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Authors: LADAPO, O. J.
Keywords: Fall-related injuries
Primary caregivers
Under-five children
Issue Date: Nov-2012
Abstract: Globally, falls and ensuing injuries are significant causes of morbidity and mortality among under-five children. However, the associated burden and types of falls and fall-related injuries have not been adequately researched in Nigeria. This study was conducted to assess Primary Caregivers’ (PCs) level of knowledge, prevalence and types of fall-related injuries among under-five children in Ibadan North Local Government Area (IbNLGA). In this cross-sectional study, a three-stage random sampling technique was used to select 507 PCs of under-five children from five of the 12 wards within IbNLGA. A validated questionnaire which included a 30-point knowledge scale (causes of falls among under five children -9 points, prevention of falls -18 points and outcome of falls -3 points) was used for data collection from selected caregivers. Information was also obtained on the occurrence and outcome of falls sustained by each caregivers’ youngest under-five child (index child). Respondent’s scores were categorized as good (21-30 points), average (11-20 points) and poor (0-10 points). Data were analyzed using descriptive statistics and Chi-square. The PCs consisted predominantly of biological mothers (91.0%). Their mean age was 32.3±8.1 years and a larger proportion of them (43.8%) were secondary school certificate holders. Respondents’ median number of children was one (range 1 – 3) and 54% of the children were males. Of the children, 47% sustained at least a fall in a rented apartment (65.9) with majority having chair fall (25.8). Of this, 56.4% sustained injuries that required first aid interventions and 51.7% were admitted in a hospital for a median period of three days (range 1 – 9). Injuries sustained included bruises and minor swellings (63.2%), abrasions (33.8%) and fractures/dislocation (1.5%). Most of the PCs (85.6%) had good knowledge of falls and their mean knowledge score was 23.9±3.1. All the respondents mentioned at least one strategy for preventing falls. Strategies adopted included close supervision (82.8%), cautioning (59.2%), good housekeeping practices (7.7%) and environmental modifications (3.2%). More children of PCs aged ≤20 years (61.0%) were found to have sustained a fall compared with those aged ≥41 years (15.4%), (p < 0.05). A higher proportion of children of PCs who were Yoruba (51.9%) sustained a fall than the PCs who were Hausa (40.6%) and Igbo (35.5%) (p < 0.05). A higher proportion of children aged 12-24 months (61.2%) experienced falls compared with those aged <12months (39.7%), 37-48 months (34.5%) and 49-59months (33.0%) (p<0.05). Prevalence of fall-related injuries among the under-five children poses a serious challenge of public health importance. This is because under-five is a period to determine their potential to learn and thrive for a life time, their physical and intellectual development might be impaired. Knowledge of prevention of falls was high but only a few were aware of appropriate preventive measures. Interventions to increase knowledge of primary caregivers are therefore recommended.
Description: A Dissertation in the Institute of Child Health Submitted to the Faculty of Public Health in Partial Fulfilment of the Requirements for the Degree of MASTERS OF PUBLIC HEALTH (Child and Adolescent Health) of the UNIVERSITY OF IBADAN
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