Project Lead(s): Stephen Beerman
Issue
The burden of child drowning in low- and middle-income countries (LMICs) is becoming recognized as a major new public health issue.
As infectious and nutritional causes of early childhood death have been prevented, drowning has been newly recognized as a leading cause of death after infancy for children in South and East Asia. It is the single leading cause of death in children aged 1–17 years in Bangladesh .
Solution
This project introduced cost-effective, culturally sensitive and appropriate drowning interventions for children in the different stages of childhood: toddlers 1–4 years old, middle childhood 5–9 years old and adolescents 10–17 years old.
The project team partnered with the Centre for Injury Prevention and Research–Bangladesh (CIPRB), which has over a decade of experience delivering public health interventions in Bangladesh.
The project created a community-led safety resource called the Village Injury Prevention Council. Under the aegis of the Council, villagers gathered at the site of drownings and discussed prevention measures. These social autopsies raised awareness and acceptance for three interventions aimed at different groups of children. (1) Anchals (village daycare centres) provided a safe place with adult supervision for children 1–5 years old; (2) SwimSafe survival swimming training was provided for children 6 years old, and rescue and CPR training was provided to children 7–9 years old; and (3) Older adolescents were trained in first aid and first response, including CPR.
Forty Anchals were created where children attended for four hours per day. While in the Anchal under the supervision of a trained Anchal Ma, children learned educational and social skills. Their mothers were counselled on safety, nutrition, sanitation and child development. A total of 1,052 children participated.
Outcome
Twenty-five ponds were modified as safe swim teaching venues for SwimSafe. Basic water safety, survival swimming skills and safe rescue were taught to younger children, and safer in-water rescue and CPR were taught to older children. A total of 2,099 children participated.
The project demonstrated that a cost-effective set of integrated drowning prevention measures was feasible in the low-resource setting of rural Bangladesh. Keys to the success include: (1) community ownership and participation in the planning and intervention activities; and (2) selection of a set of culturally acceptable interventions that overlap and cover all groups in the village. The interventions appear promising as an approach to reduce child mortality caused by drowning in rural LMICs, such as Bangladesh.
The project has led to policy changes in Bangladesh and has provided major contributions to the World Health Organization Global Report on Drowning: Preventing a Leading Killer (released by WHO in Geneva, November 2014). The project has received an additional $100,000 from philanthropic advisors to continue its work.
Impact and Results
- The Guardian: Teaching children swimming and CPR to save lives in Bangladesh (28/07/2016)