A cross-sectional exploratory study of knowledge, attitudes, and practices of emergency health care providers in the assessment of child maltreatment in Maputo, Mozambique

Liliana Pinto,Catherine A Staton,Scott M Sasser,David W Wright,Adriana Lein,Raquel Mahoque

doi:10.1186/s12873-018-0162-9

Abstract

BackgroundIn 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.MethodsThis 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.ResultsOf 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.ConclusionThis 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.

Highlights

In Mozambique, and other low-income countries (LICs), there is little information on the burden of child maltreatment (CM)
The latest global guidelines for the prevention of CM emphasize the vital role of the health sectors of Low- and middle-income country (LMIC) and our study offers evidence to guide the creation of new policies and investment in human resources in this context [25]
Health care providers in Emergency care services (ECS) play an important role in the prevention and management of cases of CM through appropriate services and referrals

Summary

Introduction

In Mozambique, and other low-income countries (LICs), there is little information on the burden of child maltreatment (CM). We aim to identify knowledge, attitudes, and practices regarding CM among health care providers in ECS at Mavalane General Hospital in Maputo, Mozambique. Child maltreatment (CM), the physical, sexual and emotional abuse, neglect, or exploitation of under 18 populations carries a heavy social cost and is a serious human rights and public health issue [1,2,3]. Distinct from other forms of violence against children, child maltreatment CM refers to acts perpetrated by parents or caregivers [4]. The highest prevalence of child sexual abuse is seen in Africa, with 34.4% of children experiencing a form before the age of 18 [10]. CM causes a range of long-term physical and mental sequelae, including neurological, cognitive, affective, and social disorders [11, 12], and is associated with poor school performance [13] and internalized acceptance towards gender-based violent attitudes in girls [14]

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