Ghanaian radiographers experience and commitment to the mandatory reporting law regarding suspected child physical abuse.

INTRODUCTION: The best interests of the child shall be paramount in any matter concerning a child and it should be the primary consideration by any court, person, institution, or other body in any matter concerned with a child. This study sought to explore the influence of legislation on and professional commitment of radiographers towards suspected child physical abuse. METHOD: A semi-structured interview was conducted with 20 radiographers selected across all the regions in Ghana. The interviews were conducted exclusively by the first author with radiographers who reporting having experience of handling suspected child physical abuse cases. There were 14 male respondents with an age range of 30-54 years and six females aged from 25 to 57 years. Upon attaining data saturation, the thematically analysed data was managed using NVivo10 software. RESULTS: Findings from the study showed that the legal framework for mandatory reporting of suspected child physical abuse was not known by radiographers. A lack of professional commitment to report cases of suspected child physical abuse was also identified. Themes that emerged from the study formed the basis of the discussion. CONCLUSION: This study revealed that radiographers interviewed were not well acquainted with national legislation requiring mandatory reporting. There is the urgent need to train radiographers on the laws protecting children to enhance their commitment to the reporting of suspected child physical abuse. IMPLICATION FOR PRACTICE: The understanding of the legal framework under which radiographers operate is imperative when considering obligations to report suspicious injuries among children.

A qualitative description of how Ghanaian radiographers identify suspected child physical abuse.

INTRODUCTION: Child physical abuse is intentionally inflicted injury of a child and presents a challenging diagnosis to clinicians mostly as a result of doubts about whether the findings were perpetrated by carers of these children. Suspected child physical abuse cannot be reported without its initial identification, substantiation and reporting. Imaging findings is one way of providing evidence of abuse in court. METHODS: A qualitative design was used to gather data. Twenty (20) radiographers were recruited using purposive criterion sampling to share their experiences of mode of identification of suspected child physical abuse. Semi-structured interviews were conducted to gain deeper insight into their experiences. RESULTS: Radiographers' suspicion or identification of child physical abuse was based on four (4) constructs: pre-radiographic observation; child's physical signs; caregiver secrecy and imaging findings. These observations provoked further investigations through questioning of the child (if of verbal age), parent or both. Their initial suspicion through assessment of cases was sometimes strengthened by the imaging findings. CONCLUSION: Radiographers suspected child physical abuse using several approaches some of which were found to be unacceptable although it led to other important information, such as additional imaging performed by the radiographers without doctor consultation. However, being able to identify child physical abuse is important in child protection activities. IMPLICATION FOR PRACTICE: Identification and reporting of suspected abuse to the appropriate child protection authorities are imperative for child protection. The possibility that some experienced radiographers may fail to deal with serious instances of child abuse exist. A radiographer's inability to identify such cases, could that the victim would miss the required protection from the professional.

Exploration of Ghanaian radiographers' reporting of suspected physical abuse amongst children.

INTRODUCTION: The success of the child protection process is dependent on rapid actions by healthcare professionals who encounter a child in possible need of protection and make appropriate referrals to statutory agencies. Clear rules that promote inter-professional working among health professionals is necessary to enhance child protection. AIM: To explore the internal factors leading to bystander attitude towards reporting of suspected physical abuse amongst Ghanaian radiographers. METHODS: Twenty radiographers across Ghana who have encountered suspected child physical abuse during practice interviewed. Data was collected using qualitative methodology using semi-structured interviews. Participants were radiographers who were selected using purposive sampling. Data was thematically analysed and managed with NVivo version 10. Themes developed formed the basis of the discussion. RESULTS: Participants reported barriers such as training deficits, lack of knowledge in reporting regulations, and the absence of a framework or structures in place to guide suspected physical abuse (SPA) management. The results showed that the majority of participants were ignorant of the role of the social worker in identified cases of SPA. Additionally, there was no teamwork in the majority of the hospitals in the management of suspected physical abuse. CONCLUSIONS: Participants' behaviour towards child protection was congruent with the situation where an individual would assess the consequences of an action. Fear, lack of direction and collaboration characterised the management of suspected physical abuse. IMPLICATION FOR PRACTICE: The timely identification of child abuse is key to providing the necessary intervention for the child. However, the mere identification of abuse would be of no use to the child when no action was taken by radiographers handling the case as a result of impediments on their way.

Behavioural beliefs of Ghanaian radiographers and reporting of child physical abuse.

INTRODUCTION: Radiographers are well placed to flag non accidental injury in children due to their unique position within the imaging chain. Being able to identify (or suspect) physical abuse in children and reporting the incident are, however, two different issues. This study was conducted to explore the external influences in the decision making of the Ghanaian radiographer to report suspected child physical abuse (CPA). METHOD: This was a qualitative study which applied interpretive phenomenology. Semi-structured interviews were conducted with 20 radiographers who were selected from various hospitals throughout the ten regions of Ghana using purposive sampling. Data was thematically analysed and managed with NVivo Version 10. Themes developed formed the basis of this discussion. RESULTS: Several socio-cultural beliefs and behaviours impacted on the Ghanaian radiographers' decisions to report suspected child physical abuse. The findings of this study indicated that cultural solidarity, superstition and police frustrations were among other factors that characterised the Ghanaian radiographer's inability to report child physical abuse when it occurred. CONCLUSION: Radiographers reported fear of both physical and spiritual attack when child physical abuse was reported. This paper argues that, to achieve the fight against child physical abuse in some African countries such as Ghana, radiographers would have to be educated and counselled against belief in superstition and adherence to some cultural values which affect child protection.

Lifting and pregnancy outcomes: feasibility of a randomized controlled trial.

Background: The highest incidence of preterm birth (18%) occurs in Africa but the causes are largely unknown. Some studies have reported adverse effects of maternal physical exertion on birth outcomes. A randomized controlled trial (RCT) is proposed to determine the effectiveness of an intervention reducing lifting and carrying in pregnant women in reducing preterm birth and low birthweight. Aims: To test the feasibility and acceptability of the proposed lift-less intervention RCT. Methods: We recruited pregnant women and midwives from antenatal clinics within the Greater Accra Region of Ghana. The midwives were trained to administer the intervention during a 5-week trial. Four intervention trial sessions were organized at weekly intervals. Results: Seven pregnant women and six midwives participated. After piloting, we observed a reduction in participants' self-reported daily exposure to heavy lifting and carrying. The daily average frequency of lifting by a participant within the first seven days of the study was 3.5 (SD 1.7) with an estimated mean total weight of 41.1 kg (SD = 13.3 kg). This had decreased to 2.3 (SD = 1.0) and the amount to 13.4 kg (SD = 10.9) within the last seven days of the study. Conclusions: The findings provide insight into the daily physical exertion experienced by pregnant women in Ghana. The lift-less intervention trial is feasible with modifications and has the potential to reduce excessive physical exertion among pregnant women in Ghana to improve birth outcomes.