A cross sectional study on factors associated with harmful traditional practices among children less than 5 years in Axum town, north Ethiopia, 2013

The Prevalence, Dental Complications, and Effects of Infant Oral Mutilation

OBJECTIVE

The aim of this scoping review on infant oral mutilation (IOM) was to study the prevalence, dental complications, and immediate and long-term effects of this practice, in addition to providing a systematic overview on existing knowledge and analysis of identified knowledge gaps on IOM.

METHODS

Five electronic bibliographic databases (OVID/Medline, Embase.com, Clarivate Analytics/Web of Science Core Collection, SCOPUS, and Global Index Medicus) were searched for relevant studies. Data were entered in a bespoke data-charting form. The risk of bias was assessed by 2 independent reviewers.

RESULTS

A total of 478 studies were identified from the search, out of which 42 studies were included in this review. Of the 42 studies, 19 were prevalence studies published between 1969 and 2019 which were additionally assessed for the risk of bias. We found the prevalence of IOM in Uganda was 2% to 30%; Ethiopia, 12% to 86%; Sudan, 10%; Kenya, 61% to 87%; and Tanzania 0% to 24%. Based on the prevalence studies, we observed that the most common factor motivating IOM was diarrhoea. The immediate effects of IOM were found to be infection, bleeding, anaemia, pneumonia, septicaemia, osteomyelitis, meningitis, tetanus, and blood-borne diseases, with some infants dying from these effects. Missing canines, enamel hypoplasia, malformations, abnormal eruption of permanent teeth, occlusal discrepancies, midline shift, chronic periapical infections, rotations, canine transposition, or odontomas were the long-term effects found in relation to IOM.

CONCLUSIONS

IOM is a practice with serious immediate and long-term consequences that is mainly performed in East Africa (or by people originated from this region) in children aged 4 to 8 months. Most frequently affected are the deciduous canines and mostly the mandibular teeth. It is important to create professional and public awareness of the procedure in low- and high-income countries. Furthermore, there is a need for more research on the prevalence of IOM in Africa and other areas of the world to determine the long-term consequences of the practice.

The burdens, associated factors, and reasons for traditional uvulectomy in Ethiopia: A systematic review and meta-analysis

INTRODUCTION

Traditional uvulectomy is a harmful procedure in which the entire or a portion of the uvula is removed by traditional practitioners. It causes complications like septicemia, transmission of infectious diseases, anemia, excessive bleeding, infection, tetanus, meningitis, and death. A summary of national data was lacking, thus, the study aimed to determine the pooled national burden and determinants of traditional uvulectomy in Ethiopia.

METHODS

Studies were retrieved from PubMed, EMBASE, CINHAL (EBSCO), Google Scholar, Web of Sciences, MEDLINE, Cochrane Library, SCOPUS, and Google databases. Finally, 19 studies were included. The methodological quality of the included studies was assessed using the JBI checklist. Data synthesis and statistical analysis were conducted using STATA Version 17 software. Heterogeneity and publication bias were assessed. Forest plots were used to present the pooled and summarized with random-effects meta-analysis models.

RESULTS

Totally 19 articles with 23,559 study participants were included in this systematic review and meta-analysis. The overall pooled prevalence of uvulectomy in Ethiopia was 44 % (95 % CI: 31%-57 %). The highest prevalence was observed among studies conducted in the Tigray region (63 % (95 % CI: 34%-94 %), between the year 2011-2014 (58 % (95 % CI: 29%-87 %)) and, community setting (57 % (95 % CI: 36%-78 %). Mothers' educational status (AOR: 1.66, 95 % CI: 1.31-2.01) and residence (AOR: 1.70, 95 % CI: 1.16-2.23) were found to be significantly associated with traditional uvulectomy in Ethiopia. Frequently cited reasons for traditional uvulectomy were to prevent swelling, pus, and rupture of the uvula, for better care, prevention of sore throats and coughs, religion, and culture.

CONCLUSION

The pooled result revealed that almost half of children are still subjected to traditional uvulectomy in Ethiopia. There is a need to intensify awareness creation campaigns against the practice by giving special attention to rural residents and uneducated ones.

