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

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.

Knowledge, attitude, and practice towards burn first aid and its associated factors among caregivers attending burn units in Addis Ababa, Ethiopia. A cross-sectional study

“…Furthermore, the respondent's area of residence was significantly associated with care giver's knowledge of burn first aid. This finding agrees with the study conducted in rural Ghana [ 21 ]. The likely reason might be a socio-demographic similarity.…”

Evaluation of needs and supply of emergency care in Kinshasa, Democratic Republic of Congo: a cross-sectional household survey

“…Our respondents were mostly female (68.1%), as it is often the case in African household surveys 20 23. Respondents were mostly heads of the households or their spouses (44% and 34.5%, respectively), which likely increases reliability of the information provided.…”

Prevalence and factors associated with domestic accidents in children in the rural district of Orodara, Burkina Faso

“…(1-4 years) as being associated with more domestic accidents [14,23,37]. The explanation seems to be linked to the developmental status of these children, who are learning to walk, combined with a natural curiosity with the urge to explore their environment, and who have, at this age, a low-risk perception and inability to perceive danger [38].…”