scholarly journals Child drowning mortality in the Sundarbans, India: Applying the Community Knowledge Approach

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Gupta ◽  
S Bhaumik ◽  
S Roy ◽  
R Panda ◽  
M Peden ◽  
...  

Abstract Background The Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region due to its remoteness and poor coverage of health and police systems. Household methodology was found to be resource and time intensive, and so a Community Knowledge Approach was used and applied to calculate injury mortality for the first time. Methods A community-based survey was conducted in the Sundarbans to determine the drowning mortality rate for 1-4 and 5-9 year old children. A Community Knowledge Approach was applied. Meetings were held with law community residents and key informants to identify drowning deaths in the population. Identified deaths were verified by the child's household through a structured survey, inquiring on the circumstances around the drowning death. Results The drowning mortality rate for children aged 1-4 years old was 243.8 per 100,000 children and 38.8 per 100,000 children for 5-9-year olds. 58.0% of deaths were of 1-2-year-old children. Most children drowned in ponds within 50 metres of their homes. Children were usually unaccompanied with their primary caretaker engaged in household work. Only one third of deaths were reported to hospitals or civil registration systems. Of deaths listed by community members, 63.0% were identified by both residents and by at least one key informant, 25.6% by key informants only, and 11.4% (n = 79) by community residents only. Conclusions Drowning is a major cause of death among children in the Sundarbans, particularly those aged 1-4 years old. The results illustrate how routine data collection systems grossly underestimate drowning deaths, emphasising the importance of community-based in rural low-and middle-income country contexts. Key messages Drowning is likely the largest killer of 1-9 year old children in the Sundarbans region, emphasising the need to better understanding drowning epidemiology in similar rural LMICs contexts. The Community Knowledge Approach provides a low-resource, valid method for capturing injury mortality data.

2020 ◽  
pp. injuryprev-2020-043911 ◽  
Author(s):  
Medhavi Gupta ◽  
Soumyadeep Bhaumik ◽  
Sujoy Roy ◽  
Ranjan Kanti Panda ◽  
Margaret Peden ◽  
...  

BackgroundThe Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region.MethodsA community-based survey was conducted in the Sundarbans to determine the drowning mortality rate for children aged 1 to 4 years and 5 to 9 years. A community knowledge approach was used. Meetings were held with community residents and key informants to identify drowning deaths in the population. Identified deaths were verified by the child’s household through a structured survey, inquiring on the circumstances around the drowning death.ResultsThe drowning mortality rate for children aged 1 to 4 years was 243.8 per 100 000 children and for 5 to 9 years was 38.8 per 100 000 children. 58.0% of deaths were among children aged 1 to 2 years. No differences in rates between boys and girls were found. Most children drowned in ponds within 50 metres of their homes. Children were usually unaccompanied with their primary caretaker engaged in household work. A minority of children were treated by formal health providers.ConclusionsDrowning is a major cause of death among children in the Sundarbans, particularly those aged 1 to 4 years. Interventions keeping children in safe spaces away from water are urgently required. The results illustrate how routine data collection systems grossly underestimate drowning deaths, emphasising the importance of community-based surveys in capturing these deaths in rural low- and middle-income country contexts. The community knowledge approach provides a low-resource, validated methodology for this purpose.


2017 ◽  
Vol 25 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Stephen W Pan ◽  
Hiu Ha Chong ◽  
Hui-Chuan Kao

IntroductionIndigenous communities in Taiwan shoulder a disproportionate burden of unintentional injury fatalities. We compare unintentional injury mortality rate trends among Taiwan’s indigenous communities and the general population from 2002 to 2013, and evaluate potential impact of a community-based injury prevention programme on indigenous unintentional injury death rates.MethodsStandardised and crude unintentional injury mortality rates were obtained from Taiwan government reports. Segmented linear regression was used to estimate and compare unintentional injury mortality rate trends before and after the intervention.ResultsBetween 2002 and 2013, unintentional injury mortality rates among Taiwan’s indigenous population significantly declined by about 4.5 deaths per 100 000 each year (p<0.0001). During that time, the unintentional injury mortality rate ratio between indigenous Taiwanese and the general population significantly decreased by approximately 1% each successive year (p=0.02). However, we were unable to detect evidence that the ‘Healthy and Safe Tribe’ programme was associated with a statistically significant decrease in the unintentional injury mortality rate trend among indigenous persons (p=0.81).ConclusionTaiwanese indigenous communities remain at significantly higher risk of unintentional injury death, though the gap may be slowly narrowing. We found no evidence that the ‘Healthy and Safe Tribe’ indigenous injury-prevention programme significantly contributed to the nationwide decline in unintentional injury mortality among indigenous Taiwanese communities from 2009 to 2013. Future interventions to address the disproportionate burden of unintentional injury fatalities among indigenous Taiwanese should consider interventions with wider coverage of the indigenous population, and complementing grass roots led community-based interventions with structural policy interventions as well.


