They reveal valuable information on costs, the distribution of resources, and the responsiveness of clients and systems to the supply of and demand for services. Finally, they reveal different approaches to decision making, including the nonrational factors that affect the psychology of decision making including decision-making thresholds.

John Fluke, vice president of the Children’s Innovation Institute at the American Humane Association, summarized a recent article in Lancet that examined the policy implications of cross-national differences in the responses of child protective systems (Gilbert et al., 2012). Before discussing the Lancet article he referred to two sources of data that have been used in cross-national approaches: self-report data and administrative data. The World Health Organization has identified selfreport data as the standard for understanding the epidemiology of child maltreatment. Examples of instruments that collect such data are the Parent-Child Conflict Tactic Scales, the Child Abuse Screening Tool developed by the International Society for Prevention of Child Abuse and Neglect, the Juvenile Violence Questionnaire, and the Multiple Indicator Cluster Study developed by the United Nations Children’s Fund (UNICEF). The article in Lancet drew primarily from administrative data, though the availability of such data depends on the existence of a functioning service delivery system. In some countries, information from health care systems can be a valuable addition to sparse or missing data from service delivery systems.

As an example of self-report data, Fluke cited international results from the UNICEF Multiple Indicator Cluster Survey on physical discipline. It found that physical punishment of children is less likely in households that share the belief that physical discipline is not necessary in child rearing, whereas physical discipline occurs more often in households that do see physical discipline as necessary. Such data indicate the feasibility of achieving a “broadband view from an international perspective across many low-and middle-income countries,” said Fluke.

A Six-Nation Comparison

The Lancet study looked at policies and practices in six high-income countries or parts of countries: England, Manitoba (in Canada), New Zealand, Sweden, the United States, and Western Australia. These countries are facing similar challenges and have relatively consistent enumeration methods that make it possible to look at multiple indicators. In particular, the study looked at children younger than 11 years old and drew data from hospital admissions and CPS agencies.

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