A Cross-sectional Exploratory Study of Knowledge, Attitudes, and Practices of Emergency Health Care Providers in the Assessment of Child Maltreatment in Maputo, Mozambique

Overview

Journal BMC Emerg Med

Publisher Biomed Central

Specialty Emergency Medicine

Date 2018 May 11

PMID 29743037

Citations 1

Authors

Liliana Pinto

Adriana Lein

Raquel Mahoque

David W Wright

Scott M Sasser

Catherine A Staton

Affiliations

Soon will be listed here.

Abstract

Background: In Mozambique, and other low-income countries (LICs), there is little information on the burden of child maltreatment (CM). Emergency care services (ECS) play an important role in recognizing, treating, and intervening in situations of CM. We aim to identify knowledge, attitudes, and practices regarding CM among health care providers in ECS at Mavalane General Hospital in Maputo, Mozambique.

Methods: This exploratory cross-sectional study evaluates the knowledge, attitudes, and practices of health care providers to diagnose and treat cases of CM. A 25 min, pilot-tested verbal interview questionnaire was administered to 49 physicians and nurses working in ECS at Mavalane General Hospital. Interviews were completed between October-November 2010. Data were managed and analyzed in SPSS 14.0 and descriptive statistics were generated.

Results: Of 49 health care providers, 83.6% reporting receiving no, or very little CM education or training. Only 61.2% had knowledge of physical abuse as a main form of child maltreatment and 38.8% were able to identify corresponding symptoms of physical abuse. Sexual abuse as a main form of CM was mentioned by 26.5 and 2% cited its symptoms. While 87.7% of health care providers strongly agreed or agreed that they hold an important role in preventing CM, 51.1% also strongly disagreed or disagreed that they feel confident diagnosing and treating CM cases. In regards to follow-up, 14.3% strongly disagreed or disagreed that they know where to refer victims for further follow-up and an additional 14.3% did not know whether they agreed or disagreed.

Conclusion: This study revealed knowledge gaps in emergency health care provider knowledge of the main forms of CM and their symptoms. The fact that a majority of health care providers in our sample did not receive information specific to CM in their medical education and training could explain this gap, as well as their unawareness of where to refer victims. Given that health care providers believe they play an important role in identifying and treating CM, future research should focus on raising physician awareness of CM and developing education and training materials grounded in cultural contexts to build response capacity in Mozambique and other LICs.

Citing Articles

Trends and outcomes following intentional injuries in pediatric patients in a resource-limited setting.

C Akinkuotu A, Purcell L, Kayange L, Phillips M, Hayes-Jordan A, Charles A Pediatr Surg Int. 2021; 37(5):649-657.

PMID: 33459861 DOI: 10.1007/s00383-020-04849-z.

References

Meinck F, Cluver L, Boyes M . Household illness, poverty and physical and emotional child abuse victimisation: findings from South Africa's first prospective cohort study. BMC Public Health. 2015; 15:444. PMC: 4418047. DOI: 10.1186/s12889-015-1792-4. View

Bridgewater G . Physical and sexual violence against children in Kenya within a cultural context. Community Pract. 2016; 89(2):30-4. View

Tansley G, Schuurman N, Amram O, Yanchar N . Spatial Access to Emergency Services in Low- and Middle-Income Countries: A GIS-Based Analysis. PLoS One. 2015; 10(11):e0141113. PMC: 4631370. DOI: 10.1371/journal.pone.0141113. View

Cho O, Cha K, Yoo Y . Awareness and Attitudes Towards Violence and Abuse among Emergency Nurses. Asian Nurs Res (Korean Soc Nurs Sci). 2015; 9(3):213-8. DOI: 10.1016/j.anr.2015.03.003. View

Abeid M, Muganyizi P, Massawe S, Mpembeni R, Darj E, Axemo P . Knowledge and attitude towards rape and child sexual abuse--a community-based cross-sectional study in rural Tanzania. BMC Public Health. 2015; 15:428. PMC: 4419483. DOI: 10.1186/s12889-015-1757-7. View

Flaherty E, Sege R . Barriers to physician identification and reporting of child abuse. Pediatr Ann. 2005; 34(5):349-56. DOI: 10.3928/0090-4481-20050501-08. View

