Northland had the highest number of child abuse cases requiring further action last year and advocates warn not enough is being done to tackle the problem.
Northland District Health Board paediatrician Roger Tuck said children who had been the victims of abuse were being dealt with on a daily basis.
As the clinical director of the board's Child, Youth and Maternal Health department, he hoped the implementation of the Government's White Paper on Vulnerable Children would help to make a difference. Child Youth and Family (CYF) is also expecting the White Paper to help solve the problem.
In the year to June 30, Northland had the highest number of notifications that required further action (2408), followed by Manurewa (2363), Tauranga (2193), Waikato West (2191) and Wellington's Hutt Valley (1951). Northland has a smaller population than all those centres.
Dr Tuck said child abuse was widespread in Northland and health and statutory agencies spent huge resources trying to tackle this issue, however it was mostly reactive.
"Unfortunately we in Northland are at the bottom of the national league tables for a number of health indices. Northland is the poorest region of New Zealand with a highly deprived population and huge inequalities. As we know from the international and New Zealand literature, abuse is strongly linked to poverty in its broadest sense and also due to the complex socioeconomic effects of colonisation, both of which are headline issues here in Northland."
Dr Tuck said there had been a strong push in recent times to encourage individuals and organisations to report "expressions of concern" to CYF which meant more previously unknown cases were being discovered. But clearly not enough was being done to address the problem.
CYF general operations manager Marama Edwards said the organisation received thousands of calls from people worried about children or families every year.
"Police are our primary referrers, followed by health and education professionals, social service providers, family members and friends, and members of the public."
Police notified CYF every time they attended a family violence incident and found a child present, she said.
"This practice, along with an increased public awareness and willingness to speak up for children, is a significant driver in the increase in notifications occurring each year over recent times," Ms Edwards said.
Of the 21,525 substantiated abuse findings in the past financial year, 12,114 were emotional abuse cases, 3249 were physical abuse, 1396 were sexual abuse and 4766 were case of neglect.
One of the key initiatives of the Government's White Paper, released last month, was establishing a database of about 30,000 "at risk" children. The database will assess the chances of a child being abused and act as an early alert system. Also introduced were measures to keep potential abusers away from children, and the ability to strip parents of guardianship rights.