The socio- demographic factors influencing oral mutilation among under five- year old children at the Kenyatta National Hospital

Abstract

Introduction and background: Oral mutilation (OM) is an important public health problem with potential health complications. These may include haemorrhage, septicaemia, tetanus, gangrene, contractures, abscesses, airway obstruction, and even death (1). Recent studies have also linked the prevalence of Human immunodeficiency Virus (HIV) infections to I practices like Oral mutilation. Hence calls for comprehensive research on this kind of practice. (2) Objectives: The objective of the study was to establish the sociodemographic factors influencing the practice of oral mutilation (OM) among children under 5 years of age, seen at Kenyatta National Hospital (KNH) in Nairobi. Methodology: This study was a descriptive, cross-sectional study among children seen at the Hospital during the study period (from April to May to 2009). The parental, guardians and/or caregivers of the children were the respondents in the study. Coded and close-ended questionnaire were administered to the respondents focusing on socio-demographic profiles and knowledge, attitudes and practices regarding oral mutilation. The children were examined and evidence of oral mutilation recorded. Results: During the study period a total of 423 children were included in the study. The respondents were mostly parents (97.9%); females (83.7%); and married (88-7%). The majority were secondary school levers (48.2%), 29.8% primary, 20.1 % post primary and 1.9% had no formal education. Most were unemployed (51.8%). The prevalence of Oral Mutilation was found to be 14.9 %; traditional surgeon performed 81% of the OM, modern healthcare workers 19%. The mothers were found to have been the main decision makers on maters relating to tradition OM, accounting for OM decisions making in 46% of the procedures. Applying Pearson's chi-squared test, significant association was found in the respondent's responses between those whose children had had OM and those who had not, with a higher likelihood of OM among children whose parents, guardians or caregivers had no formal Education or had attained Primary level of education (None + primary) (p =0.02); or had heard of uvula removal (p=0.01); and those who had heard of both uvula and tooth bud removal (p=0.008); It was also more likely among those who felt that OM was beneficial to a child's health (p=<0.001); and among those who indicated that they advocate OM in children (p=<0.001); and in those who indicated that they would advice someone to take child for OM (p=<0.001). The less likelihood of OM was in the children whose parents, guardians or caregivers who had felt that OM was a public health problem (p=0.03), and among those who said that they would worry of their child's health if the child were to undergo the procedure (p=0.002). Conclusion: The prevalence of oral mutilation among children less than five years seen at the Kenyatta National Hospital was 14.9%. The mothers of the children were the main decision makers on mater pertaining to OM. The parents/caregivers who practiced oral mutilation were likely to be those who were less knowledgeable. Those who didn't report of any oral mutilation were likely to have negative attitude towards the practice. The parents/caregivers who had at least secondary education level were less likely to practice the oral mutilation. There was significant association between the complications related to OM and the level of knowledge regarding OM complications. Recommendations: The Ministry of Public Health and other health providers should initiate public awareness programs at community level, service provider levels and nationally to discourage the practice of oral mutilation. Healthcare workers involved in the practice should be advised to discontinue these activities and encouraged to educate the public in view of elimination of the practice. More studies should be done to encompass all our communities and OM service providers in view of developing a National policy on OM practice.