BackgroundVictims and perpetrators of child abuse do not typically self-report to child protection services, therefore responsibility of detection and reporting falls on the others. Knowledge on child protection is essential for the first contact person and such information is sparse in research literature originally coming from Sri Lanka. Anecdotally, several cases of child abuse have been missed out at the first contact level. Therefore we undertook this survey to assess the knowledge, attitudes towards child protection and the experiences of medical officers, nursing officers and social workers on child protection.MethodThis was a descriptive analytical study carried out in hospitals and the community during March–October 2016. An anonymous content validated self-administered questionnaire was used as the study instrument. Knowledge, Attitude, Practices and Behaviour were assessed via multiple choice questions and responses according to Likert score. Three anonymised case records were given as case vignettes to be studied by the participants and their responses were also recorded on the questionnaire.ResultsAmong the 246 responders 156 (63.4%) were doctors. All groups of professionals identified the forms of child abuse correctly and the social indicators of child abuse was correctly identified in 152 (61.7%). Majority failed to identify the features of the perpetrator. Majority of the professionals showed a favourable response in attitude when dealing with child maltreatment. 153 (62%) had suspected child abuse in their career and 64% of them had reported it to the authority. Fifty two (21%) had attended a training workshop on child abuse and 65.8% of the responders were not satisfied with their knowledge. 229(93%) of them indicated that they wanted some form of education on child maltreatment. The Knowledge, Attitude and Behaviour towards child abuse were significantly good on people with experience in the field of Paediatrics and Judicial Medical work, when compared to those who did not have the experience in these two fields. (p value< 0.01).ConclusionAlthough the knowledge among health professionals regarding child abuse and care was satisfactory, further areas need reinforcement. The attitude was more positive, the behavior and practices on child maltreatment needed reinforcement via workshops and continuing medical education.

Exposure to multiple supratherapeutic doses of paracetamol is a risk factor to develop fulminant hepatic failure in children with an acute viral like febrile illness.

Background: Good dispensing practice is vital for rational use of medicines. There are many paediatric specific challenges when maintaining good dispensing practices to children. Lack of age appropriate dosage forms, lack of medicines in strengths suitable for children, lack of palatable medicines, lack of expertise in paediatric pharmacy are few challenges faced when maintaining good dispensing practices to children. These challenges contribute to poor dispensing practices. Hence there is an urgent need to investigate whether oral dosage forms of medicines are dispensed rationally to children. The objective of this study was to describe the rational dispensing practice of oral dosage forms of medicines to children in a Teaching Hospital in Sri Lanka. Methods: A descriptive cross sectional study was conducted to assess the dispensing practice of 1800 oral dosage forms of medicines dispensed to children under the age of 12 years in two outdoor pharmacies over a period of 1 year using validated indicators. Required data were extracted from the prescriptions and by observation using a structured pre-tested observation sheet. Descriptive statistics and wherever relevant, chi square test were used in analysing the data. Results: Information on 1800 oral dosage forms was obtained from 1889 medicines dispensed to 727 children. Liquids were 52% [95% CI: 50-55%] of these oral dosage forms. Of the solid dosage forms, about one quarter required manipulation prior to administration such as splitting and dissolving or crushing the adult dosage form. None of the medicine packs or bottles had the patient name on the label. Conclusion: Dispensing practice of oral dosage forms of medicines to children has room for improvement.

The problem of child abuse is considerable in this region and there is an urgent need to strengthen the services offered to the victims. Urgent steps are needed to safeguard these children, especially in the war affected areas.

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