Use this URL to cite or link to this record in EThOS: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.731463
Title: Community-based home injury risk assessment in rural Nepal
Author: Bhatta, Santosh
ISNI:       0000 0004 6497 033X
Awarding Body: University of the West of England
Current Institution: University of the West of England, Bristol
Date of Award: 2017
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Abstract:
Background: Unintentional injuries in the home are an important cause of death and disability among young children globally. However, in many parts of the world, particularly in the Low and Middle-Income Countries (LMICs) like Nepal, there is dearth of data regarding home injuries and home hazards to guide the development of effective interventions, and policies for preventing childhood home injuries. Aims: To explore the environmental risks associated with unintentional injuries amongst children aged 0-59 months in the Makwanpur district of Nepal, and to explore the potential for changes to the home environment to prevent injury occurrence. Methods: This study employed a multi-method approach. First, a literature review was undertaken to understand what environmental hazards had previously been identified and whether environmental change interventions are effective in reducing home hazards or home injuries in LMICs. Next, community-based studies were designed to collect both quantitative and qualitative information to best understand the problem of home injury risks in the study area. For this, quantitative data were collected through a community-based household survey (740 households) to understand home injury hazards and the injuries, and qualitative data were collected through five focus groups (FGs) to obtain perceptions on injuries and community-identified solutions to improve the safety of the home environment. Results: The literature review highlighted the limited evidence available from studies exploring the effectiveness of environmental change interventions in reducing childhood home injuries or injury hazards in LMICs. The household survey and home hazard assessment revealed a significant burden of hazards for childhood injuries within the home environment. Total of 242/1042 children < 5y (injury rate 232.2/1000 children) were reported to have sustained an injury in the previous 3 months, severe enough to require treatment or for them to be unable to take part in usual activities for at least 1 day. The most common mechanism of injury was falls (n=89/242; rate of 85.4/1000 children), followed by burns/scalds (n=67/242; rate of 64.3/1000 children) and cuts/crushes (n=53/242; rate of 50.9/1000 children) and then animal related injuries (n=24/242; rate of 23/1000 children). Most surveyed households had hazardous environments that had the potential to contribute to injuries in children < 5 years. In total, the mean number of injury hazards was 14.98 (SD = 4.48) in the 740 surveyed households with a range of 3 - 31. Results of regression analysis found a positive relationship between the number of home hazards and the number of childhood injuries. There was an estimated increase of 31% in the odds of injury occurrence associated with each additional injury hazard found in the home (AOR 1.31; 95%CI: 1.20 – 1.42). FG discussions, with different group of people revealed important insights into a community's knowledge and perception of home injury and home hazards and their suggestions for effective environmental change interventions including the barriers and facilitators. Conclusion: Overall, this thesis provides a robust baseline from which it will be possible to design targeted and culturally relevant environmental change interventions to reduce the number of home hazards in Nepal, with the potential to be adapted for similar socio-cultural settings in other low-income countries.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.731463  DOI: Not available
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