A qualitative study to inform a parental education intervention for unintentional child injury prevention in rural Nepal

Abstract

Introduction: Unintentional home injuries are a leading cause of morbidity and mortality among children under five in Nepal, particularly in rural areas. Despite this burden, culturally appropriate community-based prevention strategies remain limited. This study explored community perspectives to inform the design and delivery of a parental education intervention for childhood home injury prevention.

Methods: A qualitative study was conducted in Sunkoshi Rural Municipality, Sindhupalchok District, in December 2024. Seven focus group discussions were held with 56 mothers of preschool-aged children, and 11 key informant interviews were conducted with Female Community Health Volunteers (FCHVs), health-facility in-charges, a school health nurse, and local government officials. Data were analysed thematically using NVivo 14, guided by the Health Belief Model.

Results: Five major themes were identified: (1) Perceived household hazards and common child injuries, (2) Behaviours leading to child injuries, (3) Barriers and facilitators for prevention, (4) Prevention and control practices, and (5) Design and delivery of Information, Education and Communication (IEC) materials. Burns and falls were the most frequently reported injuries, often resulting from unsafe cooking areas, open fires, and poor supervision. Barriers to prevention included limited parental awareness, competing household priorities, and unsafe home environments, whereas community cooperation and FCHV support acted as facilitators. Participants favoured simple, visual, and low-cost educational materials, such as posters, flipcharts, and videos, delivered through participatory group discussions led by FCHVs.

Conclusion: Parents and community stakeholders demonstrated strong interest in home injury prevention education. Embedding culturally tailored parental education within existing community health platforms, particularly FCHVs and mothers' groups, represents a feasible, scalable, and sustainable approach to reducing childhood injuries in rural Nepal.

Keywords: IEC material; Nepal; home safety; parental education; qualitative research.