Perceptions and experiences of dentists towards child abuse and neglect in Nairobi City County, Kenya

Abstract

Background: Child abuse and neglect (CAN) includes all forms of physical and emotional ill-treatment, sexual abuse, neglect and exploitation that results in actual or potential harm to the child’s health, development or dignity.Since approximately half the manifestations of CAN are evident in the cranial, orofacial and neck regions, dentists are often in a strategic position to recognize cases of such maltreatment. However, there is paucity of information regarding the perception and experiences of dentists regarding CAN in Kenya.

Objective: To describe the perceptions and experiences of dentists in Nairobi County, towards CAN.

Design: A descriptive cross-sectional study

Setting: Public and private dental clinics in Nairobi City County.

Subjects: Dentists in the public and private sectors in Nairobi County who consented to be recruited to participate in the study.

Results: Out of the 167questionnaires distributed, 97 were returned duly filled by the participants. Majority of the participants (59.8%) were male. The most frequently observed indicators of CAN as reported by the participants were the child’s poor general hygiene(90.7%), poor oral hygiene(90.7%)bruises on the head(79.4%),wounds in different stages of healing in head and neck region (74.2%) and poor general health (74.2%). A large percentage (62.9%) of the participants did not know the reporting mechanisms for suspected cases of CAN. The percentage of participants with knowledge on reporting mechanism of CAN significantly increased with increasing age (X2 =25.03; p=0.01). However, the difference between the percentage of males and that of females who knew the mechanism of reporting CAN was not statistically significant. At least 86.6% of the participants had encountered suspicious cases of CAN but only 26.8% had reported such cases to the relevant authorities. Among the reasons given for not reporting the suspicious cases of CAN included lack of certainty of the diagnosis (76.3%), fear of family violence to the child (77.3%) and lack of knowledge on the referral procedures (74.2%). Actions taken on encountering such cases included documenting the signs in thepatient’s records and discussing the case with the child’s care-giver. All the participants felt there was need for additional education on CAN for the dental practitioner.

Conclusion: Although majority of the dentists could recognize suspicious cases of CAN, certain barriers to reporting these cases to relevant authorities existed. It is, therefore, recommended that all practitioners in dentistry endeavor to acquire basic knowledge on CAN diagnosis, reporting procedures and child protection.