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Home Safety Practices for Prevention of Poisoning in Young Children
This study did not evaluate the use of the safety device. Instead, the study focused on evaluating the satisfaction of caregiver with the device. The majority of caregiver
involved in the study was female and this may have contributed to the success of the intervention.
5.3 Strengths and Weakness in Relation to Other Studies Rate of Unsafe Households
This study shows 60-71 of urban and semi-urban households in Perak have unsafe homes. The figure is comparable to a study done in urban lower income households
in the USA where 77 of homes were not safe in preventing poisoning in children Kimberly E. et al. 2007.
Improvement Rate of Safe Household
In this study, good knowledge and high perception did not affect practice. This is similar to finding in other studies. A study in Turkey shows that 69 of mothers
claimed to have taken preventive measures after their child had a poisoning accident at home but they did not even mention at all basic precautions such as storage of
poisonous agents on different shelves and storage of medication and household chemicals in locked cabinets Sibel E. et al. 2006. 76.1 of mothers only mentioned
keeping the medication out of the reach of children.
The study in the USA also shows that caregiver reports of poison safetystorage 71 were falsely higher than if evaluated by a home safety checklistaudit 17 Kimberly
E. et al. 2007. This strongly suggests that home audit rather than conventional education or questionnaire alone is a more powerful tool to identify unsafe home
as well as to make significant changes in practices. The audit not only gathers information but also educates the respondents and ensures that correct practices
are adhered to.
The use of the safety device may have contributed to further improvement but this needs to be studied further.
Community-based prevention educational programmes are an important component in preventing poisonings and have been shown to change parental poison storage
habits Maiesl G. et al. 1967 as quoted by John T. Arokiasamy in an editorial Accidental Poisoning: Selected Aspects of its Epidemiology and Prevention Med. J. Malaysia
June 1994.
The rate of poisoning in household participating in this study was 1.1 over a one year period. This is lower than the average calculated from accidental poisoning in
Perak for children aged 1-4 years which was 3 HMIS data, MOH 2003-2007 and international data for developing countries 5 Kimberly E. et al. 2007. The rate is
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Home Safety Practices for Prevention of Poisoning in Young Children
lower in this study as the denominator includes all children in the household aged 0-12 years of age.
5.4 Meaning of the Study Possible Mechanism and Implication for Clinicians Policymakers
The high rate of unsafe households i.e. between 60-71 of urban and semi-urban households calls for some intervention to improve the situation. The single most
powerful means of change is the Home Safety Audit Tool.
5.5 Unanswered Questions and Future Research
One concern is whether parents will sustain good home poison safety practices after this study is over. The fact that caregiver were aware that health personnel
were returning for an audit may have contributed to them maintaining safe home practices. This could be answered by an unannounced audit one year after the 3
rd
Audit. It was uncertain from the study what impacts the use of a safety device had in
changing the household behaviour to prevent poisoning. Finally, the rate of unsafe household in rural communities is not known and needs to be investigated.
6.0 CONCLUSION RECOMMENDATIONS
This study shows between 60-71 of urban and semi-urban households in Perak have unsafe home safety practices to prevent poisoning in young children.
The intervention package, mainly the Home Safety Practices Audit developed by the researchers for this study, significantly improved home poisoning safety practices. 75.7-
85.3 of urban and semi-urban households in Perak had a safe home to prevent poisoning in children at the end of the study.
Addition of the safety device with the Home Safety Practices Audit further improves home poisoning safety practices.
Knowledge and perception does not ensure a safe household in preventing poisoning in young children.
Recommendation: 1.
There is a need to support parents to make their home poison safe. 2.
The Audit Mechanism and Package used in this study should be used by the Family Health Development Division of the Ministry Of Health Malaysia so that public health
nurses can enable caregivers to improve poison safety practices in homes.
