Objectives

To identify factors that strongly affect the presence of severe low-back pain in mothers living in the Maseru District of Lesotho, to find out whether there is any truth to the widespread belief that rural mothers are more vulnerable to severe low-back pain than their urban counteTparts, and to identify influential factors that are strongly associated with each other.

Methods

A random sample of 4001 mothers was collected from the Maseru District of Lesotho in September 1994 by using sampling techniques of stratification and proportional allocation with respect to size. The following 10 explanatory variables of study were used: intensive farm work, gravidity (number of births plus abortions), residential area, heavy weight lifting, the literacy status of the mother, strenuous manual labor, the availability of basic health services, the income status of the mother, cooking method at home, and breast-feeding. The dependent variable of study was the presence or absence of severe low-back pain. Discriminant and log-linear analyses were done to analyze the data collected. Discriminant analysis was done by using the presence or absence of severe low-back pain as a classifying variable and the 10 explanatory variables that affect the classifying variable. Log-linear analysis was also done by using the same data with 9 of the 11 variables of study.

Results

A total of 405 (10.12%) of the 4001 mothers in the study had severe low-back pain at the time of data collection, 513 (12.82%) had moderate low-back pain, and 1422 (35.54%) had mild low-back pain. A total of 319 (78.77%) of the 405 mothers with severe low-back pain were poor, illiterate, and from rural communities. Results from discriminant analysis revealed that the presence of severe low-back pain was strongly affected by intensive farm work, the residential area of the mother, and gravidity of the mother in a decreasing order of strength and led to results similar to those obtained from discriminant analysis. The study also showed that rural mothers and their children were more disadvantaged than their urban counterparts with regard to basic health services.

Conclusion

Recommendations were made to the Ministry of Health and Social Welfare of Lesotho to improve the provision of basic health services, including health education on the importance of chiropractors to the community.