Abstract
BackgroundInjuries accounted for 23% of all deaths in children and adolescents in Nepal during 2010 (n = 3,700). Despite this, there is no national death registration or injury surveillance system. Non-fatal injuries are many times more common than fatal injuries and may leave the injured person with lifelong consequences. Children in low-income settings are exposed to widespread risks of injuries but there is little awareness of how they can be prevented. Community mobilisation has been shown to be effective to reduce maternal and neonatal morbidity. This study aimed to develop a child safety programme and assess the feasibility of delivering the programme through a community mobilisation approach.MethodsWe developed a culturally appropriate, educational programme for Female Community Health Volunteers that included both primary and secondary prevention materials for unintentional child injuries. We determined the feasibility of evaluating its effectiveness through the mobilisation of women’s groups in rural Nepal. Ten women’s groups across 9 wards in one village development committee area completed the programme during 6 monthly meetings. Parent-reported injuries were collected through a notification system established for this study. Experience of the programme by women’s group participants and leaders was assessed through a structured questionnaire and process measures assessed the delivery and reach of the programme.ResultsProgramme resources were developed for this setting and adapted following feedback from users. Nine FCHVs received first-aid training and shown how to use the facilitation manual and injury prevention resources. The FCHVs convened 10 women’s groups to run over 6 months with 24–29 mothers attending each meeting (290 mothers participated in total). Each group presented their views on child injury risks and proposed prevention activities at local public meetings. Women reported 155 injuries to children under 18 years during 7 months of follow up using the notification system.ConclusionsIt is feasible to develop and implement a community mobilisation intervention where women’s groups work together with local FCHVs to prevent injuries in children. The intervention was well received by the women’s groups and by community members. The effectiveness and cost effectiveness of the intervention should now be evaluated through an experimental study.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1783-5) contains supplementary material, which is available to authorized users.
Highlights
Injuries accounted for 23% of all deaths in children and adolescents in Nepal during 2010 (n = 3,700)
In Nepal, injury was estimated to be the cause of 3,723 deaths among children and adolescents aged 1–19 years in 2010 [2]; in the absence of national death registration and injury surveillance systems, this is likely to be an underestimate of the true amount [3]
Development of intervention resources Thirteen resources were prepared during the intervention development phase and tested and finalised in the Nepali language
Summary
A study of emergency department attendances at 11 tertiary hospitals of Nepal recorded 38,000 injuries during 2008/09; about 30% of these cases were children below 15 years [13] These reports miss the cases taken to bordering Indian hospitals and those treated in local private clinics. A Global Road Safety Report estimated that 1,000 deaths, 18,000 hospitalisations and 143,000 injuries not requiring hospitalisation of children and adolescents in Nepal in 2010 were due to road injuries alone [14]. Using these estimates, there would be 161 non-fatal road injuries for every child dying on the road
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