Child Centred Approach to Climate Change and Health Adaptation through Schools in Bangladesh: A Cluster Randomised Intervention Trial

Health Interventions for Preventing Climate-Sensitive Diseases: Scoping Review

Climate variations cause public health problems, but the literature is still scarce on studies involving health interventions against climate-sensitive diseases. The objective of this review was to identify health interventions for the prevention of such diseases. We conducted a scoping review using the JBI Methodology. Six large research databases were searched (PubMed, Scopus, Web of Science, Lilacs, Embase, and Cochrane). The following inclusion criterion was used: studies addressing health interventions to prevent climate-sensitive diseases or consequences of climate on people's health. The exclusion criteria consisted of thesis, dissertations, conference proceedings, studies with unclear information/methodology, and studies not addressing climate-related health interventions. No language or date restrictions were applied. Of 733 studies identified and screened by title and abstract, 55 studies underwent full-text screening, yielding 13 studies for review. The health interventions identified were classified into three levels of management. The macro level included the use of epidemiological models, renewable energy, and policies sensitive to climate change. The meso level comprised interventions such as the creation of environmental suitability maps, urban greening, chemoprophylaxis, water security plans, and sanitation projects, among other measures. Some interventions are at the intersection, such as educational campaigns and the modification of artificial larvae sites. Finally, the micro level contained interventions such as the inspection of window screens and the use of light-colored clothing and repellents. The health interventions at the macro, meso, and micro levels and the intersection may serve as a basis for public managers to implement appropriate interventions against climate-sensitive diseases.

'Health Promoting School' Model in Prevention of Vector-Borne Diseases in Odisha: A Pilot Intervention

We tested 'Health-Promoting School model' for vector-borne diseases (VBDs) through behavioural changes among students in India for better control of the diseases in the community. A total of 1098 students from eight co-ed schools (four controls and four interventions) of Odisha participated in the study. Intervention was 12 h of class room teaching and activities on mosquito dynamics, source identification, prevention and management of VBDs. Control schools were provided with the leaflets and posters covering the objectives. Impact was assessed through change in knowledge and practice through pre- and post-test. Total mean transformed score in pre-intervention survey in both the groups was nearly 33, which increased to 38.6 and 53.9 in control and intervention group, respectively. In intervention group the mean days of absenteeism due to VBDs was reduced nearly by four times. The model can be used as effective health-promoting measures for vector control.

Knowledge and perception about climate change and human health: findings from a baseline survey among vulnerable communities in Bangladesh

BACKGROUND

Bangladesh is one of the countries most vulnerable to climate change (CC). A basic understanding of public perception on vulnerability, attitude and the risk in relation to CC and health will provide strategic directions for government policy, adaptation strategies and development of community-based guidelines. The objective of this study was to collect community-based data on peoples' knowledge and perception about CC and its impact on health.

METHODS

In 2012, a cross-sectional survey was undertaken among 6720 households of 224 enumeration areas of rural villages geographically distributed in seven vulnerable districts of Bangladesh, with total population of 19,228,598. Thirty households were selected randomly from each enumeration area using the household listing provided by the Bangladesh Bureau of Statistics (BBS). Information was collected from all the 6720 research participants using a structured questionnaire. An observation checklist was used by the interviewers to collect household- and community-related information. In addition, we selected the head of each household as the eligible participant for an interview. Evidence of association between sociodemographic variables and knowledge of CC was explored by cross-tabulation and measured using chi-square tests. Logistic regression models were used to further explore the predictors of knowledge.

RESULTS

The study revealed that the residents of the rural communities selected for this study largely come from a low socioeconomic background: only 9.6% had postsecondary education or higher, the majority worked as day labourer or farmer (60%), and only 10% earned a monthly income above BDT 12000 (equivalent to US $150 approx.). The majority of the participants (54.2%) had some knowledge about CC but 45.8% did not (p < 0.001). The majority of knowledgeable participants (n = 3645) felt excessive temperature as the change of climate (83.2%). Among all the respondents (n = 6720), 94.5% perceived change in climate and extreme weather events. Most of them (91.9%) observed change in rainfall patterns in the last 10 years, and 97.8% people think their health care expenditure increased after the extreme weather events. Age, educational qualification, monthly income, and occupation were significantly associated with the knowledge about climate change (p < 0.001). People with higher educational level or who live near a school were more knowledgeable about CC and its impact on health.

CONCLUSIONS

The knowledge level about CC in our study group was average but the perception and awareness of CC related events and its impact on health was high. The most influential factor leading to understanding of CC and its impact on health was education. School-based intervention could be explored to increase peoples' knowledge about CC and necessary health adaptation at community level.