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Implementing a crèche-based community drowning programme in rural Bangladesh: a process evaluation.

Medhavi Gupta1, Aminur Rahman2, Notan C Dutta2

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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.

Keywords:
childdrowningmixed methodsprocess/impact evaluationprogram evaluationpublic health

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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.