Key recommendations:

Criminalise failure to report child sexual abuse in an institutional context

Voluntary celibacy for priests

Abuse allegations revealed in confession must be reported

A national strategy to prevent future abuse

A royal commission argues Australia needs a national strategy to prevent child sexual abuse as it warns governments and institutions they must not fail children again.

The inquiry has controversially suggested the Catholic Church consider voluntary celibacy for diocesan clergy, and the Jehovah's Witnesses abandon a 2000-year-old rule in handling child sex abuse cases and stop shunning victims who leave the organisation.

It again called for strengthened and nationally consistent mandatory reporting laws that include people in religious ministry and no exemption when the information came from a religious confession.

It also wants abusers stripped of any honours and a national memorial to recognise the tens of thousands of children sexually abused in more than 4000 Australian institutions.

The royal commission's 17-volume final report has more than 400 recommendations, the bulk of which have already been released, aimed at making institutions safer for children.

It also places blame on state instruments, such as the police, child protection agencies and the justice system.

Government response

The government has pledged $52.1 million to support abuse victims' access to redress from a national scheme, along with a parliamentary committee, to be chaired by crossbench senator Derryn Hinch.

A taskforce will also be set up in January to look at and act on the recommendations.

Prime Minister Malcolm Turnbull praised the courage of the survivors who told their stories.

"As you go through that book… you see this repeated: ‘thank you for hearing me, thank you for believing me. The first time someone in authority has listened to me has heard my story’."

"What that commission has done has exposed a national tragedy."

The $500 million, five-year inquiry into how churches, charities and other organisations handled abuse of children concluded that abuse happened “in almost every type of institution where children reside or attend”.

“Tens of thousands of children have been sexually abused,” it says, but “we will never know the true number”.

Former Prime Minister Julia Gillard, who established the Royal Commission, expressed her thanks to the Commissioners and staff as well as survivors "who fought so hard for justice and a safer future for our children."

On this historic day, my personal thanks go to the Royal Commissioners and all who supported their work. Our nation is indebted to you and to the survivors who fought so hard for justice and a safer future for our children. JG — Julia Gillard (@JuliaGillard) 15 December 2017

The commission has given the federal, state and territory governments six months to respond to its recommendations and wants institutions to report on how they have implemented its reforms in a year's time.

The courage of survivors

More than 8,000 survivors told their personal stories, and a further 1,000 provided written accounts.

Almost all of the survivors, more than 64 per cent of whom were male, allege they were abused by an adult male, with most saying they were in their early teens when the abuse first happened.

Close to 40 per cent claim multiple perpetrators were involved.

The majority of religious institutions where abuse is believed to have taken place were Catholic-run, where leaders often had unsupervised access to, and authority over, children.

Those from culturally and linguistically diverse backgrounds say they often felt isolated as children, and faced discrimination from the broader society – something many perpetrators took advantage of.

The 14.3 per cent of survivors who were of Aboriginal or Torres Strait Islander background describe the combined pain of being abused and being separated from their family and culture, and of passing this trauma down to future generations.

Some recommendations have already been made and acted upon, including toughening background checks and establishing a redress scheme, which is still in progress.

Refusing compensation to survivors of child abuse who have gone on to commit serious crimes is of serious concern to advocates.

Mr Turnbull says blocking access to convicted criminals is government policy, but he understands the argument many had landed in jail because of the abuse they had suffered.

"But equally, you can understand how many people would be uncomfortable with and opposed to people who have committed serious offences then being provided compensation by government," he told 3AW radio on Friday.

The prime minister left the door open to revisiting the prohibition as the Commonwealth tries to finalise the redress scheme.

Opposition families spokeswoman Jenny Macklin, who helped establish the commission with former prime minister Gillard, said it was now up to the Turnbull government to step up.

And she urged all states, as well as the institutions responsible, to be a part of the redress scheme.

Queensland Premier Annastacia Palaszczuk said many of the reforms recommended were already underway in her state.

"I am pleased that a number of reforms that go to the heart of the commission's recommendations have either already been implemented or are underway in Queensland," she said.

While New South Wales Premier Gladys Berejiklian said the state would work to ensure this situation wouldn't be repeated.

"The royal commission heard evidence of shocking and appalling abuse perpetrated on children by the very people who were supposed to care for them. We will work to ensure that this situation cannot happen again," she said.