Health-seeking Behaviors of Caregivers following Non-fatal Injuries in Rural Children at a Sub-district of Bangladesh, 2018
DOI:
https://doi.org/10.59096/osir.v19i2.279245Keywords:
child injury, health-seeking behavior, caregiversAbstract
Objectives: Understanding health-seeking behaviors of caregivers following non-fatal child injuries is necessary for child-injury prevention programs to develop effective interventions. This cross-sectional study aims to provide evidence on health-seeking practices in Bangladesh.
Methods: Data were previously collected in a survey study conducted between May and June 2018 among children aged less than 18 years from a selected sub-district of Bangladesh. Cluster sampling identified mothers or caregivers to be interviewed using a pretested semi-structured questionnaire. Health-seeking responses, including first aid and subsequent treatments, were obtained only for injured children, categorized as ‘minor’ and ‘major’.
Results: Of 918 children, the prevalence of major (n=22) and minor (n=68) injuries was 2.4% and 7.4%, respectively. All but one child received first aid or other forms of treatment. Among those who had major injuries, 77% received first aid, mostly from relatives (47%) or a doctor/trained health care worker (HCW) (41%); further treatment was pursued for 64%, and 18% were hospitalized. Among those with minor injuries, 90% received first aid, primarily from a relative (54%) or an unqualified HCW (25.5%); 60% sought further treatment, and 3% were hospitalized. Unqualified HCWs continued treatment for 50% of those with major and 71% of those with minor injuries. Caregivers applied diverse substances such as oil, water, toothpaste, ointment, or leaves as first aid, regardless of injury type and pattern.
Public Health Recommendations: This study identified nearly similar first aid practices as seen earlier, with treatment adherence more towards non-qualified HCWs. Inclusion of first aid knowledge and health-seeking behaviors in prevention programs, and qualitative studies for understanding of treatment adherence behavior are recommended.
References
Institute for Health Metrics and Evaluation. Global Burden of Disease Study 2021 (GBD 2021) [Internet]. Seattle: Institute for Health Metrics and Evaluation; [cited 2025 Aug 14]. <https://vizhub.healthdata.org/gbd-results/>
United Nations Children's Fund. Child and adolescent injuries [Internet]. New York: United Nations Children's Fund; [cited 2025 Aug 15]. <https://www.unicef.org/health/injuries>
Department of Social Determinants of Health, World Health Organization. Preventing injuries and violence: an overview [Internet]. Geneva: World Health Organization; 2022 [cited 2025 Aug 14]. 14 p. <https://iris.who.int/bitstream/handle/10665/361331/9789240047136-eng.pdf?sequence=1>
World Health Organization. Injuries and violence: the facts 2014 [Internet]. Geneva: World Health Organization; 2015 Jan 26 [cited 2016 Nov 22]. 19 p. <https://iris.who.int/handle/10665/149798>
United Nations Children's Fund Innocenti Research Center. A league table of child deaths by injury in rich nations. Florence: United Nations Children's Fund; 2001. 30 p.
Petridou E. Childhood injuries in the European Union: can epidemiology contribute to their control? Acta Paediatr. 2000;89(10):1244–9. doi:10.1080/080352500750027646.
Rahman F, Rahman A, Linnan M, Giersing M, Shafinaz S. The magnitude of child injuries in Bangladesh: a major child health problem. Inj Control Saf Promot. 2004 Sep;11(3):153–7. doi:10.1080/156609704/233/289634.
Rahman A, Chowdhury SM, Mashreky SR, Linnan M, Rahman AF, Hossain MJ, et al. Bangladesh health and injury survey 2016 (BHIS 2016): summary report [Internet]. Dhaka: Directorate General of Health Services; 2016 [cited 2017 Dec 12]. <https://pure.bond.edu.au/ws/portalfiles/portal/171972849/Bangladesh_Health_and_Injury_Survey_2016.pdf>
Chowdhury S, Rahman A, Mashreky SR, Giashuddin S, Svanstrom L, Horte L, Rahman F. The horizon of unintentional injuries among children in low-income setting: an overview from Bangladesh Health and Injury Survey. J Environ Public Health. 2009;2009:435403. doi:10.1155/2009/435403.
He S, Lunnen JC, Puvanachandra P, Amar S, Zia N, Hyder AA. Global childhood unintentional injury study: multisite surveillance data. Am J Public Health. 2014 Mar;104(3):e79–84. doi:10.2105/AJPH.2013.301607.
Gyedu A, Stewart B, Otupiri E, Donkor P, Mock C. First aid practices for injured children in rural Ghana: a cluster-random population-based survey. rehosp Disaster Med. 2021;36(1):79–85. doi:10.1017/S1049023X20001430.
Harmsen AMK, Giannakopoulos GF, Moerbeek PR, Jansma EP, Bonjer HJ, Bloemers FW. The influence of prehospital time on trauma patients outcome: A systematic review. Injury. 2015;46(4):602–9. doi:10.1016/j.injury.2015.01.008.
Husum H, Gilbert M, Wisborg T, Van Heng Y, Murad M. Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia. J Trauma. 2003;54(6):1188–96. doi:10.1097/01.TA.0000073609.12530.19.
Hossain MJ, Hossain MS, Bhuiyan AA, Rahman AF, Mashrelky SR, Rahman A. Medical care-seeking behaviours among drowning casualties: Results from a national survey conducted in Bangladesh. J Taibah Univ Med Sci. 2020;15(5):374–9. doi:10.1016/j.jtumed.2020.07.008.
