Using qualitative methodology to elucidate themes for a traditional tooth gauging education tool for use in a remote Ugandan community

Abstract

The gauging of unerupted deciduous canine teeth occurs in approximately one in three children in some areas of Uganda. It is believed that such teeth are ‘maggots’ that cause fever, diarrohea and vomiting. Traditional healers use knitting needles, bicycle spokes, scissors or broken glass to extract the teeth. Post-ebino extraction complications include septicaemia, anaemia, difficulties in feeding and pain. Some children require hospitalization. Health is further compromised when multiple ebino extractions occur at one time, increasing the risk of human immunodeficiency virus/acquired immunodeficiency syndrome transmission. An ebino education initiative was developed in the southwest Ugandan province of Rukungiri, based on the findings of five community-based focus group discussions. The initiative involved role-plays, didactic presentations and discussion/debate workshops to 23 women's groups in 15 communities (total number of women exposed = 1874). After 1.5 years of the programme's inception, community awareness of the scientific causes and alternatives to ebino extractions had increased (as gauged by follow-up focus group discussion findings) and the number of hospital admissions for traditional tooth extraction complications had reduced. The appropriateness of the model in exploring and addressing ebino extraction beliefs and attitudes is discussed, as are implications of the strategy in its implementation in other communities where ebino extractions are prevalent.