A framework for addressing implementation gap in global drowning prevention interventions: experiences from Bangladesh - PubMed (original) (raw)

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A framework for addressing implementation gap in global drowning prevention interventions: experiences from Bangladesh

Adnan A Hyder et al. J Health Popul Nutr. 2014 Dec.

Abstract

Drowning is the commonest cause of injury-related deaths among under-five children worldwide, and 95% of deaths occur in low- and middle-income countries (LMICs) where there are implementation gaps in the drowning prevention interventions. This article reviews common interventions for drowning prevention, introduces a framework for effective implementation of such interventions, and describes the Saving of Lives from Drowning (SoLiD) Project in Bangladesh, which is based on this framework. A review of the systematic reviews on drowning interventions was conducted, and original research articles were pulled and summarized into broad prevention categories. The implementation framework builds upon two existing frameworks and categorizes the implementing process for drowning prevention interventions into four phases: planning, engaging, executing, and evaluating. Eleven key characteristics are mapped in these phases. The framework was applied to drowning prevention projects that have been undertaken in some LMICs to illustrate major challenges to implementation. The implementation process for the SoLiD Project in Bangladesh is used as an example to illustrate the practical utilization of the framework. Drowning interventions, such as pool fencing and covering of water hazards, are effective in high-income countries; however, most of these interventions have not been tested in LMICs. The critical components of the four phases of implementing drowning prevention interventions may include: (i) planning-global funding, political will, scale, sustainability, and capacity building; (ii) engaging-coordination, involvement of appropriate individuals; (iii) executing-focused action, multisectoral actions, quality of execution; and (iv) evaluating-rigorous monitoring and evaluation. Some of the challenges to implementing drowning prevention interventions in LMICs include insufficient funds, lack of technical capacity, and limited coordination among stakeholders and implementers. The SoLiD Project in Bangladesh incorporates some of these lessons and key features of the proposed framework. The framework presented in this paper was a useful tool for implementing drowning prevention interventions in Bangladesh and may be useful for adaptation in drowning and injury prevention programmes of other LMIC settings.

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Figures

Figure 1.

Figure 1.

Map of Saving of Children's Lives from Drowning (SoLiD) study sites in Bangladesh

Figure 2.

Figure 2.

Saving of Children's Lives from Drowning (SoLiD) study: design and timeline

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References

    1. World Health Organization Global Health Estimates (GHE). Geneva: World Health Organization. (http://www.who.int/healthinfo/global_burden_disease/en/index.html, accessed on 4 October 2013).
    1. Brenner RA. Childhood drowning is a global concern. BMJ. 2002;324:1049–50. - PMC - PubMed
    1. Blum LS, Khan R, Hyder AA, Shahanaj S, Arifeen SE, Baqui A. Childhood drowning in Matlab, Bangladesh: an in-depth exploration of community perceptions and practices. Soc Sci Med. 2009;68:1720–7. - PubMed
    1. National Institute of Population Research and Training . Dhaka: National Institute of Population Research and Training, 2012. Bangladesh demographic and health survey 2011: preliminary report; p. 46.
    1. Hyder AA, Borse NN, Blum L, Khan R, El Arifeen S, Baqui AH. Childhood drowning in low- and middle-income countries: urgent need for intervention trials. J Paediatr Child Health. 2008;44:221–7. - PubMed

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