Rahman A. Bangladesh health and injury survey: report on children. Dhaka: Bangladesh Directorate General of Health Services; 2005.
Afreen N, Billah MM, Flora MS. Child injury burden and risk profile in a Bangladeshi rural community: an age-group related overview. J Aging Sci. 2022;10(2):271. doi:10.35248/2329-8847.22.10.271.
District Statistics 2011, Narsingdi [Internet]. Dhaka: Bangladesh Bureau of Statistics; 2013 [cited 2018 Jan 17]. 123 p. <http://203.112.218.65:8008/WebTestApplication/userfiles/Image/District%20Statistics/Narsingdi.pdf>
Directorate General of Health Services, Ministry of Health and Family Welfare, Government of People's Republic of Bangladesh. Facility registry [Internet]. Dhaka: Directorate General of Health Services; [cited 2018 Jun 10]. <https://hrm.dghs.gov.bd/public/facility-registry/reports/organization-summary?submit=Run&division_id%5B0%5D=1&district_id%5B0%5D=12&city_corporation_id%5B0%5D=19&upazila_id%5B0%5D=278>
Moshiro C, Heuch I, Astrom AN, Setel P, Hemed Y, Kvale G. Injury morbidity in an urban and a rural area in Tanzania: an epidemiological survey. BMC Public Health. 2005;5:11. doi:10.1186/1471-2458-5-11.
Kamal S. Serious injury and injurious burden in urban Bangladesh. Journal of Applied Science and Technology. 2010;7(2):71–9.
Mock CN AF, Cummings P, Koepsell TD. Incidence and outcome of injury in Ghana: a community-based survey. Bull World Health Organ. 1999;77(12):955–64.
Moshiro C, Heuch I, Astrom AN, Setel P, Kvale G. Effect of recall on estimation of non-fatal injury rates: a community based study in Tanzania. Inj Prev. 2005 Feb;11(1):48–52. doi:10.1136/ip.2004.005645.
Hoque DME, Islam MI, Sharmin Salam S, Rahman QS-u, Agrawal P, Rahman A, et al. Impact of first aid on treatment outcomes for non-fatal injuries in rural Bangladesh: findings from an injury and demographic Census. Int J Environ Res Public Health. 2017 Jul 12;14(7):762. doi:10.3390/ijerph14070762.
Gyedu A, Mock C, Nakua E, Otupiri E, Donkor P, Ebel BE. Pediatric first aid practices in Ghana: a population-based survey. World J Surg. 2015;39(8):1859–66. doi:10.1007/s00268-015-3061-1.
Rahman F, Andersson R, Svanstrom L. Medical help seeking behaviour of injury patients in a community in Bangladesh. Public Health. 1998;112(1):31–5. doi:10.1038/sj.ph.1900240.
Nath A, Naik VA. Minor injuries among under-fives in a South Indian village. Indian Pediatr. 2009;46(7):621–3.
Geldsetzer P, Williams TC, Kirolos A, Mitchell S, Ratcliffe LA, Kohli-Lynch MK, et al. The recognition of and care seeking behaviour for childhood illness in developing countries: a systematic review. PLOS ONE. 2014;9(4):e93427. doi:10.1371/journal.pone.0093427.
Tannvik TD, Bakke HK, Wisborg T. A systematic literature review on first aid provided by laypeople to trauma victims. Acta Anaesthesiol Scand. 2012 Nov;56(10):1222-7. doi: 10.1111/j.1399-6576.2012.02739.x.
Pathak A, Agrawal N, Mehra L, Mathur A, Diwan V. First aid practices and health-seeking behaviors of caregivers for unintentional childhood injuries in Ujjain, India: a community-based cross-sectional study. Children (Basel). 2018;5(9):124.doi:10.3390/children5090124.
Kalaiselvan G, Dongre AR, Mahalakshmy T. Epidemiology of injury in rural Pondicherry, India. J Inj Violence Res. 2011 Jul;3(2):62–7. doi:10.5249/jivr.v3i2.74.
Pathak A, Ogunbayo A, Trushna T, Khare S, Mathur A, Atkins S, et al. Perceptions and experiences of caregivers on child injuries: a qualitative study from central India. J Prev (2022). 2022;43(4):549–65. doi:10.1007/s10935-022-00682-3.
Parmeswaran GG, Kalaivani M, Gupta SK, Goswami AK, Nongkynrih B. Unintentional childhood injuries in urban Delhi: a community-based study. Indian J Community Med. 2017;42(1):8–12. doi:10.4103/0970-0218.199791.
Graham HE, Bache SE, Muthayya P, Baker J, Ralston DR. Are parents in the UK equipped to provide adequate burns first aid? Burns. 2012;38(3):438–43. doi:10.1016/j.burns.2011.08.016.
Fadeyibi IO, Ibrahim NA, Mustafa IA, Ugburo AO, Adejumo AO, Buari A. Practice of first aid in burn related injuries in a developing country. Burns. 2015 Sep;41(6):1322–32. doi:10.1016/j.burns.2015.02.018.
Sudhinaraset M, Ingram M, Lofthouse HK, Montagu D. What is the role of informal healthcare providers in developing countries? A systematic review. PLoS One. 2013;8(2):e54978. doi:10.1371/journal.pone.0054978.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Outbreak, Surveillance, Investigation & Response (OSIR) Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
