Community-based home injury risk assessment in rural Nepal

ABSTRACTBackground: 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 childre