320 Assessing child drowning risk in the rural context of Bangladesh: a human-centered design approach

<h3>Background</h3> Bangladesh has one of the highest child drowning rates in the world which is a major cause of injury and death globally. The risk of drowning in rural areas is higher due to proximity of waterbodies. There are exiting interventions like day care centers and swimming training program for children, but there are gaps in those interventions to engage the under-2-year-old children who are the most vulnerable to drowning. <h3>Objective</h3> The objective of the study was to assess drowning risk of children in rural context using Human Centered Design (HCD) tools. <h3>Methods</h3> Human-centered design tools, such as fly on the wall observation, caregivers photo journal, transect walk and household risk-mapping were applied in the study in six drowning prone villages of Sherpur Sadar and Kalapara sub-district, during September 2023. Total 20 primary caregivers interaction with children were observed during daylight hours. Four transect walks were completed in four villages to identify physical features and waterbodies. Photo journals were produced by 20 caregivers in which they captured images of their activities that might cause child drowning risk from dawn to dusk. Four Household risk-mapping were conducted by sketching overhead view of the houses and adjacent waterbodies. The data was analyzed in a thematic method. <h3>Results</h3> Observation showed that primary caregivers are responsible for all of the household chores such as cooking, cleaning and looking after the child simultaneously, which leaves the child unsupervised. Transect walks showed that every vulnerable village has a river or canal, which is a major activity point and also causes flood with water logging during rainy season. Other waterbodies like ditches, ponds, drainage channels were identified in detail. Caregiver photo journals revealed that infants stayed with the caregivers and came in contact with water during cleaning, washing clothes and bathing, as those are done in the ponds. Household risk-maps visualized that waterbodies tend to be within 1.5–3 meters from most of the households. <h3>Conclusions</h3> HCD approach created a deep insight of child drowning context which can complement quantitative research method and make the context more visible. This will assist in designing effective child drowning prevention intervention.