Intended for healthcare professionals

Primary Care

The health of children in refuges for women victims of domestic violence: cross sectional descriptive survey

BMJ 2001; 323 doi: (Published 28 July 2001) Cite this as: BMJ 2001;323:210
  1. Elspeth Webb, senior lecturera (webbev{at},
  2. Judith Shankleman, research health visitorc,
  3. Meirion R Evans, senior lecturerb,
  4. Rachel Brooks, clinical lecturera
  1. a Department of Child Health, University of Wales College of Medicine, Cardiff CF14 4XW
  2. b Department of Epidemiology and Public Health, University of Wales College of Medicine
  3. c Sure Start, Primary Care Directorate, Cardiff and Vale NHS Trust, Lansdowne Hospital, Cardiff CF11 8UL
  1. Correspondence to: E Webb
  • Accepted 14 May 2001


Objectives: To describe the health and developmental status of children living in refuges for women victims of domestic violence and to investigate their access to primary healthcare services.

Design: Cross sectional survey.

Setting: Women's refuges in Cardiff.

Participants: 148 resident children aged under 16 years and their mothers.

Main outcome measures: Completeness of records on the child health system (register of all children that includes data on the child's health) for named health visitor, named general practitioner, and immunisation uptake; satisfactory completion of child health surveillance; Denver test results for developmental status; Rutter test scores for behavioural and emotional problems; reports of maternal concerns.

Results: 148/257 (58%) children living in refuges between April 1999 and January 2000 were assessed. Child health system data were incorrect (general practitioner and/or address) or unavailable for 85/148 (57%) children. Uptake of all assessments and immunisations was low. 13/68 (19%) children aged <5 years had delayed or questionable development on the Denver test, and 49/101 (49%) children aged 3-15 years had a Rutter score of >10 (indicating probable mental health problems). Concerns were expressed by mothers of 113/148 (76%) children. After leaving the refuge, 22 children were untraceable and 36 returned home to the perpetrator from whom the families had fled.

Conclusions: The children had a high level of need, as well as poor access to services. Time spent in a refuge provides a window of opportunity to review health and developmental status. Specialist health visitors could facilitate and provide support, liaison, and follow up.

What is already known on this topic

What is already known on this topic A pilot study showed poor uptake of immunisations and surveillance among children who live in refuges for women victims of domestic violence

Qualitative studies suggest that these children are at risk of psychological ill health

What this study adds

What this study adds Baseline health and demographic data show that children in refuges have a high level of unmet health need, particularly in relation to mental health difficulties

Their families have poor access to health services


  • Funding The Wales Office for Research and Development in Health and Social Care (study number R/98/027) and the Sanoffi-Winthrop Foundation.

  • Competing interests None declared.

  • Accepted 14 May 2001
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