University J Dent Scie 2019; Vol. 5, Issue 3 University Journal of Dental Sciences KNOWLEDGE, ATTITUDE AND PRACTICE OF MEDICAL AND DENTAL PROFESSIONALS REGARDING CHILD ABUSE IN JABALPUR CITY – A CROSS SECTIONAL SURVEY. 1 2 3 4 5 6 Deepak P Bhayya, Astha Soni, Shilpi Dadarya, Prabhat Singh, Saurabh Tiwari, Swarnam Pandey Department of Peadiatric and Preventive Dentistry Hitkarini Dental College and Hospital, Hitkarini Hills, Jabalpur. ABSTRACT : Aims and Objectives: The aim of this study is to determine the level of knowledge, attitude and practice of medical and dental professionals regarding child abuse and neglect in Jabalpur, Central India. Materials & Method: A cross-sectional survey is being conducted among the medical and dental professionals. Data will be collected from a self-administered questionnaire and will be evaluated for their knowledge, attitude and practice towards child abuse. Results: Study demonstrated an overall poor understanding of the problem, despite a very high level of interest demonstrated by the respondents and a strong desire for further information about their responsibilities and a clear need for all dentists to receive further formal training. Conclusion: Study demonstrated an overall poor understanding of the problem, despite a very high level of interest demonstrated by the respondents and a strong desire for further information about their responsibilities and a clear need for all dentists to receive further formal training. Keyword: Child Abuse; Knowledge; Attitude; Practice, medical-dental professionals. University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India 15 INTRODUCTION: Children are a heritage from the LORD; offspring a reward from him (Psalm 127:3, Holy Bible), but humans fails to respect that.[1]The UN Convention on the Rights of the Child (UN CRC) (1989) is the most widely endorsed child rights instrument worldwide, which defines children as all persons up to the age of 18 years.[2] The World Health Organization (WHO) has defined 'Child Abuse' as a violation of basic human rights of a child, constituting all forms of physical, emotional ill treatment, sexual harm, neglect or negligent treatment, commercial or other exploitation, resulting in actual harm or potential harm to the child's health, survival, development or dignity in the context of a relationship of responsibility, trust or power.[3] In India there has been no understanding of the extent, magnitude, and trends of the problem till 2007. Study on child abuse scenario was done across the India in 2007 and result suggested that, (i) two out of every three children are physically abused and (ii) 72.2%children in the age group of 5–12 years were being physically abused.[1] Four types of child abuse may be recognized: 1. Physical abuse, which occurs when a child suffers or is likely to suffer significant harm from an injury inflicted by the child's parent or caretaker; 2. Sexual abuse, which is the exploitation of the child for the sexual gratification of an adult; 3. Emotional abuse, which occurs when a child's parent or caregiver repeatedly rejects the child or uses threats to frighten the child; 4. Neglect, which is a failure of the parent or caretaker to provide for the child's basic needs such as food, clothing, Research Paper Conflict of interest: Nil No conflicts of interest : Nil
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University J Dent Scie 2019; Vol. 5, Issue 3 UniversityJournal of
Dental Sciences
KNOWLEDGE, ATTITUDE AND PRACTICE OF
MEDICAL AND DENTAL PROFESSIONALS
REGARDING CHILD ABUSE IN JABALPUR CITY –
A CROSS SECTIONAL SURVEY.
1 2 3 4 5 6Deepak P Bhayya, Astha Soni, Shilpi Dadarya, Prabhat Singh, Saurabh Tiwari, Swarnam PandeyDepartment of Peadiatric and Preventive Dentistry Hitkarini Dental College and Hospital,Hitkarini Hills, Jabalpur.
ABSTRACT : Aims and Objectives: The aim of this study is to determine the level of knowledge, attitude
and practice of medical and dental professionals regarding child abuse and neglect in Jabalpur, Central
India.
Materials & Method: A cross-sectional survey is being conducted among the medical and dental
professionals. Data will be collected from a self-administered questionnaire and will be evaluated for their
knowledge, attitude and practice towards child abuse.