Prevalence of Primary Tooth Extraction and Its Associated Factors Among Under-Five-Year-Old Children in Debre Tabor Town, North-Central Ethiopia: Community-Based Cross-Sectional Study

Introduction

In Ethiopia, primary tooth extraction is a process of pulling out of an infant's healthy primary teeth by traditional healers or family members. Traditional healers use unsterile equipment to perform teeth extraction blindly, as a result, the child is prone to different life-threatening complications such as anemia and infectious blood-borne diseases. Despite all of these consequences, it is one of the neglected health problems, especially for developing countries. Thus, this study aimed to assess the prevalence and associated factors of primary tooth extraction among under-five year's children in Debre Tabor Town, Northcentral Ethiopia.

Methods

A community-based cross-sectional study was conducted among 370 participants, from March 2020 to April 2020 in Debre Tabor town. A multistage sampling technique was employed to select study participants. The data were collected by using a semi-structured pretested questionnaire via face-to-face interviews. The data was exported to SPSS version 20 software for analysis. Both binary and multiple logistic regression have been used to observe the association between the outcome variable with each independent variable. Finally, a 95% confidence interval was computed and variables with P-value ≤0.05 were considered statistically significant.

Results

The prevalence of primary teeth extraction among under-five-year children in Debre Tabor town was found to be 11.1% [95% CI: 7.8-14.2]. Being able to read and write in educational status [AOR: 3.97 (1.20-13.09)], having a mother caregiver [AOR: 0.35 (0.15-0.82)], having poor awareness [AOR: 6.15 (1.56-27.56)], and having a previous history of using traditional medicines [AOR: 6.65 (3.09-14.34)] were significantly associated with primary tooth extraction.

Conclusion

The prevalence of primary tooth extraction was found to be high. Educational status, caregiver of the child, level of awareness, and previous history of using traditional medicines were factors associated with primary tooth extraction.

Practice and associated factors of traditional uvulectomy among caregivers having children less than 5 years old in South Gondar Zone, Amhara Region, Ethiopia, 2020

INTRODUCTION

Traditional uvulectomy is widely practiced in Africa especially in sub-Saharan countries including Ethiopia. Studies conducted in different times and areas of the world have shown that the level of practice of uvulectomy and its associated factors were varied from country to country. Therefore, this study was carried out to assess the practice and associated factors of traditional uvulectomy among caregivers having children less than 5 years old in the South Gondar Zone.

OBJECTIVE

This study aimed to assess practice and associated factors of traditional uvulectomy among caregivers having children less than 5 years old in South Gondar Zone, Amhara Region, Ethiopia, 2020.

METHOD

A community-based cross-sectional study was conducted on 634 participants who were selected using a multistage with a simple random sampling method. Data were collected using a structured interviewer-administered Amharic version questionnaire; it was entered into Epi Data and analyzed using SPSS. Descriptive statistics were calculated and logistic regressions were fitted to declare statistical significance at p-value < 0.05 and 95% CI.

RESULT

The prevalence of traditional uvulectomy in this study was 52.5% (95% CI, 48.6-56.3%). Moreover, lack of information [AOR = 2.975 (1.677-5.277)], perceived as uvula causes illness [AOR = 4.888 (2.954-8.086)], future intention or will perform [AOR = 4.188 (2.584-6.788)], perceived as traditional uvulectomy should not be eradicated [AOR = 1.893 (1.172-3.057)]), saw the previous good result [AOR = 9.396 (5.512-16.016)], health personnel hospitality problem [AOR = 5.922 (2.392-14.664)] and did not get cured by pharmacologic treatment [AOR = 3.918 (2.073, 7.405)] were significantly associated with traditional uvulectomy.

CONCLUSION AND RECOMMENDATION

The prevalence of traditional uvulectomy was high. Lack of information, perceived as uvula causes illness, future intention to uvulectomy, perceived as traditional uvulectomy should not be eradicated, saw the previous good result, health personnel hospitality problem and did not get cured by pharmacologic treatment were the factors significantly associated with traditional uvula cutting. Therefore, special attention will be given to creating further awareness to the community at large and setting controlling mechanisms for the health care delivery system.