2020 ◽  
Vol 2 (3) ◽  
pp. 145-150
Author(s):  
Syaifuddin Syaifuddin ◽  
Wildan Suharso

Pendataan yang bersifat manual menjadikan permasalahan pada proses dilakukannya pendataan, hal ini juga terjadi pada Dinas Pendidikan dan Kebudayaan Kota Pasuruan dimana pendataan masih bersifat manual dengan keterbatasan jumlah Sumber Daya Manusia (SDM) yang ditugaskan untuk melakukan pendataan, oleh karena itu pada kegiatan pengabdian ini dilakukan pelatihan sistem informasi untuk meningkatkan waktu pendataan dan mengurangi kompleksitas dalam proses pendataan pada pegawai di Dinas Pendidikan dan Kebudayaan Kota Pasuruan. Pelatihan sistem informasi yang dimaksud adalah sistem informasi pendataan berbasis masyarakat, yang berisikan data dasar yang diperlukan oleh Pemerintah Daerah dalam rangka penyusunan rencana pembangunan. Data informasi tidak akan memberikan manfaat jika tidak dijadikan sebagai bahan acuan dalam penyusunan rencana pembangunan sehingga pelatihan dan pendampingan perlu dilakukan untuk tercapainya tujuan.Kata Kunci : Sistem Informasi, Berbasis Masyarakat, PendataanABSTRACT Manual data collection causes problems in the data collection process, this also occurs in the Pasuruan City Education and Culture Office where data collection is still manual with a limited number of Human Resources (HR) assigned to collect data, therefore this service activity is carried out information system training to increase data collection time and reduce complexity in the data collection process for employees at the Pasuruan City Education and Culture Office. The information system training referred to is a community-based data collection information system, which contains basic data required by the Regional Government in the framework of formulating development plans. Information data will not provide benefits if it is not used as a reference in the preparation of development plans so that training and assistance are needed to achieve the goals.Keywords : Information System, Community Based, Data Collection 


Author(s):  
Desfira Ahya ◽  
Inas Salsabila ◽  
Miftahuddin

Angka Kematian Bayi/ Infant Mortality Rate (IMR) merupakan indikator penting dalam mengukur keberhasilan pengembangan kesehatan. Nilai IMR juga dapat digunakan untuk mengetahui tingkat kesehatan ibu, kondisi kesehatan lingkungan dan secara umum, tingkat pengembangan sosio-ekonomi masyarakat. Penelitian ini bertujuan untuk memperoleh model IMR terbaik menggunakan tiga pendekatan: Model Linear, Model Linear Tergeneralisir dan Model Aditif Tergeneralisir dengan basis P-spline. Sebagai tambahan, berdasarkan model tersebut akan terlihat variabel yang mempengaruhi tingkat kematian bayi di provinsi Aceh. Penelitian ini menggunakan data jumlah kematian bayi di tahun 2013-2015. Data dalam penelitian ini diperoleh dari Profil Kesehatan Aceh. Hasil menunjukkan bahwa model terbaik dalam menjelaskan angka kematian bayi di provinsi Aceh tahun 2013-2015 ialah Model Linear Tergeneralisir dengan basis P-spline menggunakan parameter penghalusan 100 dan titik knots 8. Faktor yang sangat mempengaruhi angka kematian ialah jumlah pekerja yang sehat.   Infant mortality rate (IMR) is an important indicator in measuring the success of health development. IMR also can be used to knowing the level of maternal health, environmental health conditions and generally the level of socio-economic development in community. This research aims to get the best model of infant mortality data using three approaches: Linear Model, Generalized Linear Model and Generalized Additive Model with Penalized Spline (P-spline) base. In addition, based on the model can be seen the variables that affect to infant mortality in Aceh Province. This research uses data number of infant mortality in Aceh Province period 2013-2015. The data in this research were obtained from Aceh’s Health Profile. The results show that the best model can be explain infant mortality rate in Aceh Province period 2013-2015 is GAM model with P-spline base using smoothing parameter 100 and knots 8. Factor that high effect to infant mortality is number of health workers.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1224.3-1225
Author(s):  
J. Nossent ◽  
D. Preen ◽  
W. Raymond ◽  
H. Keen ◽  
C. Inderjeeth

