Every day in Bangladesh 40 children under the age of ten drown, with 30 of those children under the age of five. To highlight World Drowning Prevention Day we spoke to RNLI and their partner CIPRB about their work setting up Anchals - community-based creches - to provide young children a safe space away from open water. Listen in to hear about the success of the project and how this has led to a national scale-up programme with the government of Bangladesh.
0:03 – 1:00 Sarah:
Hello and welcome to the Learning Post, a podcast dedicated to sharing insights and learning from UK Aid Match. My name is Sarah and I'm the Fund Director for UK Aid Match, as well as your host for this episode.
In this episode we speak to Darren Williams, Programme Manager at RNLI and Dr. Aminur Rahman, Deputy Executive Director and Drowning Prevention lead for RNLI's partner in Bangladesh, the Center for Injury Prevention and Research Bangladesh (known as CIPRB).
Many people know of the work of the RNLI for their work across the UK, saving lives around Britain's coastline. But the RNLI has an international focus too, which is what we're going to talk about today and specifically their UK Aid Match project in Bangladesh. I'm delighted to be joined today by Darren and Aminur to discuss this in more detail. Good afternoon and thank you for joining me.
1:00 – 1:02 Darren:
Hi, thank you and thanks for having us.
1:02 – 1:11 Sarah:
So to start with Darren, could you give us a brief overview of your recently completed UK Aid Match project in Bangladesh and what were its key aims?
1:11 – 1:33 Darren:
Sure. So, the project was called Creches for Bangladesh. And essentially the aims were to deliver 300 community daycare centres, known as Anchals locally, which would reduce the risk of drowning for children, up to 5,400 children in rural communities in Barisal region of Bangladesh.
1:33 – 1:43 Sarah:
Great, thanks Darren. It sounds really interesting and I was lucky enough to come out and visit the project earlier in the year as well. So, could you tell us a little bit about how you partnered with CIPRB to deliver the project?
1:43 - 2:46 Darren:
We first started working with CIPRB back in 2012, 2013 and that was to support with the delivery of a lifeguards service down in Cox's Bazar. That was essentially providing lifeguard training to a group of volunteers on the beach that have witnessed a number of drownings. Our role was to support CIPRB to create a sustainable lifeguard service. And fast forward, is 10 years now. The service is now being funded by other donors and the RNLI's role is now more of a technical support role, and then we worked on a project called BASHA, which was based around the drowning risk in the rural areas of Bangladesh in Barisal.
So, actually as you've already mentioned, drowning is a significant issue in Bangladesh, claims the lives of around 19,000 people every year, of which the majority are children, and interventions like the community daycare, the creches can significantly reduce the risk of a child drowning. Another intervention that we work with CIPRB to deliver is the survival swimming for children aged six to 12 years.
2:46 – 2:59 Sarah:
Great, thanks very much Darren. I think a lot of our listeners might be quite surprised by those statistics. And Aminur, it'd be interesting if you could explain to our listeners a little bit more about that scale of the problem that Darren's just touched on in terms of drowning in Bangladesh.
2:59 – 8:10 Aminur:
Okay, thank you. In 2005 we did a groundbreaking survey called Bangladesh Health and Injury Survey, which actually identified that drowning is the number one killer of children under 18 after infancy and children one to four year and five to nine year age groups are the most vulnerable groups.
Every day, if we consider under five children, about 30 children drown. And if we consider under 10-year-old children, that will come about 40 children a day. We are trying to find out what would be the solution for drowning prevention.
We found that the highest rate of drowning is at the age of one and with the increase of age, drowning rate declines.
We did another study and we found that the children of Bangladesh, especially of the rural community, used to go to water at the age of three. These water body are the ponds, ditches, which are only about 20 to 50 meters walking distance.
In these ponds, they used to drown, where their parents or siblings are taking their bath, or washing their clothes, or washing utensils and water for their daily work. We found that from three years onward, the swimming ability of the children increases and at the age of 10, about 60% children who were 10 years and over can swim and it means that children who are lower than 10 years, the death rate is high. One of the reasons could be that those who cannot swim.
That gives an idea to develop a drowning prevention strategy. So children less than five they need to be supervised. If they are supervised, they shouldn't actually drown. It means that it is not possible for the parents, or the mothers, or the community at large to supervise, especially during the parents' busy hour.
By busy hours, I mean the time when most of the fathers are away for work, the older siblings at school, the youngest one and the mom at home. But mom is busy with the household chores, so the supervision cannot occur. That's why I'm saying that we design that it should be institutional supervision during 9:00 AM to 1:00 PM. And the children who are older than six years or so should receive survival swimming. We found that in the rural communities, the women who are housewives, they are not actually engaged in any occupation professionally, but does household chores, could be engaged, and if the families allow one room to accommodate 20 to 25 children for 9:00 AM to 1:00 PM and if these women become interested to be paid volunteers to look after the children and also at the same time, they could provide early childhood development stimulations, so it will protect the children and also help them developmentally.
And so, it's an innovation and we found that the children who are in such type of supervision, this is we call Anchal. Anchal means community daycare. Now, there is 82% less chance of drowning than those who are not participating in similar settings.
Again, if the children learn survival swimming, then some essential thing, for example needs some water bodies, where children should learn. Unfortunately, we cannot erect swimming pools in every villages. We utilized rural ponds and installed a bamboo structure which helps children to learn their basic skills of swimming safely.