The global prevalence of female genital mutilation/cutting: A systematic review and meta-analysis of national, regional, facility, and school-based studies

BACKGROUND

Female genital mutilation/cutting (FGM/C) is a nonmedical procedure entailing the modification of the external female genitalia. A description of the prevalence and distribution of FGM/C allows the tracking of progress toward ending FGM/C by 2030 (Sustainable Development Goal (SDG): target 5.3). This systematic review aimed to examine FGM/C prevalence and types, by World Health Organization (WHO) region and country.

METHODS AND FINDINGS

A systematic search using Medical Subject Headings (MeSH) and keywords from 2009 to March 24, 2022 was undertaken in MEDLINE, PubMED, PsycINFO, Web of Science, and Embase to identify studies presenting FGM/C prevalence. Abstract and full-text screening, quality assessment, and data extraction were undertaken by 2 reviewers. Only nationally representative studies were included in the meta-analysis. Pooled FGM/C prevalence was estimated by random-effects meta-analysis using generalized linear mixed models (GLMMs). FGM/C prevalence with 95% confidence intervals (CIs), prediction intervals (PIs), and FGM/C type were presented separately by women aged 15 to 49 years and girls aged 0 to 14 years. A total of 163 studies met the inclusion criteria and 30 were included in the meta-analysis, of which 23 were from the WHO African Region (AFR), 6 from the Eastern Mediterranean Region (EMR), and 1 from the South East Asian Region (SEAR). These studies included data from 406,068 women across 30 countries and 296,267 girls across 25 countries; the pooled prevalence estimate of FGM/C among women aged 15 to 49 years was 36.9% (95% CI: 19.6% to 58.3%; PI: 0.4% to 99.0%), and 8.27% (95% CI: 3.7% to 17.3%; PI: 0.1% to 89.3%) among girls aged 0 to 14 years. Among included countries, this gave a total estimated prevalence of 84,650,032 women (95% CI: 45,009,041 to 133,834,224) and 13,734,845 girls with FGM/C (95% CI: 6,211,405 to 28,731,901). Somalia had the highest FGM/C prevalence among women (99.2%), and Mali had the highest among girls (72.7%). The most common type of FGM/C among women was "flesh removed" (Type I or II) in 19 countries. Among girls, "not sewn closed" (Type I, II, or IV) and "flesh removed" (Type I or II) were the most common types in 8 countries, respectively. Among repeated nationally representative studies, FGM/C decreased for both women and girls in 26 countries. The main limitation of the study methodology is that estimates were based on available published data, which may not reflect the actual global prevalence of FGM/C.

CONCLUSIONS

In this study, we observed large variation in FGM/C prevalence between countries, and the prevalence appears to be declining in many countries, which is encouraging as it minimizes physical and physiological harm for a future generation of women. This prevalence estimate is lower than the actual global prevalence of FGM/C due to data gaps, noncomparable denominators, and unavailable surveys. Yet, considerable policy and community-level interventions are required in many countries to meet the SDG target 5.3.

TRIAL REGISTRATION

Registration: CRD42020186937.

Antenatal care follow-up decreases the likelihood of cultural malpractice during childbirth and postpartum among women who gave birth in the last one-year in Gozamen district, Ethiopia: a community-based cross-sectional study

Background

Recent evidence has found widespread reports of women experiencing cultural malpractice during childbirth in Asia and sub-Saharan African countries. Despite an endeavor made to drop maternal and neonatal mortality, Ethiopia remains amongst the highest mortality rate. Thus, strengthening antenatal care (ANC) follow-up is the midst of cultural malpractice reduction during childbirth. This study was aimed to assess the magnitude of cultural malpractice and associated factors during childbirth and postpartum among women who gave birth within one year in Gozamen district, Ethiopia.