Devries K, Knight L, Child J, Kyegombe N, Hossain M, Lees S . Witnessing intimate partner violence and child maltreatment in Ugandan children: a cross-sectional survey. BMJ Open. 2017; 7(2):e013583. PMC: 5337724. DOI: 10.1136/bmjopen-2016-013583. View

Lansford J, Godwin J, Tirado L, Zelli A, Al-Hassan S, Bacchini D . Individual, family, and culture level contributions to child physical abuse and neglect: A longitudinal study in nine countries. Dev Psychopathol. 2015; 27(4 Pt 2):1417-28. PMC: 4839471. DOI: 10.1017/S095457941500084X. View

Menoch M, Zimmerman S, Garcia-Filion P, Bulloch B . Child abuse education: an objective evaluation of resident and attending physician knowledge. Pediatr Emerg Care. 2011; 27(10):937-40. DOI: 10.1097/PEC.0b013e3182307ae5. View

10.

Al-Moosa A, Al-Shaiji J, Al-Fadhli A, Al-Bayed K, Adib S . Pediatricians' knowledge, attitudes and experience regarding child maltreatment in Kuwait. Child Abuse Negl. 2003; 27(10):1161-78. DOI: 10.1016/j.chiabu.2003.09.009. View

11.

Yahaya I, de Leon A, Uthman O, Soares J, Macassa G . Individual and community-level socioeconomic position and its association with adolescents experience of childhood sexual abuse: a multilevel analysis of six countries in Sub-Saharan Africa. J Inj Violence Res. 2013; 6(1):21-30. PMC: 3865452. DOI: 10.5249/jivr.v6i1.316. View

12.

Ward C, Sanders M, Gardner F, Mikton C, Dawes A . Preventing child maltreatment in low- and middle-income countries: Parent support programs have the potential to buffer the effects of poverty. Child Abuse Negl. 2016; 54:97-107. DOI: 10.1016/j.chiabu.2015.11.002. View

13.

Pereda N, Guilera G, Forns M, Gomez-Benito J . The prevalence of child sexual abuse in community and student samples: a meta-analysis. Clin Psychol Rev. 2009; 29(4):328-38. DOI: 10.1016/j.cpr.2009.02.007. View

14.

Sherr L, Hensels I, Skeen S, Tomlinson M, Roberts K, Macedo A . Exposure to violence predicts poor educational outcomes in young children in South Africa and Malawi. Int Health. 2015; 8(1):36-43. PMC: 4716801. DOI: 10.1093/inthealth/ihv070. View

15.

Mudany M, Nduati R, Mboori-Ngacha D, Rutherford G . Perceptions of child discipline and its contributions to child abuse in a low-income community in Nairobi, Kenya. Paediatr Int Child Health. 2013; 33(4):228-32. DOI: 10.1179/2046905513Y.0000000071. View

16.

Hillis S, Mercy J, Amobi A, Kress H . Global Prevalence of Past-year Violence Against Children: A Systematic Review and Minimum Estimates. Pediatrics. 2016; 137(3):e20154079. PMC: 6496958. DOI: 10.1542/peds.2015-4079. View

17.

Akmatov M . Child abuse in 28 developing and transitional countries--results from the Multiple Indicator Cluster Surveys. Int J Epidemiol. 2010; 40(1):219-27. DOI: 10.1093/ije/dyq168. View

18.

Garbin C, Rovida T, Joaquim R, De Paula A, Guimaraes e Queiroz A . [Reported violence: occurrences of maltreatment against children and adolescents registered in a police unit]. Rev Bras Enferm. 2012; 64(4):665-70. DOI: 10.1590/s0034-71672011000400006. View

19.

Gilbert R, Widom C, Browne K, Fergusson D, Webb E, Janson S . Burden and consequences of child maltreatment in high-income countries. Lancet. 2008; 373(9657):68-81. DOI: 10.1016/S0140-6736(08)61706-7. View

20.

Schols M, de Ruiter C, Ory F . How do public child healthcare professionals and primary school teachers identify and handle child abuse cases? A qualitative study. BMC Public Health. 2013; 13:807. PMC: 3847190. DOI: 10.1186/1471-2458-13-807. View