Thực trạng tai nạn thương tích trẻ em dưới 15 tuổi và một số can thiệp dự phòng tai nạn đuối nước tại hai huyện ở tỉnh bình định tt tiếng anh

MINISTRY OF EDUCATION AND TRAINING ẠI MINISTRY OF HEALTH HAIPHONG UNIVERSITY OF MEDICINE AND PHARMACY BUI LE VI CHINH THE STATUS OF INJURY ACCIDENTS AMONG CHILDREN UNDER 15 YEARS OLD AND SOME PREVENTIONS OF CHILDREN DROWNING IN TWO DISTRICTS OF BINH DINH PROVINCE Speciality: Public Health Code: 62.72.03.01 SUMMARY OF PUBLIC HEALTH PHD DISSERTATION ôGS.TS Tr ängHAI PHONG - 2020 THE DISSERTATION COMPLETED AT HAIPHONG UNIVERSITY OF MEDICINE AND PHARMACY Academic Supervisors: Assoc Prof Dinh Van Thuc Assoc Prof Duong Thi Huong Reviewer 1: Reviewer 2: Reviewer 3: The dissertation will be defended at University level Council of Dissertation Assessment at Haiphong University of Medicine and Pharmacy Time: …… date …… month …… year 2020 The dissertation could be found at: National Library Library of Haiphong University of Medicine and Pharmacy INTRODUCTION Injury accidents among children are a very important public health problem worldwide This is the cause of about million deaths every year, accounting for 9% of total deaths worldwide and 12% of the global burden of disease Drowning is now one of the public health issues of global concern Although Tuy Phuoc is a large delta district in the southern part of Binh Dinh province, there are quite intermittent systems of rivers and lakes, each year most affected by floods than other districts in the province, prevention of drowning in Children are interested in and focused on implementing these activities over the years However, the situation of drowning in the district in recent years has tended to increase Objectives of the study: Description of epidemiological characteristics of injury and drowning accident in children under 15 years old in Tuy Phuoc and Hoai Nhon districts, Binh Dinh province in 2015 Describe the knowledge and practices of people and health workers about drowning prevention in children under 15 years in Tuy Phuoc district - Binh Dinh province Evaluating the effectiveness of educational interventions to prevent drowning of children under 15 years old in the community of Tuy Phuoc district - Binh Dinh province THE CONTRIBUTION OF THE THESIS This is the first study on the situation of childhood injury and some drowning preventive intervention were conducted in two coastal districts of Binh Dinh province The study contributes to a better explanation of the reason for injury, especially child drowning, while the locality has been implementing an injury prevention program for many years The results of the study will give managers a number of recommendations and appropriate solutions to reduce the burden of drowning STRUCTURE OF THE THESIS The main part of the thesis is 116 pages long, consisting of the following sections: Introduction: pages; Chapter 1- Overview: 31 pages; Chapter 2- Research Object and Method: 18 pages; Chapter 3Research Results: 31 pages; Chapter 4- Discussion: 31 pages; Conclusions and recommendations: pages The thesis has 149 references, of which 68 are in Vietnamese and 81 are in English The thesis has 41 tables and pictures CHAPTER OVERVIEW 1.1 Injury accident - Accident: is an unexpected, unintended event (incidental, unintentional) caused by an outside agent that causes physical or mental damage and injuries - Injury: is the physical damage to the human body due to the effects of energies (including: mechanics, heat, electricity, chemistry, radiation ) with different degrees and speeds In addition to injury, there is a shortage of essentials for life - Consequences of injury injuries: The consequences of injuries left to children are health effects, causing physical pain because they may be partially injured or disabled for life, even death; Mental and psychological effects such as children with inferiority complex, inferiority complex, always in a state of fear and costly treatment of trauma Since then, making children difficult to integrate into the society, and child injuries also cause more socio-economic burden for families, localities and the country 1.2 Drowning among children Drowning is any liquid that gets into the airway and interferes with breathing Drowning leads to lack of oxygen to the brain, if it is not provided in a timely manner, the victim will lose consciousness, death or serious damage to the brain causing complications such as learning disorders, memory problems and permanent permanent loss of function or permanent vegetative state; Factors causing drowning in children: The development and behavior of children, agents, environment, socio-economic 1.3 Knowledge and practice of people and health workers about child drowning prevention Drowning is now one of the public health issues of global concern The prevention of drowning is a very important issue because knowledge about prevention of drowning is not only related to health workers but also to all people The right knowledge will have good drowning attitudes and good practices and behaviors 1.4 Solutions to prevent drowning in children Health education and communication is one of the top ten contents of primary health care and the most important content to help people have the knowledge and skills to protect their own health Drowning occurs not only in lakes, rivers, canals, etc but also can occur at home, work, schools, preschools Therefore, parents, teachers, everyone needs to know how to prevent and rescue drowning emergency skills is essential Health education programs can help people gain the right knowledge and practice about drowning prevention CHAPTER 2: METHODOLOGY 2.1 Population, location and and time frame of study 2.1.1 Study population 