Article Text

Download PDFPDF
Child supervision practices for drowning prevention in rural Bangladesh: a pilot study of supervision tools
  1. J A Callaghan1,
  2. A A Hyder1,
  3. R Khan2,
  4. L S Blum2,
  5. S Arifeen2,
  6. A H Baqui1
  1. 1International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  2. 2International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
  1. Correspondence to Adnan A Hyder, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Suite E-8132, Baltimore, MD 21205, USA; ahyder{at}


Background Injuries are an increasing child health concern and have become a leading cause of child mortality in the 1–4 years age group in many developing countries, including Bangladesh.

Methods Household observations during 9 months of a community-based pilot of two supervision tools—a door barrier and a playpen—designed to assess their community acceptability in rural Bangladesh are reported in this article.

Results Statistical analysis of 2694 observations revealed that children were directly supervised or protected by a preventive tool in 96% of visits. Households with a supervision tool had a significantly lower proportion of observations with the child unsupervised and unprotected than households without a tool. Families that received a playpen had 6.89 times the odds of using it at the time of the visit than families that received a door barrier.

Conclusions Interventions such as the playpen, when introduced to households through community-based programs, are accepted by parents. Field trials are urgently needed to establish the effectiveness of barrier-based interventions at reducing under-five drowning mortality rates in low-income countries like Bangladesh.

  • Child health
  • injury
  • drowning
  • child supervision
  • Bangladesh
  • childhood injury
  • child supervision
  • injury

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding This article is part of a larger study funded by the US Agency for International Development through the Global Research Activity grant to the Department of International Health, Johns Hopkins Bloomberg School of Public Health. Address: Ronald Reagan Building, Washington, DC 20523-0016, USA.

  • Competing interests The authors have no competing interests to declare.

  • Patient consent Obtained.

  • Ethics approval This study was approved by the institutional review boards at the Johns Hopkins Bloomberg School of Public Health and the International Center for Diarrhoeal Disease, Bangladesh.

  • Provenance and peer review Not commissioned; not externally peer reviewed.