Objectives

• Review of BASS activities phase 1.0• Challenges in implementing different

activities of phase 1.0• Finalise the activities for phase 1.5

Components of BASS Phase 1.0

• Anchal V3.0• SwimSafe V3.0• Injury surveillance• Community awareness

Component of Anchal V3.0

– Supervision of U5 children & provision of ECD

stimulations through different activities

– Anthropometric measurements for physical

development

– Measurement of mental and social development

– Screening for disabilities

– Playpen use for safety and supervision

– Health issues – immunization status

Supervision and ECD in Anchal

40 Anchals

functioning

Anchal children by age and sexin July 2015

Age in month Boys Girls Both

9-11 months 1 (0.2) 2 (0.4) 3 (0.3)

12-23 months 45 (9.5) 56 (10.9) 101 (10.3)

24-35 months 140 (29.6) 114 (22.3) 254 (25.8)

36-47 months 161 (34.0) 182 (35.5) 343 (34.8)

48-59 months 126 (26.6) 158 (30.9) 284 (28.8)

Current children 473 512 985

Graduate 17(1.6) 17(1.6) 34 (3.2)

Drop out 25(2.3) 32 (3.0) 57 (3.2)

Total enrolled 515 (47.9) 561 (52.1) 1076 (100.0)

FORM 1

Anthropometric measurements

• Weight and height of Anchal children 985

• 40 Anchal Ma trained• Instruments used

– Bathroom scale-2-5 years– Salter scale-< 2 years– Wooden height scale

• Measurement done-every month– 8 rounds (Nov’14-June’15)

FORM 3

Anthropometric measurements-June ‘15Nutritional status -Severe stunt (below-3SD) :

Height for age

Age in months

BDHS-2011

%

%(Number)

%(Total)

9-11 11.60.0(0)

100.0 (3)

12-17 15.631.3(5)

100.0(16)

18-23 21.922.5(19)

100.0(85)

24-35 18.814.6(37)

100.0(254)

36-47 18.19.9(34)

100.0(343)

48-59 14.37.4(21)

100.0(284)

All ages11.8(116)

100.0(985)

Nutritional status - Severe wasting (below -3SD): Weight for age

Age in months

BDHS-2011 %

%(Number)

%(Total)

9-11 7.60.0(0)

100.0

(3)

12-17 9.20.0(0)

100.0

(16)

18-23 12.8 3.5(3)

100.0(85)

24-35 11.56.3(16)

100.0(254)

36-47 13.4 5.8(20)

100.0(343)

48-59 10.34.2(12)

100.0 (284)

All ages   5.2 (51) 100.0 (985)

Challenges in Anthropometric measurement

Challenges Solutions

Bathroom scales - measurement errors oUsed a fixed known weightoChanged batteriesoCompared with other scaleAlternate: Use of Standard weighing machine, but expensive

Measuring weight and height by AMs (5%)

oIncreased supervisionoAssistance during measurementsoRefreshers training (twice)

Plotting growth charts (25%) oIncreased supervisionoAssistance during plotingoRefreshers training (twice)

Measurement of mental and social development

Two sets of checklists used for child development screening

–CDC checklist • 9, 12, 18, 24, 36, 48, 60 months

–WHO 10 Questions for disability screening• 2-5 years old children

Development of Anchal childrenCDC checklist

  Developmental Delay (CDC)

Age Category (in months)

Sex of children

Boys N= 476 Girls N=522 Both N=998

n % n % n %

9 months (N=20, Male-8, Female-12) 0 0 0 0 0 0.0

12 months (N=81, Male-29, Female-52) 1 3.4 1 1.9 2 2.4

18 months (N=91, Male-48, Female-43) 0 0 1 2.3 1 1.0

24 months (N=315, Male-168 Female-147) 2 1.1 3 1.3 5 1.5

36 months (N=327, Male-145 Female-182) 1 0.6 2 1 3 0.9

48 months (N=163, Male-77 , Female-86) 4 5.1 2 2.3 6 3.6

60 months (N=1 Male-1) 1 100.0 0 0.0 1 100.0

Total 9 1.8 9 1.6 18 1.8

Screening of child disability by 10Qs

Age in monthsBoys Girls Both

n % n % n %

24 months (N=320, Boys=166, Girls=154) 18 10.8 30 19.5 48 15.0

36 months (N=321, Boys=138, Girls=183) 6 4.3 6 3.3 12 3.7

48 months (N=140, Boys=69, Girls=71) 3 4.3 7 9.9 10 7.1

Total (N=781, Boys=373, Girls=408) 27 7.2 43 10.5 70 9.0

Challenges in using development checklists

Challenges of using CDC checklist Solutions

Extensive and complicated oIncreased supervision

oAssistance during measurements to >50% AMs

oRefreshers training during cluster meetings

Time consuming

Do more mistakes

Can we consider to exclude in Phase 1.5 and Phase 2 ?

