Background Adult supervision is a protective factor against unintentional childhood injuries. Older siblings routinely provide supervision to younger siblings when parents are unavailable. The quality of sibling supervision has been demonstrated to be inferior to adult supervision, potentially increasing supervisee injury risk.
Objective This study assessed sixth-grade Ugandan students’ experiences providing sibling supervision in order to determine the prevalence, nature, and predictors of supervisee injuries.
Methods 206 sixth-grade students in rural Uganda completed self-report questionnaires of sibling supervision activities and past year supervisee injury history. Students reported injury type and whether medical care was obtained. Binary logistic regression was used to determine predictors of students who endorsed a history of medically-attended supervisee injuries in the past year.
Findings 97 percent of sixth-graders reported supervising younger children in a hazardous situation at least once in the past week. 47 percent endorsed at least one medically-attended supervisee injury in the past year. The most common injuries were cuts, falls, and burns. Model predictors included supervisor demographics, supervisor injury history, and frequency of providing supervision. This overall model did not significantly predict medically-attended supervisee injuries, but the Wald test indicated supervisor injuries significantly predicted supervisee injuries. A reduced model was significant. Students with a past year history of medically-attended injuries were 2.25 times more likely to report a medically-attended supervisee injury.
Conclusion Ugandan sixth-grade students routinely engage in sibling supervision, and thus are positioned to prevent supervisee injury. They frequently fail, however. Improving the quality of sibling supervision has potential to reduce supervisee injuries.
Policy implications Public health surveillance systems could identify families recurrently seeking care for unintentional childhood injuries in order to provide targeted interventions, including training in child supervision for parents and older siblings.