Violence against children and adolescents: PAHO launches a new toolkit to strengthen health systems’ response

The initiative has a particular focus on preventing sexual violence, which affects 1 in 6 girls under the age of 18

Washington, D.C., 16 June 2026 (PAHO) - The Pan American Health Organization (PAHO) has launched the ANIMA-AA Kit, a new practical tool designed to support health care workers in identifying, responding to, and supporting children and adolescents affected by violence. The initiative aims to strengthen frontline health services across the Americas, where violence remains a widespread and urgent public health challenge.

Violence is highly prevalent in the region, and sexual violence is of particular concern, as it disproportionately affects girls. Among adolescents aged 15 to 19, 1 in 5 experience physical or sexual violence from an intimate partner, according to PAHO/WHO estimates, while 1 in 6 girls are subjected to sexual violence before the age of 18, based on UNICEF data.

Child marriage - affecting 1 in 5 girls - further increases the risk of violence and adolescent pregnancy. Taken together, these figures highlight the scale of the problem and its significant impact on physical, mental, social and reproductive health.

A tool for health workers

The ANIMA-AA Kit was developed with the support of the Spanish Agency for International Development Cooperation (AECID) in response to a persistent gap: health workers are often the first point of contact for survivors, yet they frequently lack the training and practical tools needed to provide timely, appropriate and empathetic care.

The toolkit provides concise, accessible, and easy-to-use guidance tailored to everyday clinical practice, with a particular focus on girls, who face heightened risks and greater barriers to being heard and accessing services.

"Health services can be a turning point in the lives of children and adolescents experiencing violence," said Britta Baer, Advisor on violence and injury prevention at PAHO. "A compassionate, timely, and non-judgmental response can mean the difference between continued harm and the beginning of protection and recovery."

Seven actions for an immediate response

The ANIMA-AA model promotes first-line support as an essential health service and organizes it into seven practical steps: attentive listening, non-judgmental validation, identifying and responding to needs, improving safety, offering support, creating child-friendly environments, and supporting caregivers - that is, those responsible for the child who are not perpetrators of violence and who may also need guidance and support.

The ANIMA-AA acronym captures these key elements and guides an integrated, survivor-centered, and empathetic response. The toolkit presents them in a practical format that can be applied immediately in primary care and emergency settings, where every interaction - and every hour - can be critical, particularly following sexual assault.

Despite the high prevalence of violence, relatively few cases are identified within health services, pointing to a critical opportunity to improve early detection and response. Although thousands of cases of sexual abuse are reported each year in some countries, these figures remain well below estimated prevalence levels, reflecting limitations in the capacity of health systems to respond. Without timely identification and response, violence often continues and escalates, leading to more severe and lasting consequences.

The development of the ANIMA-AA Toolkit reflects a participatory process involving direct input from adolescents and young people across the region. Their perspectives and recommendations were gathered through national workshops in Argentina, Bolivia and Honduras, as well as a regional dialogue that brought together youth representatives, health sector actors and other stakeholders. This process was carried out in collaboration with PAHO's Youth for Health group.

The toolkit aims to strengthen health systems' capacity to respond to violence and protect the rights and well-being of children and adolescents. PAHO is calling on countries, health institutions and partners to adopt and implement the ANIMA-AA approach, and to invest in training and systems that enable health workers to deliver high-quality, survivor-centered care.