Methods

A community-based cross-sectional study was conducted from November 1st to December 30th, 2019. A two-stage sampling technique was used to get a total of 600 women who gave birth within the last one year. Data were collected by using a semi-structured and pretested questionnaire. Then, data were entered into Epi info version 7.0 and exported to SPSS version 25 for analysis. Both bivariate analysis and a multivariable logistic regression model were fitted. The level of significance was declared based on the adjusted odds ratio (AOR) with its 95% confidence interval (CI) and a p-value of ≤0.05.

Result

The Overall magnitude of cultural malpractices during childbirth and postpartum was found to be 31.2% (95%CI: 27.8, 34.7). Out of 600 women, 203(33.9%) were delivered at home, 67(11.2%) practiced abdominal massage, 31(16.6%) avoided colostrum, 24(12.8%) practiced pre-lacteal feeding and 138 (23%) washed their baby before 24 h after delivery. Mothers who have antenatal follow-up (AOR=0.52 95%CI 0.28, 0.94), married marital relation (AOR=0.24, 95%CI:0.07, 0.89), being farmer husband occupation (AOR=6.25 (95%CI: 1.22, 30.30), parity ≥5 (AOR=5, 95%CI: 2.44, 9.52), had significant association with cultural malpractice during childbirth and postpartum.

Conclusions

This study showed there is an improvement in the magnitude of cultural malpractices during childbirth and postpartum, but still it’s high as compared to the country’s maternal health service utilization aim. A well-enforced health education program by well-trained healthcare personnel besides sufficient number of ANC visits are needed to overcome these cultural practices. Further, intervention modalities health education communication outreach programs would be very important to reduce the prevalence of cultural malpractices in the community.

Cultural and Personal Practices with Unusual Oral Findings: Three Case Reports and a Literature Review

Due to increased migration, dentists are encountering patients with varied cultural practices. The main aim of this study was to report three cases in which cultural/individual oral practices appeared to be suggestive of disease, leading to initial misdiagnoses. We describe the case findings of three individuals treated at the Oral Diagnosis Clinic at the College of Dentistry at King Saud University in Riyadh, Saudi Arabia. In two cases, the patients presented with a missing uvula and dark maxillary gingiva. The initial diagnoses in both cases were incorrect. Further questioning revealed that the individuals had gingival tattoos and uvulectomies performed for traditional reasons. The patient in the third case presented with a diffuse red and white bilateral lesion on the buccal mucosa. The initial diagnosis was possible speckled leukoplakia. Upon further questioning, a definitive diagnosis of a chemical burn from a coarse salt mouth rinse due to personal oral practices was made. A literature review of these cultural practices is included. Our case report findings and the literature review highlight the need to consider cultural practices that can affect oral health and cause unusual oral findings when recording medical histories. Increasing awareness regarding these practices may help dentists provide appropriate treatment plans and reduce misdiagnoses. Furthermore, by understanding cultural practices, dentists may educate their patients about the harmful effects of some of these traditions.

Harmful cultural practices during perinatal period and associated factors among women of childbearing age in Southern Ethiopia: Community based cross-sectional study

INTRODUCTION

Although the maternal mortality ratio has decreased by 38% in the last decade, 810 women die from preventable causes related to pregnancy and childbirth every day, and two-thirds of maternal deaths occur in Sub-Saharan Africa alone. The lives of women and newborns before, during, and after childbirth can be saved by skilled care. The main factors that prevent women from receiving care during pregnancy and childbirth are harmful cultural practices. The aim of this study was to assess the level of harmful cultural practices during pregnancy, childbirth, and postnatal period, and associated factors among women of childbearing age in Southern Ethiopia.

METHODS

A community-based cross-sectional study design was conducted in the Gurage zone, among representative sample of 422 women of reproductive age who had at least one history of childbirth. A simple random sampling technique was used to recruit participants. Data were collected by six experienced and trained data collectors using a pretested structured questionnaire with face to face interviews. Harmful cultural practices are assessed using 11 questions and those who participate in any one of them are considered as harmful cultural practices. Descriptive statistics were performed and the findings were presented in text and tables. Binary logistic regression was used to assess the association between each independent variable and outcome variable.