Results: Study demonstrated an overall poor understanding of the problem, despite a very high level of
interest demonstrated by the respondents and a strong desire for further information about their
responsibilities and a clear need for all dentists to receive further formal training.
Conclusion: Study demonstrated an overall poor understanding of the problem, despite a very high level of
interest demonstrated by the respondents and a strong desire for further information about their
responsibilities and a clear need for all dentists to receive further formal training.
Keyword:
Child Abuse;
Knowledge; Attitude;
Practice, medical-dental
professionals.
University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India 15
INTRODUCTION: Children are a heritage from the LORD;
offspring a reward from him (Psalm 127:3, Holy Bible), but
humans fails to respect that.[1]The UN Convention on the
Rights of the Child (UN CRC) (1989) is the most widely
endorsed child rights instrument worldwide, which defines
children as all persons up to the age of 18 years.[2]
The World Health Organization (WHO) has defined 'Child
Abuse' as a violation of basic human rights of a child,
constituting all forms of physical, emotional ill treatment,
sexual harm, neglect or negligent treatment, commercial or
other exploitation, resulting in actual harm or potential harm
to the child's health, survival, development or dignity in the
context of a relationship of responsibility, trust or power.[3]
In India there has been no understanding of the extent,
magnitude, and trends of the problem till 2007. Study on child
abuse scenario was done across the India in 2007 and result
suggested that, (i) two out of every three children are
physically abused and (ii) 72.2%children in the age group of
5–12 years were being physically abused.[1]
Four types of child abuse may be recognized:
1. Physical abuse, which occurs when a child suffers or is
likely to suffer significant harm from an injury inflicted by the
child's parent or caretaker;
2. Sexual abuse, which is the exploitation of the child for the
sexual gratification of an adult;
3. Emotional abuse, which occurs when a child's parent or
caregiver repeatedly rejects the child or uses threats to
frighten the child;
4. Neglect, which is a failure of the parent or caretaker to
provide for the child's basic needs such as food, clothing,
Research
Paper
Conflict of interest: Nil
No conflicts of interest : Nil
shelter and medical attention to the extent that the child's
health and development is, or is likely to be, significantly
harmed.[4]
Child protection is critical to the achievement ofMillennium
Development goals (MDG). These MDGs can't be achieved
unless child protection is an integral part of program &
strategies to protect children from child labor, street children,
child abuse, child marriage, violence in school and various
forms of exploitation.[3]
Child Abuse & Neglect (CAN) is a world widesocial and
public health problem, which exertsa multitude of short and
long term effects onchildren. The consequence of children's
exposure to child maltreatment includes elevated levels
ofpost-traumatic stress disorder, aggression, emotional and
mental health concerns, such as anxiety and depression. A
well designed epidemiologic, Adverse Childhood
Experiences (ACEs) Study5 revealed a high risk of heart
disease in adult survivors of maltreated children, after
correcting for age, race, education, smoking & diabetes.
A Government of India, Ministry of Women & Child
Development (2007) survey showed that the prevalence of all
forms of child abuse is extremely high (physical abuse (66%),
sexual abuse (50%) and emotional abuse (50%).[6] Amore
recent study by the National Commission for Protection of
Child Rights (NCPCR), conducted amongst 6,632 children
respondents, in 7 states; revealed 99% children face corporal
punishment in schools.[7]
Several developed countries of the world have well-
developed child protection systems, primarily focused on
mandatory reporting, identification and investigations of
affected children, and often taking coercive action. The
burden of high level of notifications and investigations is not
only on the families, but also on the system, which has to
increase its resources.8In these contexts, the problems of
child abuse and neglect in India need serious and wider
consideration, particularly among the underprivileged rural
and urban communities.
The aim of this study was done to assess the educational
experience, knowledge and attitude of medical and dental
professionals of Jabalpur city with regards to child abuse and
encourage the reporting of suspected cases.