Background:IgA vasculitis is generally considered to be a self-limiting condition, but this is at odds with the increased mortality observed in adult patients with IgA vasculitis (1).Objectives:With sparse data on prognostic factors in IgAV, we investigated whether pre-existing conditions are risk factors for mortality in adult IgAV patients.Methods:Observational population-based cohort study using state-wide linked longitudinal health data for adults with IgAV (n=267) and matched controls (n=1080) between 1980-2015. Charlson comorbidity index (CCI) and serious infections (SI) were recorded over an extensive lookback period prior to diagnosis. Date and causes of death were extracted from the WA Death Registry. Mortality rate (deaths/1000 person-years) ratios (MRR) and time dependent survival analysis assessed the risk of death. Age and gender specific mortality rate data were obtained from the Australian Bureau of Statistics.Results:During 9.9 (±9.8) years lookback IgAV patients accrued higher CCI scores (2.60 vs1.50 p<0.001) and had higher risk of SI (OR 8.4, p<0.001), not fully explained by CCI scores. During 19 years follow-up, the risk of death in IgAV patients (n=137) was higher than in controls (n=397) (MRR 2.06, CI 1.70-2.50, p<0.01) and the general population (SMRR 5.64, CI 4.25, 7.53, p<0.001). Survival in IgAV was reduced at five (72.7 vs. 89.7 %) and twenty years (45.2% vs. 65.6 %) (both p<0.05). CCI (HR1.88, CI:1.25 - 2.73, p=0.001), renal failure (HR 1.48, CI: 1.04 - 2.22, p=0.03) and prior SI (HR 1.48, CI:1.01 – 2.16, p=0.04) were independent risk factors. Death from infections (5.8 vs 1.8%, p=0.02) was significantly more frequent in IgAV patients.Conclusion:Premorbid accrual of comorbidity is increased and predicts premature death in IgAV patients. However, comorbidity does not fully explain the increased risk of serious infections prior to diagnosis or the increased mortality due to infections in IgAV.References:[1]Villatoro-Villar M, Crowson CS, Warrington KJ, Makol A, Ytterberg SR, Koster MJ. Clinical Characteristics of Biopsy-Proven IgA Vasculitis in Children and Adults: A Retrospective Cohort Study. Mayo Clin Proc. 2019;94(9):1769-80.Acknowledgements:The authors would like to acknowledge the support of the Arthritis Foundation of WA and acknowledge the Western Australian Data Linkage Branch, the Western Australian Department of Health, and the data custodians of, the Hospital and Morbidity Data Collection, the Emergency Department Data Collection the WA Cancer Register and the WA Death Register for their assistance with the study.Disclosure of Interests:None declared


2021 ◽  
pp. 147332502110293
Author(s):  
Laura A. Chubb ◽  
Christa B. Fouché ◽  
Karen Sadeh Kengah

The call to decolonise research processes and knowledge produced through them has spawned a powerful shift in working relationships between community researchers and members of local communities. Adaptation of a traditional conversational space in a community-based participatory research study offers a context-specific example of a decolonising method for data collection and as pathways for change. This article reports on learnings encountered while adapting the space and highlights the relevance for other cultural contexts. We present principles to adapt traditional conversational spaces both for collecting data and as a means of working in partnership with indigenous communities to enable different ways of knowing and action.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Shah ◽  
Q Jamali ◽  
F Aisha