RESULTS

Harmful cultural practices were found to be 71.4% [95%CI, 66.6-76.0]. The mean age of study participants was 27.6 (SD ± 5.4 years). Women with no formal education [AOR 3.79; 95%CI, 1.97-7.28], being a rural resident [AOR 4.41, 95%CI, 2.63-7.39], having had no antenatal care in the last pregnancy [AOR 2.62, 95%CI, 1.54-4.48], and pregnancy being attended by untrained attendants [AOR 2.67, 95%CI, 1.58-4.51] were significantly associated with harmful cultural practice during the perinatal period.

CONCLUSION

In this study we found that low maternal education, rural residence, lack of antenatal care and lack of trained birth attendant were independent risk factors associated with women employing harmful cultural practices during the perinatal period. Thus, strong multi-sectoral collaboration targeted at improving women's educational status and primary health care workers should take up the active role of women's health education on the importance of ANC visits to tackle harmful cultural practices.

Parental Traditional Medicine Use for Children and Associated Factors in North Mecha District, North West Ethiopia

Introduction

Traditional medicine (TM) has existed in human societies before application of modern science to health. Even though there have been many studies conducted on adults' TMuse, there were limited studies done on the issue of parenteral TM use to children in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of parental TM use for children in North Mecha District, North West Ethiopia.

Methods

A community-based cross-sectional study was conducted among 374 parents with children aged under 18 in the North Mecha District from March 1st to 30th, 2020. A multistage sampling technique was used. Kebeles were selected by using a simple random sampling method from the district. Then, the sample size was proportionally allocated to each kebele. Households were selected by using a table of random sampling technique from the kebele. An interviewer-administered questionnaire was used to collect the data. The bivariable and multivariable logistic regression models were used to assess the association between dependent and independent variables. Factors that had a statistically significant association with the dependent variable (p<0.05) were identified as significant in the multivariable logistic regression analysis.

Results

From 374 sampled participants, 351 of them were participated in the study making a response rate of 93.90%. The prevalence of parental TM use for children was 90.30%. Being non educated [AOR=5.65, 95% CI: (1.25, 25.50)], rural residence [AOR=6.33, 95% CI: (1.97, 20.32)], having good attitude [AOR=4.91, 95% CI: (1.90,12.65)], very poor wealth index [AOR=8.43, 95% CI: (3.08, 23.06)] and accessibility of TM [AOR=4.01, 95% CI: (1.11, 14.38)] were the determinants of TM utilization.

Conclusion

TM use was high in this study. TM utilization was affected by modifiable factors. Therefore, the government should give especial emphasis to factors of parental TM use for children under 18-year-old.

Prevalence of female genital mutilation among women in Ethiopia: A systematic review and meta-analysis

Background

Female genital mutilation affects the social, psychological, spiritual and physical well-being of women. In Ethiopia, studies regarding the female genital mutilation were conducted in various settings and years.

Objective

This systematic review and meta-analysis was aimed to summarize the prevalence of female Genital Mutilation in Ethiopia.

Methods

A systematic search of articles was conducted in PubMed, African Journals Online (AJOL), Excerpta Medica database (EMBASE), SCOPUS, Web of Science, and JSTOR. Data were extracted using a standardized data extraction format prepared in Microsoft Excel. The data were analyzed using STATA version 11 software. Cochrane Q statistic was used to assess the presence of significant between-study heterogeneity. I² was used to quantify between-study heterogeneity. A leave-one-out sensitivity analysis and subgroup analysis based on a study period and setting were done. The funnel plot and Egger's regression tests were used to measure the presence of substantial publication bias. The pooled estimated prevalence of female genital mutilation was conducted using a DerSimonian and Laird random effects model.

Results

The pooled prevalence estimate of FGM was 77.28% (95% CI: 55.81, 98.76). The pooled prevalence was higher in studies conducted from 2013-2017 (78.39%, 95%CI: 48.24, 108.54) and studies conducted in Hospital (92.02: 95%CI: 55.81, 98.76).

Conclusion

The prevalence of Female Genital Mutilation is high. Therefore, interventions that are focused on health education, social support and advocacy are recommended.

