Millions of children across Europe and beyond experience abuse or neglect at the hands of those who should care for them. Global evidence shows that more than half of children aged 2–17 have experienced some form of interpersonal violence. In Europe alone, tens of millions of children are affected by abuse or neglect each year, with hundreds dying as a result. These figures are based on international public health research led by the World Health Organization, as well as comparative studies on violence against children.

However, despite decades of research highlighting the scale and lifelong consequences of child maltreatment, many protection systems across Europe still struggle to respond effectively. A major challenge is that many cases of abuse and neglect are never identified or recorded by services. As a result, there is limited information on which children come to the attention of the authorities, who receives support, and who remains invisible to the system.

Even when cases are identified, countries record child abuse and neglect in very different ways. The lack of comparable administrative data makes it difficult to understand how child protection systems function, where prevention efforts are most needed, and whether the most vulnerable groups are being identified. For families, this can mean that two children with similar experiences of abuse may receive very different responses depending on where they live.

The COST Action Multi-Sectoral Responses to Child Abuse and Neglect in Europe: Incidence and Trends (Euro-CAN) addressed this challenge by bringing together researchers, policymakers, administrators and practitioners from across Europe. The network aimed to improve how child maltreatment and maltreatment-related fatalities are defined, recorded and compared, and to develop practical recommendations that countries can use to strengthen their systems.

Speaking the same language

The scale and impact of child maltreatment have long been recognised in research. Children experience sexual and physical assault, neglect, psychological harm, and exposure to violence at home, at school, in their communities, and online. These experiences can have lasting effects on mental and physical health, development, education, and later working life.

One of the challenges highlighted by Euro-CAN is that health, social services and justice systems often use different definitions and categories to record cases. According to Andreas Jud, Chair of Euro-CAN, “Definitions of child maltreatment differ widely across Europe, and clear definitions are often missing. In health services, coding systems for child maltreatment are poorly defined, so professionals may record similar cases in different ways. In criminal law, countries use different age limits to define child sexual abuse. Some rely on fixed age thresholds, while others allow small age gaps between adolescents, which leads to different legal outcomes for similar situations. Some countries also use concepts in child protection that do not exist elsewhere.”

Without shared approaches, countries struggle to learn from one another, promising practices remain local, and prevention becomes harder.

“Even in countries with strong welfare and health infrastructures, administrative data are rarely comparable,” says Andreas. “Guidelines are lacking, and definitions of maltreatment vary widely across sectors and jurisdictions.”

These differences create uneven access to support for families and fragmented data across systems. Euro-CAN found that knowledge about child maltreatment often fails to translate into coordinated policy and services.“These inconsistencies within countries make it nearly impossible to generate reliable European estimates across countries or to monitor the effectiveness of interventions over time”, adds Andreas.

Building common ground on definitions and evidence

One of Euro-CAN’s most important achievements was developing a pan-European consensus definition of child maltreatment. This was achieved through a rigorous Delphi study involving experts from various sectors and countries. “It was a Herculean effort that demonstrated both the complexity and the necessity of reaching common ground in how child maltreatment is defined for data collection and surveillance,” Adreas confides.

The network sees this agreement as a starting point rather than a final destination. The results provide a foundation for further validation and practical use across countries and sectors.

In parallel, Euro-CAN research examined how health systems respond to childhood sexual abuse. A systematic review of national clinical guidelines found that only 17 out of the 34 surveyed European countries have national guidance on how to provide clinical care and treatment to affected children. These findings, published in The Lancet Regional Health – Europe, revealed major gaps and inconsistencies. The results have informed policy discussions in several countries and reinforced the need for clearer standards of care across Europe.

Learning from lived experience

Alongside the technical work on definitions and surveillance, Euro-CAN placed strong emphasis on participatory approaches. “It is not only an ethical imperative to include survivors’ expertise in improving surveillance,” notes Andreas Jud. “Involving children and adult survivors also improves the quality of data by reducing blind spots and ensuring that systems reflect lived realities.”

The Action’s edited volume, Participatory Research on Child Maltreatment with Children and Adult Survivors: Concepts, Ethics, and Methods, brings together approaches from different disciplines and shows how the perspectives of survivors can be gathered and used in research, practice, teaching and service management. The book provides practical guidance for research, service development, teaching and management, and contributes to the wider debate in Europe and beyond.

Investing in people and long-term collaboration

Euro-CAN’s impact went beyond research, with a strong focus on capacity building. “Training multiple early-career researchers and segueing them into responsible positions in the network was a quintessential success for the sustainability of our COST Action’s goals,” says Andreas Jud.

For Laura Cowley and Eva Mora-Theuer, the COST Action was more than just a network; it was a stepping stone to leadership roles and a prestigious follow-up project, SERENA, funded by the Horizon Europe programme.

“Being part of the COST Action gave me the opportunity to co-lead a working group and to lead meetings and work packages,” explains Laura. “This did wonders for my confidence and my ability to lead teams and collaborate internationally. The Action helped me secure a promotion to Senior Research Officer. It also greatly expanded my professional network and opened opportunities for new projects and grant proposals.”
Dr Laura Cowley, Swansea University, UK, Euro-CAN WG co-Leader

Laura presented her research across Europe, completed scientific missions, and contributed to two landmark papers, including one as lead author. “My participation in the international e-Delphi study on child maltreatment definitions was especially meaningful and was only possible through the energetic collaboration of the working group and the support of the Action. This led to my first-authored publication in The Lancet Regional Health – Europe, of which I am extremely proud,” she adds.

Eva Mora-Theuer also gained confidence and skills by leading an Action working group.

“Through collaborations, I learned far more than I had ever imagined possible. This process allowed me to significantly strengthen my skills as a young researcher, particularly in contributing to the evidence base within our research field. It was truly hands-on training that neither my PhD nor any other collaboration could have provided in such a comprehensive way.”
Dr Eva Anna Mora-Theuer, Medical University of Vienna, Austria, Euro-CAN WG Leader

As the SERENA project leader at her university, she now coordinates her country’s contributions, manages a small research group and represents the team in international discussions.

The stories of both Laura and Eva show how collaboration within a COST Action can deliver high-impact research while accelerating confidence, leadership and career growth.

Continuing the work beyond the Action

Although the formal COST Action has ended, the impact of Euro-CAN continues through new collaborations and initiatives. Many members are involved in the Horizon Europe project SERENA, which is based on Euro-CAN’s work of strengthening multi-sector data systems to improve access to health and social care for children affected by abuse.

Current initiatives include the development and evaluation of clinical protocols in hospitals and outpatient settings across Europe, with a focus on trauma-informed care. Euro-CAN alumni contribute to a learning network in which clinicians and academics share data, experience and best practice. Collaborative education continues via the International Course on Child Abuse Paediatrics (InterCAP), promoting professional development and standardising training across Europe.

Furthermore, Andreas Jud also co-leads the Child Maltreatment Data Collection Working Group of ISPCAN, ensuring the network maintains an international presence and visibility through co-located congress activities.