We need swimming instructors. We actually utilize the rural youths who are good swimmers and have interested to be a paid volunteer to teach children swimming. And we trained them for five days on swimming skills and also, we trained them with the resuscitation skills like CPR, cardiopulmonary resuscitation.
Since 2006 through all our projects, we actually trained 700,000 children to learn to swim. And the children who learn swimming through this process, there is 96% less chance of drowning than those who doesn't learn from through this process. So, these are the two innovations. And in UK aid project, we utilise the supervision or anchal part.. And actually, Darren already mentioned the number of, was about 300?
And around 7,500 children because each can accommodate 25 children whilst in supervision and received early childhood development stimulations.
8:10 – 8:49 Sarah:
Yeah, absolutely. The two-pronged approach is fascinating and certainly interesting to have seen how the impact of that work that you've had in the communities that you've been working in. Your UK Aid Match program has now recently ended and one of the things that we talked about, and I understand you guys will be working on is a scale up to a national programme, working with the government of Bangladesh. It would be great to understand a little bit more about your partnership with the government and how that programme's come to be and how you've worked with them, the policy appetite for this kind of work and the evidence that you've presented?
8:49 – 10:51 Darren:
I believe there's around 3000 community daycare centers that are being implemented by CIPRB, of which that includes the 300 from UK Aid Match, which have been continued post-project funding and we're very fortunate to be able to continue those, thanks to the investment from the Bangladesh government. So, the project itself is 32 million US dollars worth of investment and it is what's called a DPP, or a development project proforma. So, it's the first stage if you like, for getting national level scale up of these proven interventions.
The project itself is sponsored by the Ministry of Women and Children's Affairs and then implemented by the lead agency called Bangladesh Shishu Academy. So there's two then development partners supporting this project, one of which is the RNLI and the other is Bloomberg Philanthropies. And interestingly, both Bloomberg Philanthropies and the RNLI have a common partner and that is CIPRB.
The project itself will be focused around early childhood development, positive parenting, supervision through the community daycare, injury prevention and also learn to swim. So, it's quite a holistic approach to reducing child mortality, but also around early childhood development.
The project in its first phase is scaling up from what is currently one district to 16 districts, so that's 3,000 community daycare centres, to 8,000 community daycare centres. And then in terms of SwimSafe from one district again to 16 districts, and that's currently from 65 swim centres to 1,600. So, this first phase of scale up is quite significant, but the aim of it is to prove that actually, other organisations can deliver these interventions that essentially have been developed through CIPRB.
10:51 – 12:31 Aminur:
After we finished our research work, we thought that CIPRB is a research organization. It doesn't have the mandate and also the capacity to expand these interventions throughout the country. So, it has to come from the government.
We have 34 million children who needs this kind of daycare centre support. So, we have to talk with the government. And it's hard to find out the lead agency. If you think about the death or morbidity issue, yes, it is a Ministry of Health issue. If you consider as development or education, then again it could be Minister of Education's responsibility. Swimming teaching, if you consider is an as a sport. Yes, it is also then Minister of Youth and Sports responsibility. That means it is a multi-sectoral kind of approach needs to be taken. So, donors and CIPRB, and also taking other actors on board, we started talking to different ministries of Bangladesh government.
And finally, the activities that we want to do actually matched closely with the activities of the Ministry of Women and Children Affairs. This is one of the largest project and it is called the Mega Project, it's an integrated child development and supervision and protection issues, and teaching children's survival swimming.
12:31 – 13:06 Sarah:
It's fantastic and something that you should absolutely celebrate.
It's been really interesting to hear about both the interventions that you've delivered under UK Aid Match programme, but also what that's led to for your future programming. One final question to ask, is if you could think about your three top learnings from your UK Aid Match work for listeners, particularly I'm thinking around the sustainability of your work, which I think your programme is a fantastic example of where you've been able to influence different stakeholders and your work is going to be continuing and scaling up at huge scale, which is fantastic.
13:07 – 14:19 Darren:
The most important thing that I've learned is adaptive management and the ability to adapt and the willingness as well to adapt from the partner, but also from the donor and from the fund manager. I think that actually for us, the ability to adapt and deliver COVID prevention messaging and to integrate drowning prevention messaging really helped with the engagement with the local, divisional and the national level government and key stakeholders. So, I think that really helped when it came to working through that journey with the government scale up project and getting that signed across the line. So I think that it would be that ability to adapt is really important considering the context in which you're working.
Another one for me would be ensuring that whatever the intervention is that's being delivered has some clear evidence and if it doesn't, that that should be fundamental to the project to generate the evidence in order to be able to scale up across countries, across regions. Because I think without that, as has already been mentioned, it's very difficult to convince the key decision-makers at government level why particular interventions are so important.
14:19 –15:09 Aminur:
I will say it from a different perspective, as a Bangladeshi organization, why we have been awarded by UK Match fund? Why were we successful? Number one, we had a context-specific, proven intervention. Number two, it engaged community people. Without community, without their active engagement, this kind of interventions cannot be implemented.
And number three, the relevant stakeholders actually accepted this. Including the parents, they actually accepted, that these are useful for their children. We had a proven intervention that helped us to get more grant. We are successful in proving that we could engage community in this action.
15:09 – 15:36 Sarah:
Brilliant. Thank you so much and thank you so much both for your time today. It's been fantastic hearing about both your work on the UK Match programme and your future work that we wish you all the best of luck with.
To find out more about UK Aid Match projects, head over to the appeals and grants section of UK Aid Match website at ukaidmatch.org/grants. Don't forget to subscribe to The Learning Post so you don't miss any future episodes. And thanks for listening.