The burden of traditional neonatal uvulectomy among admissions to neonatal intensive care units, North Central Ethiopia, 2019: A triangulated crossectional study

Background

Traditional neonatal uvulectomy is unsupervised, unscientific and potentially dangerous cultural malpractice. It is often accompanied with life threatening neonatal morbidities such as infection, septicemia, anemia, aspiration and oropharyngeal injury. However, there is no current regional and even national data of its public health importance in the health care system. Therefore, this study was aimed at assessing the burden, associated factors and reasons of traditional uvulectomy among neonatal admissions at Debre Tabor General Hospital, North Central Ethiopia, from September 2018 to August 2019.

Methods

A quantitative cross sectional study supplemented with phenomenological study was employed on 422 mother-neonate pairs. Eight mothers who were not included in the quantitative part were involved as key informants of the qualitative study. Systematic and purposive sampling techniques were used to select study participants for the quantitative and qualitative parts of the study respectively. Multivariable logistic regressions were fitted to investigate significant predictors of traditional neonatal uvulectomy at p-value ≤ 0.05 and 95% CI. Moreover, the qualitative data were carefully transcribed, coded, screened, thematized, synthesized and then triangulated with the quantitative results.

Results

The burden of postuvulectomy admission was 67 (15.88%). Most of these admissions had post uvulectomy sepsis [59 (88.1%)] followed by anemia (55.23%). From multivariable analysis, factors that had significant odds of association with traditional neonatal uvulectomy include: having male neonate [AOR = 4.87; 95% CI: 1.10, 21.59], antenatal couple counseling about traditional neonatal uvulectomy [AOR = 0.053; 95% CI: 0.01, 0.35], home delivery [AOR = 6.02; 95% CI: 1.15, 31.61], postnatal couple counseling about traditional neonatal uvulectomy [AOR = 0.101; 95% CI: 0.02, 0.65], prior history of traditional neonatal uvulectomy [AOR = 7.15; 95% CI: 1.18, 43.21] and knowing at least one adverse effect of traditional neonatal uvulectomy [AOR = 0.068; 95% CI: 0.01, 0.44]. Furthermore, maternal perception of “there is no modern medicine to treat elongated and swollen neonatal uvula’ was the most explained reason to practice traditional neonatal uvulectomy.

Conclusion and recommendation

The burden of traditional neonatal uvulectomy was high. Fortunately, its predictors are modifiable. Therefore, several advocacy teams of neonatal health consisting of mainly women health development armies, elders, religious fathers, health professionals and criminal prosecutors should be actively mobilized against traditional neonatal uvulectomy. Besides, parental couple counseling about the adverse effects of traditional neonatal uvulectomy should be properly implemented in the routine antenatal and postnatal continuum of care in South Gondar Zone, North Central Ethiopia.

Hepatitis B virus infection and associated factors among pregnant women attending antenatal clinics in West Hararghe public hospitals, Oromia region, Ethiopia

Introduction

Globally, approximately 350-400 million persons are chronically infected with hepatitis B virus (HBV), over 65 million of whom are in Africa. One in four people with chronic hepatitis B develop serious health problems. Mother-to-child transmission (MTCT) is responsible for more than half of chronic infections. If infected at birth, a child has a 90% chance of becoming a chronic carrier. We evaluated hepatitis B virus prevalence and risk factors for infection among pregnant women attending antenatal clinics in West Hararghe public hospitals, Oromia region, Ethiopia.

Methods

We conducted a cross-sectional study among 363 pregnant women at routine antenatal clinic visits in West Hararghe public hospitals from April-May, 2017. We used systematic random sampling method to enroll participants. We used a structured questionnaire to collect information on risk factors, and collected blood samples to test for hepatitis B Virus surface antigen (HBsAg) by enzyme-linked immunosorbent assay (ELISA). Data were entered using EpiData Version.3.1 and exported to SPSS Version 23.0 for descriptive analyses and binary logistic regression.

