SERENA Project

The implementation of the EU-funded SERENA project officially launched on January 1, 2025. This multidisciplinary initiative aims to enhance access to health and social care services for children affected by maltreatment across Europe.

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Addressing a Critical Need

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Child maltreatment, including physical, sexual, psychological abuse, and neglect, remains a prevalent though underreported public health problem in Europe, leading to long-term physical and mental health challenges for victims. Despite the availability of health and social care services, many affected children face significant barriers to accessing timely and effective support.​

The SERENA project seeks to:​

• Identify and analyze barriers to accessing health and social care services for maltreated children across different European contexts.​

• Assess current care pathways and the inequalities present in service provision before and after the recognition of child maltreatment.​

• Evaluate the financial burden of child maltreatment on victims, families, and society.​

• Develop actionable recommendations to improve detection, management, and prevention strategies, aiming to influence policy and practice across EU countries.​

 

A Comprehensive, Multinational Approach

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SERENA brings together 22 organisations across Europe and adopts a mixed-method research approach to examine how children affected by maltreatment access health and social care services across different national contexts.

The project combines qualitative research conducted in three EU countries with quantitative analyses based on longitudinal cohort data from seven countries, as well as aggregated child protection services data from 26 countries. This cross-country perspective allows the project to identify common challenges, national differences, and structural inequalities in service provision.

An interdisciplinary and participatory synthesis of the findings will be conducted with key stakeholders, including health and social care professionals and adult survivors of child maltreatment. This collaborative process will contribute to a shared assessment of the current situation and help define priority actions for improving access to care.

Based on this evidence, the project will formulate operationally and economically viable recommendations with the potential to be adapted and implemented across EU countries.
The overall analytical framework of the SERENA project is summarised in the figure below.

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​Research Design and Analytical Framework 

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​The project is structured around several complementary research components:

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Quantitative studies (QUANT 1–4)
These studies analyse pseudonymised administrative and hospital data from multiple sectors, including health, social care, education, and justice. They examine different stages of care pathways followed by children affected by abuse or neglect in order to identify patterns of service use and potential disparities in access to care.

• QUANT 1: analysis of hospital data prior to the diagnosis of child maltreatment.

• QUANT 2: analysis of hospital data during the first two years of follow-up after diagnosis.

• QUANT 3: analysis of data provided by health and social care services.

• QUANT 4: analysis of hospital data covering up to ten years of follow-up after diagnosis.
   

Qualitative study (QUAL):

This component explores experiences and perceptions related to care pathways through in-depth interviews with:

• individuals with a history of child maltreatment;

• healthcare professionals;

• social care professionals.
   

These interviews provide insights into how survivors and professionals navigate health and social care systems, helping to identify barriers and enabling factors in access to support.

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Synthesis studies (SYNT):
Integrative analyses combine quantitative and qualitative evidence to better understand patterns of service access and gaps in care pathways across Europe.

• SYNT <2 years: synthesis of results from QUANT 2, QUANT 3 and QUAL to analyse short-term follow-up and operational barriers across countries.

• SYNT global: integration and validation of findings from all studies to identify long-term patterns and analytical gaps.
   

Economic evaluation (ECONeval):
This study assesses the service-related and societal costs associated with child maltreatment, providing an estimation of the broader economic burden across European health and social systems.

Policy recommendations (RECS)
The final stage of the project focuses on translating evidence into policy-relevant recommendations through:

• consultation with a panel of health and social care experts;

• a survey among front-line professionals;

• review of existing policies and practices.
   

These activities aim to support improved follow-up strategies, better data practices, and stronger coordination between services across Europe.

The overall structure and analytical workflow of the SERENA project are illustrated in the figure below.​

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​Anticipated Impact

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By addressing the systemic barriers that hinder effective support for maltreated children, SERENA aspires to:​

• enhance early detection and intervention strategies;​

• reduce the recurrence and severity of maltreatment cases;

• alleviate the long-term societal and financial burdens associated with child maltreatment.​

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The project's outcomes are expected to inform legislative measures, improve service availability and validity, and foster better coordination among health and social care services throughout Europe.