OBJECTIVE: Interventions that mitigate drowning risk in developing countries are needed. This study presents the cost-effectiveness of a low-cost, scalable injury and drowning prevention program called Prevention of Child Injuries through Social-Intervention and Education (PRECISE) in Bangladesh. METHODS: Between 2006 and 2010, the 2 components of PRECISE (Anchal, which sequestered children in crèches [n = 18 596 participants], and SwimSafe, which taught children how to swim [n = 79421 participants]) were implemented in rural Bangladesh. Mortality rates for participants were compared against a matched sample of nonparticipants in a retrospective cohort analysis. Effectiveness was calculated via Cox proportional hazard analysis. Cost-effectiveness was estimated according to World Health Organization–CHOosing Interventions that are Cost Effective guidelines. RESULTS: Anchal costs between $50.74 and $60.50 per child per year. SwimSafe costs $13.46 per child. For Anchal participants, the relative risk of a drowning death was 0.181 (P = .004). The relative risk of all-cause mortality was 0.56 (P = .001). For SwimSafe, the relative risk of a drowning death was 0.072 (P < .0001). The relative risk of all-cause mortality was 0.750 (P = .024). For Anchal, the cost per disability-adjusted life-year (DALY) averted is $812 (95% confidence interval: $589\x{2013}$1777). For SwimSafe, the cost per DALY averted is $85 ($51\x{2013}$561). Combined, the cost per DALY averted is $362 ($232\x{2013}$1364). CONCLUSIONS: Based on World Health Organization criteria, PRECISE is very cost-effective and should be considered for implementation in other areas where drowning is a significant problem.

This study set out to explore the epidemiology of suicide in Bangladesh. A cross-sectional study was carried out during 2003 (January to December). This encompassed a population of 819,429 of all age-groups and sexes. Data was collected by face-to-face interviews at a household level. Suicide was found to be the leading cause of death by injury in the age group of 10–19 years. Adolescent females (10–19 year age group) were found to be the most vulnerable. Overall, the suicide rate was 7.3 (95% CI 5.6–9.5) per 100,000 per year and the highest rate was found in the age group of 60+ years. The rate of suicide was found to be 17-fold higher (95% CI 5.36–54.64) in the rural population, compared to urban rates. Adolescent suicide rate in rural areas was 20.1 (95% CI 12.6–31.7) per 100,000. The rate was 17.7 (95% CI 8.6–34.9) and 22.7(95% CI 12–42) among males and females respectively. Poisoning was found as the most frequent method of suicide. The majority of the suicide victims were found to be very poor and illiterate. Suicide is a major public health problem in Bangladesh. Age, place of residence, economic status and literacy were the major associating factors related to suicide. Adolescents, elderly and those residing in rural regions were the most vulnerable groups.

Objective: To determine the epidemiology of child drowning in order to propose possible interventions for Bangladesh and other similar low-income countries. Design: Population-based cross-sectional study. Setting: Rural and urban communities in Bangladesh. Subjects: About 352 000 children 0–17 years were selected from over 171 000 households, using multistage cluster sampling. Main outcome measures: Incidence of fatal drowning. Results: Drowning was the leading cause of death (28.6 per 100 000 child-years) in children aged 1–17 years. The highest incidence (86.3 per 100 000 child-years) was in children aged 1–4 years. More than two-thirds of drownings occurred in ponds and ditches. Most drownings (85%) happened in daylight. In more than one-third of cases of drowning, the child was alone. In the two-thirds of cases in which the child was accompanied, almost half were with children who were 10 years or below. Only 7% of drowned children over 4 years of age knew how to swim. Conclusions: Drowning is a major cause of childhood mortality in Bangladesh. Creating drowning-safe homes, improving supervision of children, modifying the environment, and developing water safety skills for children and the community may be effective interventions for drowning prevention.

Background: Diet diversity of pregnant women is associated with nutrition sufficiency, micronutrient adequacy, and pregnancy outcomes. However, the sociodemographic determinants of diet diversity among pregnant women in low-income countries are not well studied. Objective: The analysis was undertaken to study the determinants of high dietary diversity and consumption of micronutrient-rich foods by pregnant women from rural Bangladesh. Methods: Pregnant women (508) were randomly selected from southwestern Bangladesh and interviewed to collect data about diet and sociodemographic characteristics. A 24-hour recall was used to collect information about diet. Diet diversity score was calculated for 9 major food groups. All analyses were conducted using STATA SE 12. Result: The overall mean diet diversity score was low at 4.28 and was significantly high among pregnant women who have higher educational achievement, whose husbands’ occupation was business, who live in households of 4 or more family members, and who were dwelling in a house with more than 1 room. Highest gap on knowledge and consumption was reported for 3 food groups including dairy foods, eggs, and dark green leafy vegetables. Consumption of dairy and eggs was lower among women from low socioeconomic status, but no significant association was found between sociodemographic characteristics and consumption of leafy vegetables. Conclusion: Our analysis has shown that diet quality of pregnant women was poor and intake of micronutrient-rich foods was low despite having knowledge about the importance of these foods, underscoring the need for promoting the diet quality in developing countries through behavior change communication programs.