2.1.1.1 Study population for objective - Children under 15 years old living in Tuy Phuoc and Hoai Nhon districts, Binh Dinh province Exclusion: Children with severe medical conditions such as cerebral palsy and disability - Parents or caregivers of children under 15 years old Exclude subjects with limited communication skills who are unable to understand and answer questions or not agree to participate in study 2.1.1.2 Study population for objective and - Parents or caregivers of children under 15 years old in Tuy Phuoc district; Health worker working at 13 commune health stations in Tuy Phuoc district, Binh Dinh province 2.1.2 Study location Tuy Phuoc and Hoai Nhon districts - Binh Dinh province 2.1.3 Time frame: The study was conducted from January 2015 to December 2018 2.2 Methods 2.2.1 Study design: The project is conducted in consecutive research designs: Cross-sectional study and controlled community intervention study 2.2.2 Sample size and sample selection 2.2.2.1 Sample size, sample selection for objective 1: Apply the formula to calculate the sample size: In fact, 9.335 children in communes of the two districts were included 2.2.2.2 Sample size, sample selection for objective 2: Sample size of parent / caregiver In fact, 4,467 people were surveyed in Tuy Phuoc district * Sample size/ sample selection of health workers: Interview all health workers working at 13 commune health stations in Tuy Phuoc district 2.2.2.3 Sample size, sample selection for objective 3: Intervention research * Sample for community intervention: In fact, 1689 people in the intervention area and 1451 people in the control area were included 2.3 Technical details and data collection tools 2.3.1 Collecting data for objective and 2: Describe the epidemiological characteristics of injury and drowning incidents for children under 15 years old in Tuy Phuoc and Hoai Nhon districts, Binh Dinh province in 2015 2.3.1.1 Developing a toolkit: Developing a survey form for the community on injuries based on the guidance of the Ministry of Health's investigation, amending and supplementing a number to suit the local situation and thesis's objectives The questionnaire for interviewing knowledge and practice was designed based on the guidance of the Department of Health Environment Management and the overview of previous researches 2.3.1.2 Steps to conduct research: Select a list of children under 15 years old; Conduct investigations; Collect surveys form 2.3.2 Collecting data for objective 3:Assessment of changes in knowledge and practice of people and health workers after years of intervention in Tuy Phuoc district, Binh Dinh province 2.3.3 Criteria for evaluating knowledge about drowning prevention - Knowledge of circumstances of drowning; emergency drowning; handling when drowning children; measures to prevent drowning; - People's practices on preventing children from being exposed to environmental risk factors for drowning 2.4 Implementation of intervention activities - Developing communication materials for child drowning prevention as follows Develop 01 propaganda message about child drowning prevention; Designing and developing leaflets on drowning prevention and distribution in the community Number of leaflets produced and distributed: 3,000 leaflets; painted 40 pano, propaganda posters in crowded public places Put up warning signs in places prone to drowning - Organizing 14 small group communication sessions for people who take care of children daily in the community 14 sessions at school; Integrating propaganda in programs such as expanded vaccination, prevention of malnutrition, mass activities ; Organized 04 swimming lessons for 120 children Organizing 03 training courses for 50 people who are health workers and commune-level child care and protection officers on drowning prevention communication skills; identify and manage drowning cases in children 2.6 Ethics in research The research was carried out according to the thesis outline which was approved by the Ethical Committee of Hai Phong University of Medical and Pharmacy and approved by local leaders; Participants voluntarily participate in research; Chapter RESEARCH RESULTS 3.1 Epidemiological characteristics of injury and drowning incidents in children under 15 years in Tuy Phuoc and Hoai Nhon districts, Binh Dinh province in 2015 3.1.1 Epidemiological characteristics of injury accident of children under 15 years old Table Prevalence of child injuries in two districts in 2015 Number of Children Commune / town children with % p research injury Tuy Phuoc district 4467 531 11,9 - Dieu Tri Town (1) 1.546 172 11,1 p1,2 = - Pure farming (2) 2921 359 12,3 0,252 + Phuoc Son commune 1446 179 12,4 + Phuoc Quang commune 1475 180 12,2 Hoai Nhon district 4868 521 10,7 p3,4 = - Tam Quan town (3) 1.576 165 10,5 0,716 - Pure farming (4) 3292 356 10,8 + Hoai My commune 1715 185 10,8 + Hoai Huong commune 1577 171 10,8 Total 9335 1052 11,3 Comment: In Tuy Phuoc district: The rate of children injured in the district is 11.9%; Hoai Nhon District: The rate of children injured in the district is 10.7% The rate of children injured injuries in districts accounted for 11.3% Male Female % 15 13.5 11.8 10.1 9.5 10 Tuy Phuoc district Hoai Nhon district Figure 3.1 Prevalence of injury-related children by gender (n=9335) Comment: The rate of injuries in young boys in Tuy Phuoc district is 13.5%, Hoai Nhon is 11.8% The incidence in girls is 10.1% and 9.5%, respectively Table 3.2 Age-related injury accidents among children in two districts (n = 9335) District Area Town1 Tuy Phuoc Pure farming2 Hoai Nhon Town1 Num of children Num of children injury % p Num of children Num of children injury % p Num of children Num of children injury % p