Results

The overall seroprevalence of HBsAg among participants was 6.1% (95% CI 3.9-8.5). History of abortion (aOR=4.3, 95% CI 1.3-15.0), traditional tonsillectomy (tonsillectomy conducted by an untrained practitioner) (aOR=4.4, 95% CI 1.1-17.8), admission to a health facility (aOR=4.4, 95% CI 1.2-16.9), multiple sexual partners (aOR=6.3, 95% CI 1.7-23.4) and familial liver disease (aOR=8.2, 95% CI 2.1-32.8) were associated with hepatitis B virus infection among pregnant women.

Conclusion

The prevalence of hepatitis B virus in study area indicates a high-intermediate level epidemic. Multiple types of healthcare, as well classic risk factors such as multiple sex partners and a family history of liver disease increased the odds of infection. Hygiene promotion and infection prevention methods in healthcare settings are recommended to avoid nosocomial infections. To reduce MTCT, we recommended screening all pregnant women for hepatitis B virus as part of routine antenatal care and supportive treatment and making available methods of preventing infection at birth, including prophylaxis and birth dose vaccine.

Experiences and perceptions of infant dental enucleation among Somali immigrants in Sweden: a phenomenographic study

Objective: The aim of this study was to explore and describe ways of experiencing and perceiving the Eastern African practice of infant dental enucleation (IDE) among immigrants of Somali origin living in Sweden. Material and methods: Six informants, three men and three women aged 26-54 years, were recruited for semi-structured individual interviews. Phenomenographic analysis of the interview transcripts was performed. Findings: Informants described four ways of experiencing and perceiving IDE: as an effective, necessary treatment; as a disputed tradition; as an alternative to failure; and as a desperate measure. The experiences and perceptions were highly influenced by the contexts the informants had been in, namely, communities in which traditional treatments were used frequently, in which other people were influential over their daily lives, and in which negative experiences of formal health care were common, as well as other difficult circumstances beyond the informants' individual control. Conclusions: The findings contribute to deepened understanding of IDE and the importance of context to the practice of it. Further, the findings deepen understanding of the decision to have the practice performed on infants, which may help dental and health care personnel to adequately communicate with individuals of Somali origin about the harmfulness of IDE.

Knowledge, experiences and attitudes of dental and health care personnel in Sweden towards infant dental enucleation

Purpose

To examine self-rated knowledge of clinical experiences and attitudes towards the practice of infant dental enucleation among dental and health care personnel in Sweden.

Methods

A questionnaire survey was performed among 776 licensed dental and health care personnel working in emergency departments, midwifery, child health centres, school health services and public dental health services in 10 Swedish cities. The response rate was 56.2% (n = 436).

Results

Fewer than a fifth of the respondents reported self-rated knowledge of the practice. Approximately 13% of personnel encountering children professionally believed they had seen subjected patients in their clinical practice. Personnel with self-rated knowledge and clinical experience worked mostly in dental care. Additionally, the personnel had diverging attitudes regarding agreement and disagreement concerning professional responsibility for patients subjected to or at risk of infant dental enucleation.

Conclusions

The study indicated there is need for increased knowledge about the practice and for clarification of obligatory responsibilities among dental and health care personnel regarding management and prevention of cases of infant dental enucleation.

Traditional practices for maternal and newborn care among Turkish postpartum women

AIM

Researchers used descriptive study design to examine the traditional practices of women in relation to maternal and newborn care in the postpartum period.

METHODS

523 postpartum women included who were between 15 and 49years of age, had at least one child, and had no medical complications that affect the mother-infant health. A questionnaire was used to collect data. Comparisons were made between the responses about the women's knowledge of traditional practices and other variables.

RESULTS

We found that women widely used traditional practices such as putting Koran (Holy book for Muslims) and packing needle under the mother's pillow to prevent mother from "al basması", pouring lead in a cup over the head of the newborn to repel evil spirits, and covering the baby's face with a piece of yellow cloth to prevent neonatal jaundice. The rate of using postpartum traditional practices increased with age and number of pregnancies and decreased with education (p<0.05).

CONCLUSION

Educational activities are recommended to increase awareness of harmful traditional practices in the field of reproductive health for nurses and midwives. Health professionals should pay special attention to less educated, older and primiparous women from rural areas enable them to reinforce positive cultural practices, and discourage them from using harmful ones by providing non-critical scientific explanations.