Gomes R, Deslades SF, Veiga MM, Bhering C, Santos J. Por que as crianças são maltratadas? Explicacões para a prática de maus-tratos infantis na literatura. [Why are children mistreated? Explanations in the literature concerning the mistreatment of children.] Cadernos de Saúde Pública [Public Health Notebooks] (Rio de Janeiro, Brazil) 2003 May-June; 18(3):707-714.

Objectives:To analyze factors relating to child abuse based upon articles published in the principal Brazilian pediatric publications

Methodology:Bibliographic review with content analysis.

Results: Brazil, Colombia, and Cuba exhibited a growing trend in mortality from external causes (traffic accidents, homicides, etc.) within all age groups, although the trend was much more accentuated among individuals 10 to 24 years of age during the period 1979-1990. In Brazil, violence committed against children and youths has acquired dramatic proportions. In addition to violence that leads to death, other forms of victimization exist. Domestic or intra-family violence is, without doubt, responsible for the victimization of thousands of children in Brazil.

One of the most important elements in preventing abuse against children and young people is to understand how this problem is being explained in the field of child health. Such an understanding sheds light on the obstacles to and resistance against policies and actions designed to overcome the limitations of the biomedical treatment of the problem. The explanatory theoretical models encountered most widely in the literature reviewed are: a) the repetition on the part of aggressors of experiences of violence committed against them; b) family and psychological maladjustments and alcoholism; and c) macro-structural conditions.

A deconstruction analysis demonstrates, first, a reductionism with which the problem is treated. The authors propose a theoretical-methodological understanding that coordinates the unique nature of each case with the accumulated knowledge gained through the care given to thousands of families enmeshed in the situation of abuse, both in Brazil and in other countries.

Conclusions:The limited number of articles published in the principal pediatric journals in Brazil, as well as deficiencies in the explanatory approaches used and the lack of data on the problem, demonstrate that the scientific output in child health promotion does not adequately address the problem of violence.