Complexity in Implementing Community Drowning Reduction Programs in Southern Bangladesh: A Process Evaluation Protocol

• Published in: International journal of environmental research and public health Vol. 16; no. 6; p. 968
• Main Authors: Gupta, Medhavi, Rahman, Aminur, Ul Baset, Kamran, Ivers, Rebecca, Zwi, Anthony B, Hossain, Shafkat, Rahman, Fazlur, Jagnoor, Jagnoor
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 18-03-2019; MDPI
• Subjects: Access control; Bangladesh - epidemiology; Caregivers; Child; Child, Preschool; Children; Children & youth; Complexity; Data collection; Drowning; Drowning - epidemiology; Drowning - prevention & control; Early childhood education; Female; Focus Groups; Gender; Humans; Infant; Injury prevention; Intervention; Male; Population; Poverty; Program Evaluation - methods; Protocol; Qualitative research; Resuscitation; Rural Population; Supervisors; Sustainable development; Swimming; Teaching; Bangladesh; evaluation studies; process evaluation; Bangladesh; education; rural population; community health workers; injury; drowning; child
• DOI: 10.3390/ijerph16060968
• EISSN: 1660-4601
• ISSN: 1660-4601; 1661-7827

Living and geographical conditions in Bangladesh expose children to a high risk of drowning. Two programs operating in the Barishal Division of Bangladesh aim to reduce drowning risk through the provision of crèches (Anchal) and swim and rescue classes (SwimSafe). Anchal provides a safe environment with early childhood education to children aged 1⁻5 years old, while SwimSafe teaches children aged 6⁻10 years old basic swimming and rescue skills. Despite evidence for their effectiveness, it is unclear under which conditions these programs best operate. This protocol describes a project that seeks to conduct a process evaluation and gender analysis to identify implementation inefficiencies and contextual considerations for improved sustainability of the programs. A mixed- method approach using both qualitative and quantitative data will be used. Quantitative program data will be analysed to measure program utilisation, delivery and reach, while qualitative data will be collected via key informant in-depth interviews (IDIs), focus group discussions (FGDs) and observations. The process evaluation of the Anchal and SwimSafe programs provides an opportunity for implementers to identify practical strategies to improve program delivery and improve contextual adaptability of these programs. Furthermore, the findings may provide guidance to other implementers aiming to deliver community-based programs in rural lower-middle income contexts.