Screening for physical disabilitiesCongenital and acquired disabilities

Anchal children Siblings Status Boys Girls Both Boys Girls BothDisabled 10 (2.0) 7 (1.3) 17 (1.6) 16 (3.9) 14(2.9) 30(3.3)Normal 482 (98.0) 534 (98.7) 1016(98.4) 395 (96.1) 472(97.1) 867(96.7)Total 492 (100.0) 541 (100.0) 1033 (100.0) 411(100.0) 486(100.0) 897(100.0)

Distribution of Anchal children and their siblings by physical disability and sex

Anchal children & their siblings Sex Both %Boys % Girls %Disabled 26 2.9 21 2.0 47 2.4Normal 877 97.1 1006 98.0 1883 97.6Total 903 100.0 1027 100.0 1930 100.0

Immunization status of children

Vaccine’s

Name

Immunization Status Sex Total

Boys N= 475 Girls N=524 Both N= 999

N % N % N %

B.C.G 475 100.0 524 100.0 999 100.0

DPT 473 99.6 523 99.8 996 99.7

OPV 422 88.8 483 92.2 905 90.6

MR 432 90.9 460 87.8 892 89.3

Measles 419 88.2 482 92.0 901 90.2

Playpen use in Anchal

Age: 9-24 months (90% AM)

Time: During anchal activities (92% AM)

Sleeping, not interested to participate

Duration: About 30 mins (92% AM) children were kept in anchal

Not suitable: 30 months and overWooden playpen

SwimSafe

SwimSafe

Swimming Result

3 years (%)

4 years (%)

5 years (%)

6 years (%)

7 years (%)

8 years (%)

9 years (%)

All ages (%)

Pass31

(29.5)81

(68.1)112

(70.4)146

(82.5)205

(87.2)221

(83.4)230

(84.9)1026 (77.1)

Fail44

(41.9)27

(22.7)38

(23.9)19

(10.7)12 (5.1)

22 (8.3)

17 (6.3)

179 (13.4)

Drop out30

(28.6)11

(9.2)9

(5.7)12

(6.8)18

(7.7)22

(8.3)24

(8.9)126 (9.5)

Total105

(100.0)119

(100.0)159

(100.0)177

(100.0)235

(100.0)265

(100.0)271

(100.0)1331

(100.0)

SwimSafe: First response

• A total of 659 children have been graduated

• Children age group

was 7-9 years old

• Target was to train 600 children

CPR graduates (Mid July – Sep ‘14)

Distribution of CPR graduates by age and sex with the percentage

Status 7 year (%)

8 year (%)

9 year (%)

All ages (%)

Pass

201 (85.5)

226 (85.9)

232 (85.9)

659 (85.8)

Fail 14 (6.0)

9 (3.4)

7 (2.6)

30 (3.9)

Drop out 20 (8.5)

28 (10.6)

31 (11.5)

79 (10.3)

Total 235 (100.0)

263 (100.0)

270 (100.0)

768 (100.0)

Swimming teaching for disabled children in a portable pool

Disabled children• Target was to teach 40

disabled children

– 18 were attended but not graduated

– Next swimming session will be started soon

Injury surveillance

• At the three unions including Dhangara injury surveillance has been conducted.

• Each surveillance round is a 6 months cycle• Two rounds of surveillance has been conducted

during BASS phase 1.0.• Data entry is in progress

Population in Dhangara union

• Total household – 9,687• Total population – 50,240

Male: 25,195

Female: 25,225• U5 children – 11, 618

Male: 5,875

Female: 5,743

Plan for BASS 1.5

Bridging period July – Dec 2015 /Mar 2016

Anchal activitiesBass 1.0 Proposed BASS 1.5

1 Child supervision and ECD possible (Form 1)

The same activities continue

2 Anthropometric measurement possible by Anchal Mas (Form 3)

Moderate and severe malnourished children will be referred to IMCI of UHC

3 Identification of disabilities in children is possible(Checklists- CDC and 10Q; Form-7 and Form 8)

Disabled children will be referred to1. JPUF (disability centre) – Sirajganj2. Surgical cases – Bogra Medical

College Hospital

4 Measurement of immunization status possible

Those who missed immunization will be referred to vaccination centres

5 Vitamin A capsule ingestion not checked

Vitamin A capsule –check and referral (Form 9)

6 Deworming not checked Deworming – check and referral

7 Common illness – not done Common illness information (Form 13)

8 Play-pen observation (Form 10)

??

SwimSafe

Age BASS 1.0 BASS 1.5

3 -4 yrs

1. 25 meters swimming2. 30 seconds treading/floating3. Reach or throw rescue

1. 25 meters swimming2. 30 seconds treading/floating3. Reach or throw rescue4. Risk management

5 – 6 yrs

1. 25 meters swimming2. 30 seconds treading/floating3. Reach or throw rescue4. Height measurement

1. 25 meters swimming2. 30 seconds treading/floating3. Reach or throw rescue4. Height measurement5. Weight measurement6. Risk management7. In water rescue*

(*Draft instructions for CSIs)

SwimSafeAge BASS 1.0 BASS 1.5

7 – 9 yrs 1. 25 meters swimming2. 30 seconds treading/floating3. Reach or throw rescue4. In water rescue5. First aid including CPR6. Height measurement

1. 25 meters swimming2. 30 seconds treading/floating3. Reach or throw rescue4. Height measurement5. In water rescue6. Weight measurement7. Risk management8. First aid including CPR9. First response to the community- Reporting form available from

IDRC-B project

Disabled children

1. 25 meters swimming2. 30 seconds treading/floating

SwimSafe: in water rescue

• Children below 7 years old will not be trained to conduct in-water rescue

• During conduction of rescue; rescuer should not enter more than chest level of water.

• Rescuer will call adults for help during rescuing.

Type of in water rescue

• In water throw rescue– Rescuer could rescue a person by throwing a floating

object into the water

Type of in water rescue• In water reach rescue

– The rescuer will conduct reach rescue with a bamboo pole or stick, rope or cloth

Type of in water rescue

• In water reach rescue– Maintaining a certain distance or not entering

into the water, rescuer will pull the drowned person to the bank holding his/her hand, leg, hair, part of clothing

Type of in water rescue

• In water reach rescue– By forming human chain

Thank You