Child supervision practices for drowning prevention in rural Bangladesh: a pilot study of supervision tools.

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.