Developing an integrated community mobilisation package to prevent childhood injuries in rural Bangladesh

We will design a package of activities that can be delivered in rural communities in Bangladesh to enable them to prevent the incidence and deaths of children aged 0-5 years caused by unintentional injuries. Based on current evidence, the package is likely to include community action groups, as the main component, to enable caregivers to work together to overcome the barriers that may exist to putting these actions into practice. The package is also likely to include home visits to help caregivers learn practical actions to prevent injuries and public health campaigns to raise awareness about the causes of injuries.

To design this package we will review the main causes of unintentional child injuries in rural Bangladesh and the existing community-based strategies that are being used. We will also speak to caregivers to explore what they perceive as risks for their children and what environmental and behavioural factors may increase the risk of injury. Using this information we will design the package of activities and test how well they work and what people think of them.

Aim: to develop and assess the feasibility and acceptability of an integrated package of community mobilisation interventions in preventing childhood injuries in rural Bangladesh.

Potential interventions: The main intervention will be an integrated package of community mobilisation activities - combining the strengths of community action groups (CAGs), of household-visits in providing tailored practical advice, and of mass media in generating awareness in catalysing social action on the barriers to taking action.

Target population: all caregivers in the community with children aged 0-5 years.

Methods: The study aim will be achieved though qualitative formative research and engagement with local and national stakeholders. Specifically the following activities will be conducted:
- Phase 1: Inception: engagement with stakeholders, agree on project objectives and research plan and build potential theory of change.
- Phase 2: Formative research: conduct qualitative individual and group interviews with different stakeholders in order to gain in-depth understanding of attitudes and practices regarding childhood injuries and prevention.
- Phase 3: Design: design the intervention package using findings from Phases 1 and 2.
- Phase 4: Pre-testing: the designed intervention and its components will be piloted at a small scale, for example in one village using individual and group interviews with caregivers and delivery agents, as well as using the Trials of Improved Practices (TIPs) approach.
- Phase 5: Dissemination: findings will be shared with the stakeholders in a one-day meeting in Dhaka, and through academic papers as well as conference presentations to wider audiences.

Unintentional injures are among the major causes of deaths and disabilities among children in low and middle income countries (LMICs), creating a substantial social and economic burden. This project will develop an innovative integrated package of community mobilisation interventions to prevent childhood injuries in rural Bangladesh. Findings from this study will provide evidence on potential feasibility, acceptability and accessibility of the innovative model for injury prevention in Bangladesh and other LMICs with high burdens of childhood injuries. The evidence generated by this study in particular will benefit parents and caregivers, their children and communities in the study area and other settings by increasing their awareness of childhood injuries, associated risk factors and formulating collective preventative action. This in turn will reduce incidence of childhood injuries and injury-related mortality.