Abstract
Unintentional childhood injuries are a significant public health concern in low- and middle-income countries. Effective supervision reduces child injury risk, yet older siblings may be less effective than adults in preventing supervisee injury. This study examined self-reported caregiver expectations and beliefs regarding sibling supervision, and sixth-grade students’ self-reported experiences with sibling supervision, among families in rural Uganda. One hundred forty-four caregivers and 206 students were recruited to complete self-report questionnaires assessing parental expectations and student experiences with sibling supervision. Binary logistic regression assessed predictors of supervisee injury history. Caregivers in 82% of households expected children under Age 2 to be supervised by older siblings on a daily basis. Frequency and duration of expected sibling supervision increased with supervisor age. Students endorsed supervising younger siblings in 5 risky situations an average of 13 times total in the past week. Approximately half of students and supervisees experienced at least 1 medically attended injury in the past year. Student history of injury increased supervisee risk of injury 2.25 times. Students endorsed corporal punishment as an effective disciplinary strategy at higher rates than caregivers. Sibling supervision is a widespread practice in rural Uganda, and supervisee injuries are common. Interventions to improve supervision may reduce child injury risk.
Implications for Impact Statement
Adult caregivers widely expect older siblings to provide supervision to younger siblings in rural Eastern Uganda. Sixth graders routinely provide child supervision and fail to prevent serious injury to supervisees. Interventions are needed to improve the quality of child supervision in low- and middle-income countries.
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