Article Text
Abstract
Background Drowning is one of the leading causes of childhood mortality in Bangladesh, with the highest rates of drowning in newly-mobile children aged 1–4 years. However, drowning prevention interventions targeted at this age-group face challenges in uptake, particularly for children under two years.
The Sonamoni Project is working with communities in the Kalapara and Sherpur Sadar sub-districts of Bangladesh, identified by previous studies as having high rates of drowning, to explore and co-design interventions for this younger age-group using a Human Centred Design (HCD) approach. Community risk mapping, a participatory process of mapping risk across a geographic area using input from community stakeholders, can assist HCD.
Objective Conduct community risk mapping to identify areas of high drowning risk within the sub-districts of Kalapara and Sherpur Sadar.
Programme Description A literature review identified environmental and social risk factors for drowning. A key was developed to show physical attributes associated with these risk factors, including the location of water bodies, the availability of piped water to the home, and areas frequently affected by flooding. Question prompts for the facilitators were developed to understand activities undertaken in and around water, and areas of known child drowning incidents, which could be mapped and overlaid. Participants in the communities were asked to consider seasonal changes. A grading criterion was established to rank areas from ‘high’ to ‘low’ risk.
An iterative bottom-up risk mapping process was undertaken from sub-district to village level. Mapping teams comprised of ten local residents (20% female). Team members included the local administrative body (Union Parishad officials), village injury prevention committee members, and village representatives. Findings were triangulated at the village level by community members not participating on the risk mapping team, alongside transect walks by the project team.
Annotated hand-drawn maps were produced. Discussions were recorded, and thematically analysed.
Outcomes and Learnings 30 high-risk villages were identified to be included in the next phase of the project.
Implications and Conclusions The risk mapping process facilitated community engagement and input, providing a cost-effective method for identifying high-risk locations in the absence of reliable mortality data.