Geneva Health Forum 2024

Ensuring equity: Assessment of a drowning prevention intervention for 1-5 years’ children in rural Bangladesh

Not scheduled

15m

Geneva

Oral presentation Health and the environment, time for solutions

Description

Introduction-Objectives:
Drowning is responsible for a large number of fatal drowning cases worldwide. Approximately 236,000 occur due to drowning globally with the majority of deaths occurring in low- and middle-income countries (WHO, 2018). According to the Bangladesh Health and Injury Survey (BHIS-2016), the fatal drowning rate of children aged 1-4 years was 71.1/100,000 in Bangladesh. Moreover, the absence of ECD provision exposes rural children to a high degree of adverse experiences during the critical period in childhood. A low-cost community-based child supervision model called Anchal was implemented from 2017-2019 by the Centre for Injury Prevention and Research Bangladesh (CIPRB), in collaboration with the Royal National Lifeboat Institution (RNLI) and The George Institute for Global Health (TGI) to reduce the rate of child drowning in the three sub-districts of the Barishal division, the most drowning-prone region of Bangladesh. The aim of the study was to assess the intervention's key achievements in terms of reach, successes, and challenges, of a community-based child supervision model resulting in the reduction of children drowning in Bangladesh.

Methodology:
An inbuilt three-year intervention’s monitoring system data of enrolled participants, attendance, dropout, graduation, non-adherence to guidelines, and condition of program locations were used for the evaluation. To monitor Anchal intervention’s reach and quality of service provision, there was an inbuilt monitoring system, and an intervention-specific Standard Operating Procedure (SOP). A quasi-experimental design also applied to assess 3-5 years’ children from the intervention Early Education outcome. A real-time monitoring system was steered by REDCap software to monitor daily Anchal’s intervention activities.

Results and Discussion:
Over the three-year project period, the project successfully enrolled 17,651 children in the Anchals while its aim was to enrol 10,000 children, representing 29.3% of the 1-5-year-old population in the intervention areas. Of these, 3,881 children graduated, 5,579 children dropped out, and 8,191 children were receiving supervision services. However, the project faced a dropout rate of 31.6% for both boys and girls. The average attendance was 16.5 days. One of the key challenges of the intervention was that younger child was less likely to stay in the centre for a longer period. Children’s overall ECD outcome was significantly higher (23%) than the children in the control group (6%). However, Integration of the ECD intervention into the child drowning prevention intervention helped significantly enhance children's overall ECD development.

Conclusions:
The Anchal intervention, which integrates measures to reduce child drowning mortality and improve early childhood development outcomes. The intervention has the potential to make a significant impact in reducing child mortality associate with drowning as well as other child injuries and improving ECD outcomes and can be replicated in low-resource settings. The intervention has the potential to make a significant impact in reducing child mortality associated with drowning and other child injuries and improving ECD outcomes and can be replicated in low-resource settings. Enrolled children not attending the centres indicate children’s vulnerability to drowning risks. Future interventions should find effective and culturally competent measures to increase child attendance, particularly for under two children in limited-resourced settings.