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The feasibility of community mobilisation for child injury prevention in rural Nepal: a programme for female community health volunteers.

Pant PR, Budhathoki B, Ellis M, Manandhar D, Deave T, Mytton J - BMC Public Health (2015)

Bottom Line: Nine FCHVs received first-aid training and shown how to use the facilitation manual and injury prevention resources.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.

View Article: PubMed Central - PubMed

Affiliation: Centre for Child and Adolescent Health, University of the West of England, Bristol, UK. pant.puspa@gmail.com.

ABSTRACT

Background: Injuries 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.

Methods: We 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.

Results: Programme 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.

Conclusions: It 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.

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Map of Makwanpur district, showing Hatiya VDC and wards.
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Fig1: Map of Makwanpur district, showing Hatiya VDC and wards.

Mentions: The project was based in Hatiya Village Development Committee (VDC) in Makwanpur district and was conducted between September 2013 and May 2014. Makwanpur district represents typical rural Nepali settings and is described in detail elsewhere [23,27]. There is one main urban centre, Hetauda. Hatiya VDC has a population of 13,000 in 2,750 households across 9 wards [28]. Most of the families are subsistence farmers often supplemented by remittances sent by one of the family members working abroad. People also work in a local cement factory. There is one government health-post which provides basic care such as immunisations, ante-natal and post-natal services. A paramedic (Health Assistant) is incharge of the health-post and nine Female Community Health Volunteers (FCHVs), who are local women, are responsible for providing preventive mother and child health care and education in the community. In Hatiya, each FCHV covers an area of between 400–900 households. The FCHV usually delivers health promotion through facilitated discussions at monthly women’s group meetings held in each ward. In general, a women’s group has at least 20 members, including mothers of children of any age (0–17 yrs). In ward number 5, there are two women’s groups due to the elongated shape of the ward (Figure 1).Figure 1


The feasibility of community mobilisation for child injury prevention in rural Nepal: a programme for female community health volunteers.

Pant PR, Budhathoki B, Ellis M, Manandhar D, Deave T, Mytton J - BMC Public Health (2015)

Map of Makwanpur district, showing Hatiya VDC and wards.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4418066&req=5

Fig1: Map of Makwanpur district, showing Hatiya VDC and wards.
Mentions: The project was based in Hatiya Village Development Committee (VDC) in Makwanpur district and was conducted between September 2013 and May 2014. Makwanpur district represents typical rural Nepali settings and is described in detail elsewhere [23,27]. There is one main urban centre, Hetauda. Hatiya VDC has a population of 13,000 in 2,750 households across 9 wards [28]. Most of the families are subsistence farmers often supplemented by remittances sent by one of the family members working abroad. People also work in a local cement factory. There is one government health-post which provides basic care such as immunisations, ante-natal and post-natal services. A paramedic (Health Assistant) is incharge of the health-post and nine Female Community Health Volunteers (FCHVs), who are local women, are responsible for providing preventive mother and child health care and education in the community. In Hatiya, each FCHV covers an area of between 400–900 households. The FCHV usually delivers health promotion through facilitated discussions at monthly women’s group meetings held in each ward. In general, a women’s group has at least 20 members, including mothers of children of any age (0–17 yrs). In ward number 5, there are two women’s groups due to the elongated shape of the ward (Figure 1).Figure 1

Bottom Line: Nine FCHVs received first-aid training and shown how to use the facilitation manual and injury prevention resources.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.

View Article: PubMed Central - PubMed

Affiliation: Centre for Child and Adolescent Health, University of the West of England, Bristol, UK. pant.puspa@gmail.com.

ABSTRACT

Background: Injuries 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.

Methods: We 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.

Results: Programme 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.

Conclusions: It 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.

Show MeSH
Related in: MedlinePlus