A Review of Drowning Prevention Interventions for Children and Young People in High, Low and Middle Income Countries

Abstract

Globally, drowning is one of the ten leading causes of child mortality. Children aged <5 years are particularly at risk, and children and young people continue to be overrepresented in drowning statistics. Accordingly, evidence informed interventions to prevent children drowning are of global importance. This review aimed to identify, assess and analyse public health interventions to reduce child drowning and investigate the use of behavioural theories and evaluation frameworks to guide child drowning prevention. Thirteen databases were searched for relevant peer reviewed articles. The systematic review was guided by the PRISMA criteria and registered with PROSPERO. Fifteen articles were included in the final review. Studies were delivered in high, middle and low income countries. Intervention designs varied, one-third of studies targeted children under five. Almost half of the studies relied on education and information to reduce drowning deaths, only three studies used a multi-strategy approach. Minimal use of behavioural theories and/or frameworks was found and just one-third of the studies described formative evaluation. This review reveals an over reliance on education and information as a strategy to prevent drowning, despite evidence for comprehensive multi-strategy approaches. Accordingly, interventions must be supported that use a range of strategies, are shaped by theory and planning and evaluation frameworks, and are robust in intervention design, delivery and evaluation methodology. This approach will provide sound evidence that can be disseminated to inform future practice and policy for drowning prevention.

HIV, Other Blood-Borne Viruses and Sexually Transmitted Infections amongst Expatriates and Travellers to Low- and Middle-Income Countries: A Systematic Review

“…Procedures used in this review followed those from other systematic reviews conducted by the Collaboration for Evidence, Research and Impact in Public Health [45,46,47]. The review was registered in the PROSPERO International Prospective Register of Systematic Reviews (Registration number: CRD42016033106).…”

The epidemiology of drowning in low- and middle-income countries: a systematic review

“…HIC interventions, however, are not universally applicable to LMICs as interventions specific to income level and region are necessary to account for varying epidemiologic, demographic, and cultural factors as well as differences in resources. In LMICs, issues such as the large burden of drowning, lack of epidemiological data, and limited public health infrastructure and outreach programs create further difficulties in implementing cost-effective methods of prevention [4, 13, 14]. This paper seeks to make recommendations for preventing drowning in LMICs based on the demographics of individuals at greatest risk of drowning and the reported epidemiology of drowning.…”

Caregiver Supervision Practices and Risk of Childhood Unintentional Injury Mortality in Bangladesh

“…Even though safety barriers between residences and water bodies can be an effective environmental intervention for drowning, it is nearly impossible to fence large natural water bodies, as in the case of Bangladesh [30,31,32]. Young children can experience drowning due to lapses in adult supervision despite physical barriers between the children and the water bodies [10,16].…”

“…The notion that giving swimming lessons to young children could reduce drowning deaths lacks sufficient evidence; in fact, there is recommendation against this strategy for children less than two years of age [31]. Therefore, primary prevention in the form of adequate adult supervision cannot be overemphasized in preventing childhood drowning deaths [23,31,32]. …”