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First Aid Practices for Injured Children in Rural Ghana: A Cluster-Random Population-Based Survey

Published online by Cambridge University Press:  01 December 2020

Adam Gyedu Open the ORCID record for Adam Gyedu [Opens in a new window] ,
Barclay Stewart ,
Easmon Otupiri ,
Peter Donkor  and
Charles Mock
Adam Gyedu*
Affiliation:
Department of Surgery, School of Medicine and Dentistry, KNUST, Kumasi, Ghana University Hospital, KNUST, Kumasi, Ghana
Barclay Stewart
Affiliation:
Harborview Injury Prevention & Research Center, Seattle, WashingtonUSA Department of Surgery, University of Washington, Seattle, WashingtonUSA
Easmon Otupiri
Affiliation:
Department of Population, Family and Reproductive Health, School of Public Health, KNUST, Kumasi, Ghana
Peter Donkor
Affiliation:
Department of Surgery, School of Medicine and Dentistry, KNUST, Kumasi, Ghana
Charles Mock
Affiliation:
Harborview Injury Prevention & Research Center, Seattle, WashingtonUSA Department of Surgery, University of Washington, Seattle, WashingtonUSA Department of Global Health, University of Washington, Seattle, WashingtonUSA
*
Correspondence: Adam Gyedu, MD, MPH Department of Surgery School of Medicine and Dentistry, KNUST Private Mail Bag, University Post Office Kumasi, Ghana E-mail: [email protected]
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Abstract

Introduction:

The majority of injury deaths occur outside health facilities. However, many low- and middle-income countries (LMICs) continue to lack efficient Emergency Medical Services (EMS). Understanding current first aid practices and perceptions among members of the community is vital to strengthening non-EMS, community-based prehospital care.

Study Objective:

This study sought to determine caregiver first aid practices and care-seeking behavior for common household child injuries in rural communities in Ghana to inform context-specific interventions to improve prehospital care in LMICs.

Methods:

A cluster-randomized, population-based household survey of caregivers of children under five years in a rural sub-district (Amakom) in Ghana was conducted. Caregivers were asked about their practices and care-seeking behaviors should children sustain injuries at home. Common injuries of interest were burns, laceration, choking, and fractures. Multiple responses were permitted and reported practices were categorized as: recommended, low-risk, or potentially harmful to the child. Logistic regression was used to examine the association between caregiver characteristics and first aid practices.

Results:

Three hundred and fifty-seven individuals were sampled, representing 5,634 caregivers in Amakom. Mean age was 33 years. Most (79%) were mothers to the children; 68% had only completed basic education. Most caregivers (64%-99%) would employ recommended first aid practices to manage common injuries, such as running cool water over a burn injury or tying a bleeding laceration with a piece of cloth. Nonetheless, seven percent to 56% would also employ practices which were potentially harmful to the child, such as attempting manual removal of a choking object or treating fractures at home without taking the child to a health facility. Reporting only recommended practices ranged from zero percent (burns) to 93% (choking). Reporting only potentially harmful practices ranged from zero percent (burns) to 20% (fractures). Univariate regression analysis did not reveal consistent associations between various caregiver characteristics and the employment of recommended only or potentially harmful only first aid practices.

Conclusions:

Caregivers in rural Ghanaian communities reported using some recommended first aid practices for common household injuries in children. However, they also employed many potentially harmful practices. This study highlights the need to increase context-appropriate, community-targeted first aid training programs for rural community populations of LMICs. This is important as the home-based care provided for injured children in these communities might be the only care they receive.

Keywords

first aidGhanainjurypediatricrural
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 1 , February 2021 , pp. 79 - 85
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Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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References

Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2017 (GBD 2017) Results. Seattle, Washington USA: Institute of Health Metrics and Evaluation (IHME); 2018. http://ghdx.healthdata.org/gbd-results-tool. Accessed September 20, 2019.Google Scholar
World Health Organization. Injury and Violence: The Facts 2014. Geneva, Switzerland: World Health Organization; 2014.Google Scholar
Gathecha, GK, Githinji, WM, Maina, AK. Demographic profile and pattern of fatal injuries in Nairobi, Kenya, January-June 2014. BMC Public Health. 2017;17(1):34.CrossRefGoogle Scholar
Mock, CN, Jurkovich, GJ, nii-Amon-Kotei, D, Arreola-Risa, C, Maier, RV. Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. J Trauma. 1998;44(5):804-812; discussion 812-814.10.1097/00005373-199805000-00011CrossRefGoogle ScholarPubMed
Husum, H, Gilbert, M, Wisborg, T, Van Heng, Y, Murad, M. Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia. J Trauma. 2003;54(6):1188-1196.CrossRefGoogle ScholarPubMed
Murad, MK, Issa, DB, Mustafa, FM, Hassan, HO, Husum, H. Prehospital trauma system reduces mortality in severe trauma: a controlled study of road traffic casualties in Iraq. Prehosp Disaster Med. 2012;27(1):36-41.CrossRefGoogle Scholar
Sasser, S, Varghese, M, Kellermann, A, Lormand, JD. Prehospital Trauma Care Systems. Geneva, Switzerland: World Health Organization; 2005.Google Scholar
Suryanto, Plummer V, Boyle, M. EMS systems in lower-middle income countries: a literature review. Prehosp Disaster Med. 2017;32(1):64-70.CrossRefGoogle ScholarPubMed
Gyedu, A, Mock, C, Nakua, E, Otupiri, E, Donkor, P, Ebel, BE. Pediatric first aid practices in Ghana: a population-based survey. World J Surg. 2015;39(8):1859-1866.CrossRefGoogle ScholarPubMed
Pathak, A, Agrawal, N, Mehra, L, Mathur, A, Diwan, V. First aid practices and health-seeking behaviors of caregivers for unintentional childhood injuries in Ujjain, India: a community-based cross-sectional study. Children (Basel). 2018;5(9):124.Google ScholarPubMed
The World Bank Group. World Development Indicators. https://data.worldbank.org/indicator/SP.POP.TOTL?locations=GH. Accessed April 24, 2020.Google Scholar
Fatmi, Z, Kazi, A, Hadden, WC, Bhutta, ZA, Razzak, JA, Pappas, G. Incidence and pattern of unintentional injuries and resulting disability among children under 5 years of age: results of the National Health Survey of Pakistan. Paediatr Perinat Epidemiol. 2009;23(3):229-238.CrossRefGoogle ScholarPubMed
Bland, JM, Butland, BK, Peacock, JL, Poloniecki, J, Reid, J, Sedgwick, P. Statistics Guide for Research Grant Applicants: Sample size calculations. s.l: s.n; 2009. http://www-users.york.ac.uk/~mb55/guide/size.htm. Accessed April 1, 2012.Google Scholar
Statistical Service, Ghana. 2010 Population and Housing Census: Summary Report of Final Results. Accra, Ghana: GSS; 2012.Google Scholar
Wansi, E, Mtango, D, Maganga, E, Banda, E, Msiska, T. Community IMCI baseline survey in Malawi. UNICEF; 2000. http://www.medcol.mw/commhealth/publications/UNICEF%20Malawi%20HCPS.pdf. Accessed October 28, 2014.Google Scholar
Spinella, PC. Zero preventable deaths after traumatic injury: an achievable goal. J Trauma Acute Care Surg. 2017;82(6):S2-S8.CrossRefGoogle Scholar
Ndile, ML, Saveman, B-I, Outwater, AH, Mkoka, DA, Backteman-Erlanson, S. Implementing a layperson post-crash first aid training program in Tanzania: a qualitative study of stakeholder perspectives. BMC Public Health. 2020;20(1):750.CrossRefGoogle ScholarPubMed
Tiska, MA, Adu-Ampofo, M, Boakye, G, Tuuli, L, Mock, CN. A model of prehospital trauma training for lay persons devised in Africa. Emerg Med J. 2004;21(2):237-239.10.1136/emj.2002.002097CrossRefGoogle Scholar
Lam, NN, Li, F, Tuan, CA, Huong, HTX. To evaluate first aid knowledge on burns management amongst high risk groups. Burns Open. 2017;1(1):29-32.CrossRefGoogle Scholar
Aries, MJH, Joosten, H, Wegdam, HHJ, van der Geest, S. Fracture treatment by bonesetters in central Ghana: patients explain their choices and experiences. Trop Med Int Health. 2007;12(4):564-574.CrossRefGoogle ScholarPubMed
Nimoh, SK. Indigenous Traditional Medicine in Ghana. In: Emeagwali, G, Dei, GJS, (eds). African Indigenous Knowledge and the Disciplines. Rotterdam, Netherlands: Sense Publishers; 2014.Google Scholar
Wedam, E, Amoah, ST. Traditional bone setting: analysis of contribution and patronage in Northern Ghana. GJDS. 2017;14(2):23-42.Google Scholar
Onyemaechi, NO, Itanyi, IU, Ossai, PO, Ezeanolue, EE. Can traditional bonesetters become trained technicians? Feasibility study among a cohort of Nigerian traditional bonesetters. Hum Resour Health. 2020;18(1):24.CrossRefGoogle ScholarPubMed
Kano, M, Siegel, JM, Bourque, LB. First-aid training and capabilities of the lay public: a potential alternative source of emergency medical assistance following a natural disaster. Disasters. 2005;29(1):58-74.CrossRefGoogle ScholarPubMed
Arli, SK, Yildirim, Z. The effects of basic first aid education on teachers’ knowledge level: a pilot study. Int J Caring Scis. 2017;10(2):813.Google Scholar
El Tayeb, S, Abdalla, S, Van den Bergh, G, Heuch, I. Use of healthcare services by injured people in Khartoum State, Sudan. Int Health. 2015;7(3):183-189.CrossRefGoogle ScholarPubMed
Buor, D. Analyzing the primacy of distance in the utilization of health services in the Ahafo-Ano south district, Ghana. Int J Health Plann Manage. 2003;18(4):293-311.CrossRefGoogle Scholar