Abstract Background Unsafe practices such as cutting umbilical cord with unsterilized instruments and application of harmful substances, are in practice in many rural areas of Pakistan, and associated with high risk of neonatal sepsis and mortality. Methods We conducted an implementation research in 2015 in Tharparkar district, in Sindh province of Pakistan to understand the feasibility and acceptability of community-based distribution of chlorhexidine (CHX) in rural Pakistan. For this cohort group-only study, 225 lady health workers (LHWs) enrolled 495 pregnant women. Enrolled women received 4% CHX gel and user’s instructions for newborn cord care. The LHWs also counseled women on the benefits and correct use of CHX. Study enumerators collected data from CHX receiving women 3 times: at around 2 weeks before delivery, within 24 hours after delivery, and on the 8th day after delivery. We implemented this study jointly in collaboration with Ministry of Health in Sindh province, Pakistan. Results Among enrolled participants, 399 women (81%) received only the first visit, 295 women (60%) received first two visits and 261 women (53%) received all three visits by enumerators. Among 399 women, who received CHX gel, counseling on its use and were respondent to the first round data collection, 78% remembered that the CHX gel to be applied to cord stump and surrounding areas immediately after birth; but less than a third (29%) forgot the need to keep the cord clean and dry. Among 295 respondents in the first two rounds of data collection, who delivered at home, 97% applied CHX to cord stump on the first day. Conclusions Community-based CHX distribution by LHWs, along with counseling to recipient women, resulted in a high rate of cord care with CHX among newborn delivered at home. Results from this study may help program implementers to consider expanding this intervention for improving newborn cord care on the first day of life in Pakistan. Key messages Community-based distribution of chlorhexidine for newborn cord care appears as highly acceptable and feasible in rural communities in Pakistan. Relevant program policy supporting community-based CHX distribution along with counseling by LHW may help expanding coverage of newborn cord care in rural communities in Pakistan.


Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Holly Kramer ◽  
Adam Bress ◽  
Srinivasan Beddhu ◽  
Paul Muntner ◽  
Richard S Cooper

Background: The Systolic Blood Pressure Intervention Trial (SPRINT) trial randomized 9,361 adults aged ≥50 years at high cardiovascular disease (CVD) risk without diabetes or stroke to intensive systolic blood pressure (SBP) lowering (≤120 mmHg) or standard SBP lowering (≤140 mmHg). After a median follow up of 3.26 years, all-cause mortality was 27% (95% CI 40%, 10%) lower with intensive SBP lowering. We estimated the potential number of prevented deaths with intensive SBP lowering in the U.S. population meeting SPRINT criteria. Methods: SPRINT eligibility criteria were applied to the National Health and Nutrition Examination Survey 1999-2006, a representative survey of the U.S. population, linked with the mortality data through December 2011. Eligibility included (1) age ≥50 years with (2) SBP 130-180 mmHg depending on number of antihypertensive classes being taken, and (3) presence of ≥1 CVD risk conditions (history of coronary heart disease, estimated glomerular filtration rate (eGFR) 20 to 59 ml/min/1.73 m 2 , 10-year Framingham risk score ≥15%, or age ≥75 years). Adults with diabetes, stroke history, >1 g/day proteinuria, heart failure, on dialysis, or eGFR<20 ml/min/1.73m 2 were excluded. Annual mortality rates for adults meeting SPRINT criteria were calculated using Kaplan-Meier methods and the expected reduction in mortality rates with intensive SBP lowering in SPRINT was used to determine the number of potential deaths prevented. Analyses accounted for the complex survey design. Results: An estimated 18.1 million U.S. adults met SPRINT criteria with 7.4 million taking blood pressure lowering medications. The mean age was 68.6 years and 83.2% and 7.4% were non-Hispanic white and non-Hispanic black, respectively. The annual mortality rate was 2.2% (95% CI 1.9%, 2.5%) and intensive SBP lowering was projected to prevent 107,453 deaths per year (95% CI 45,374 to 139,490). Among adults with SBP ≥145 mmHg, the annual mortality rate was 2.5% (95% CI 2.1%, 3.0%) and intensive SBP lowering was projected to prevent 60,908 deaths per year (95% CI 26, 455 to 76, 792). Conclusions: We project intensive SBP lowering could prevent over 100,000 deaths per year of intensive treatment.


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