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Int J Environ Res Public Health
2017 Oct 04;1410:. doi: 10.3390/ijerph14101170.
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Housing as a Determinant of Tongan Children''s Health: Innovative Methodology Using Wearable Cameras.
Robinson A
,
Hulme-Moir S
,
Puloka V
,
Smith M
,
Stanley J
,
Signal L
.
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Housing is a significant determinant of health, particularly in developing countries such as Tonga. Currently, very little is known about the quality of the housing in Tonga, as is the case with many developing countries, nor about the interaction between children and the home environment. This study aimed to identify the nature and extent of health risk factors and behaviours in Tongan houses from a child''s perspective. An innovative methodology was used, Kids''Cam Tonga. Seventy-two Class 6 children (10 to 13-year-olds) were randomly selected from 12 randomly selected schools in Tongatapu, the main island. Each participating child wore a wearable camera on lanyards around their neck. The device automatically took wide-angled, 136° images of the child''s perspective every seven seconds. The children were instructed to wear the camera all day from Friday morning to Sunday evening, inclusive. The analysis showed that the majority of Tongan children in the study live in houses that have structural deficiencies and hazards, including water damage (42%), mould (36%), and electrical (89%) and burn risk factors (28%). The findings suggest that improvements to the housing stock may reduce the associated health burden and increase buildings'' resilience to natural hazards. A collaborative approach between communities, community leaders, government and non-governmental organisations (NGOs) is urgently needed. This research methodology may be of value to other developing countries.
Figure 1. Range of house quality observed: (a) House without any evidence of structural damage and exterior is well maintained; (b) House surrounded by pools of rain water due to insufficient drainage, interior of house water damaged; (c) Poor building quality indicated by holes in the external wall and use of building materials to patch up exterior; (d) Children’s bedroom with damaged ceiling and walls, and evidence of water staining on the cardboard covering holes in the ceiling.
Figure 2. Risk factors and behaviours observed in the home environment that increase the risk of injury or harm to children: (a) Cooking on an open fire in a cooking shed filled with smoke. Low-quality building materials used in structure; (b) Child burning rubbish and standing near flame; (c) Electrical extension blocks and power cables next to a washing machine and in the vicinity of a water spill; (d) Fabric covered in mould next to a food preparation surface.
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