studies Estimates for recent violence against children aged 0–19 were included.

Results The most common perpetrators of physical and emotional violence for both boys and girls across a range of ages are household members, with prevalence often surpassing 50%, followed by student peers. Children reported experiencing more emotional than physical violence from both household members and students. The most common perpetrators of sexual violence against girls aged 15–19 years are intimate partners; however, few data on other perpetrators of sexual violence against children are systematically collected internationally. Few age-specific and sex-specific data are available on violence perpetration by schoolteachers; however, existing data indicate high prevalence of physical violence from teachers towards students. Data from other authority figures, strangers, siblings and other adults are limited, as are data on neglect of children.

Conclusions Without further investment in data generation on violence exposure from multiple perpetrators for boys and girls of all ages, progress towards Sustainable Development Goals 4, 5 and 16 may be slow. Despite data gaps, evidence shows violence from household members, peers in school and for girls, from intimate partners, should be prioritised for prevention.

Trial registration number PROSPERO 2015: CRD42015024315.

  • violence against children
  • child abuse
  • intimate partner violence
  • bullying
  • school violence

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Handling editor Imti Choonara

  • Contributors KD designed the study, conducted data analysis, drafted the manuscript and obtained funding. LK input into the design of the study, conducted data analysis, performed the overall data synthesis and drafted the graphics and annexes. MP provided input into the statistical methods and data synthesis and conducted data analysis. KGM and LM conducted the systematic review and conducted data analysis. AW assisted with the systematic review. CC, KLC, NH, HK, AP, SDW, CG-M and SK contributed and/or analysed data. CW obtained funding. NA and CW input into the design of the study and provided criticalcomments to shape the direction of the manuscript. All authors input into the writing of the manuscript and approve of its contents. KD had full access to all of the data in the study and had final responsibility for the decision to submit for publication.

  • Funding This work was funded by the Know Violence in Childhood Initiative (to CW) and the Pan-American Health Organization (to KD). MP received funding from the Special Programme of Research and Research Training on Human Reproduction (HRP) in the Department of Reproductive Health and Research at WHO. SK received funding from USAID (DHS-7 contract). AP received funding from the UK Department for International Development (DIFD).

  • Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other affiliated institutions. Alessandra Guedes and Betzabe Butron are staff members of the Pan American Health Organization. The authors alone are responsible for the views expressed in this publication, and they do not necessarily represent the decisions or policies of the Pan American Health Organization. Claudia Garcia-Moreno is a staff member of the World Health Organization. The author alone is responsible for the views expressed in this publication and they do not necessarily represent the views, decisions, or policies of the World Health Organization.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement In this large data synthesis effort, most data in this study are published or publicly available. Access to datasets which are not publicly available can be requested from investigators on those studies.