METHODOLOGY: A cross sectional survey was carried
out among the medical and dental professionals practicing in
Jabalpur city at least since 1 year. An anonymous, self-
administered, close ended 10-question survey was
constructed using a multiple choice or yes / no format to
assess the knowledge, awareness and attitude towards child
abuse.
Residents of Hitkarini dental college and Netaji Subhash
Chandra Bose medical colleges of Jabalpur city were
included in this study. Residents of Pedodontics and
Preventive Dentistry, Oral Medicine and Radiology, Oral and
Maxillofacial Surgery, Endodontics and conservative
dentistry and Orthodontics from dental colleges; and
residents of Pediatrics, Radiology, and Orthopedics from
medical colleges were included. Dental and medical general
practitioners (graduates) who have minimum one year of
clinical experience were also selected. The questionnaire pro
forma was distributed personally and the professionals were
encouraged to complete all question on the same visit.
Data was entered in Microsoft excel 2016 for Windows.
Frequencies and percentages of responses for questionnaire
were calculated. To compare responses between different
groups Pearson's Chi-square test was applied. P value <0.05
was considered statistically significant. Data analyses were
performed using version 21.0 of the Statistical Package for
Social Sciences (IBM Corporation, Armonk, New York,
USA).
RESULTS: A total of 361 complete responses were
collected, among which 184 were dental practitioners
including both general dentists (111) and selected specialists
(73) and 177 were medical practitioners, including general
physician (106) and selected specialists (71).
Graph 1 show among dental professional 98.91% and among
medical professionals 100.00% study subjects were aware
regarding child abuse. Two study subjects among dental
professionals were not aware regarding child abuse, hence
they were excluded from further analysis.
Graph 1: Awareness among study subjects for child abuse.
Table 2 represents the 61.33% dental professionals and
54.80% medical professionals said they see 1-2 child abuse
cases in a month. 24.86% dental professionals and 39.55%
medical professional said they did not see any case of child
abuse in a month. Chi-square test showed significant
University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India 16
University J Dent Scie 2019; Vol. 5, Issue 3
difference between dental and medical professionals for
number of child abuse cases seen in a month. Chi-square test
showed significant difference between post graduate and
graduate medical professionals for number of child abuse
cases seen in a month.
Table 2: Numbers of child abuse cases encountered in a
month.
Table 3 shows in overall sample Chi-square test showed no
significant difference between dental and medical
professionals for responses for recognition of a case of child
abuse. Chi-square test showed significant difference between
post graduate and graduate dental professionals for responses
for recognition of a case of child abuse. While among Medical
professionals Chi-square test showed no significant
difference between post graduate and graduate medical
professionals for responses for recognition of a case of child
abuse.
Table 3: Recognition of a case of child abuse.
In Graph 4 overall samples shows 18.23% dental
professionals and 2.82% medical professionals said male
children are most likely abused. Chi-square test showed
significant difference between dental and medical
professionals for responses for gender of the children are
more likely to be abused. Chi-square test showed significant
difference between postgraduate and graduate medical
professionals for responses for gender of the children are
more likely to be abused.
Graph 4: Gender of the children is more likely to be abused
Table 5 shows among overall samples 38.67% dental
professionals said working mother families where as 46.89%
medical professionals said step mother/father families are
having child abuse more commonly. Chi-square test showed
significant difference between dental and medical
professionals for responses for type of families abused more
commonly.
Table 5: Type of families abused more commonly.
Table 6overall sample shows Chi-square test showed no
significant difference between dental and medical
professionals for responses for agency appropriate to deal
with child abuse cases.
Dental professionals, 98.61% postgraduate and 73.39%
graduate dental professionals said that police are the agency to
deal with child abuse cases. Chi-square test showed
significant difference between post graduate and graduate
dental professionals for responses for agency appropriate to
deal with child abuse cases.
University Journal of Dental Sciences, An Official Publication of Aligarh Muslim University, Aligarh. India 17
University J Dent Scie 2019; Vol. 5, Issue 3
Table 6: Agency appropriate to deal with child abuse cases