Assessing the Effect of Training of Traditional Bone Setters in Enugu State South East Nigeria

Abstract

In Nigeria, the traditional bone setters, perhaps more than any other group of traditional health provider enjoy high patronage and confidence by the society.^5,6 Indeed, the patrons of this service cut across every strata of the society including the educated and the rich.^5-7 The origin of the practice is shrouded in mystery but passed on by practitioners from one generation to another^8-10.

Methods: Bivariate analysis was used with the aid of SPSS Version 16 and Epi-info version 6; respondents were described by their socio-demographic characteristics, a comparison of intervention and control group were checked with the chi-square analysis at base line to determine the differences in their knowledge and practice of Traditional bone setters on traditional bone setting. It was also carried out at post-intervention period (6 months after intervention) to determine the effect of training of traditional bone setters on the uptake of X-ray services, modern orthopedic practices, POP, anti-tetanus injections, antibiotics and insecticide treated nets.

Results: The general knowledge of bone setting by the respondents improved after training, except in the need to provide the in-patients with ITNs which recorded no change. After the training, all the traditional bone setters knew the importance of having nurses and other paramedical staff in their clinics (p = 0.000). The signs and symptoms of wound and tetanus infection did not change after training. However, the need for sterilization of instruments and hygienic dressing improved significantly after training (p = 0.000). Equally, the knowledge of the need for POP improved significantly (p = 0.005). Interestingly, the acknowledgement that continual adjustment of splitting could lead to mal-union or non-union improved statistically after training (p = 0.000). The practice of bone setting by TBSs in the study group after training statistically improved. The acceptance of training of other people in the clinics and use of antibiotics/anti-tetanus toxoid were statistically significant after training of the TBS in the study group. Interestingly, the referral of patients with serious fracture to orthopedic surgeons for better management improved significantly after training (p = 0.039).

Conclusion: From the study, there were remarkable improvements in the management of bone fracture by TBSs after training. The knowledge, attitudes and practices of TBSs improved significantly after training on basic orthopedic practices. There was also an improvement on prompt referral of serious fractures to orthopedic surgeons for better management.

Keywords: ITN; Traditional Bone Setting; TBS; ITN; Orthopaedic surgeons

DOI: 10.7176/JHMN/58-08