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Implementing a crèche-based community drowning programme in rural Bangladesh: a process evaluation
Medhavi Gupta1, Aminur Rahman2, Notan C Dutta2
1The George Institute for Global Health, Newtown, New South Wales, Australia.
Summary
The Anchal programme reduces child drowning risk in rural Bangladesh. Improvements include better supervision, targeted 1-2 year old programs, and community engagement for enhanced child safety.
Area of Science:
- Public Health
- Child Safety Interventions
- Program Evaluation
Background:
- Rural Bangladesh presents high drowning risks for children due to living and environmental conditions.
- The Anchal programme offers crèche-based supervision by local carers to mitigate drowning risks.
- Understanding optimal conditions for the Anchal programme's effectiveness is crucial.
Purpose of the Study:
- To conduct a process evaluation of the Anchal programme.
- To identify enabling factors and challenges influencing programme implementation.
- To determine conditions that maximize child protection against drowning.
Main Methods:
- Analysis of quantitative programme data (child participation, implementation fidelity).
- Qualitative data collection from participants and implementers.
- Framework guided by the UK Medical Research Council's process evaluation guidelines.
Main Results:
- 400 Anchal centres operated, meeting enrollment targets, but daily attendance fell below the 80% goal.
- Youngest children (1-2 years) had lower enrollment/attendance due to engagement issues and safety concerns.
- Geographic distance and lower regional educational attainment impacted attendance and carer retention.
Conclusions:
- The Anchal programme achieved most delivery targets but can be enhanced.
- Recommendations include improved supervision, staff training, tailored programs for 1-2 year olds, community ownership, and transport services.
- Contextual solutions are adaptable for similar community-based child safety programs to boost effectiveness and sustainability.
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