Childhood drowning in low‐ and middle‐income countries: Urgent need for intervention trials

Abstract

Data available for low-and middle-income countries (LMICs) indicate that the burden of drowning in children is significant and becoming a leading public health problem. At the same time, interventions for drowning are not well documented in LMICs. The overall purpose of this paper is to make the case for research investments in conducting intervention trials to prevent child drowning in LMICs.In high-income countries (HICs), existing drowning prevention interventions include among others: pool fencing, supervision, lifeguards and water safety training at a young age. However, these measures may not be the most relevant in curtailing the number of drowning deaths in LMICs. There are differences with regard to geographical, social, cultural and behavioural factors associated with drowning between HICs and LMICs, often making it inappropriate to apply existing interventions directly in LMIC settings.This paper focuses on drowning from LMICs and reveals a dearth of data on incidence rates and risk factors; absence of public health interventions; lack of research on intervention effectiveness and cost-effectiveness; and paucity of national drowning prevention programs. Based on this evidence, this paper calls for immediate attention to drowning prevention by increasing research investments. This paper specifically discusses Bangladesh as a case study and proposes a drowning intervention study focusing on children less than 5 years in LMICs as an example of appropriate research investment.

Predictors of Swimming Skill of Primary School Children in Rural Thailand

“…Providing swimming lessons is an important strategy to prevent childhood drowning (Brenner et al, 2009;Hyder, Borse et al, 2008;McIntosh, 2009;Rahman et al, 2010;World Health Organization, 2008). This is the first study that has attempted to estimate the swimming skill of rural children in a developing country and factors associated with swimming skill.…”

“…Several strategies have been proposed to prevent child drowning in developed and developing countries: increasing supervision, limiting exposure to bodies of water, equipping boats with flotation devices, and providing swimming lessons (Brenner et al, 2009;Committee on Injury Violence and Poison Prevention, 2010b;Dyson, 2005;Hyder, Borse et al, 2008;Smith, 1995;Thompson & Rivara, 1998;Towner & Ward, 1998;Turner, 2004). Specific prevention strategies should be matched to the appropriate age groups.…”

“…Specific prevention strategies should be matched to the appropriate age groups. Teaching swimming to increase survival skills in water is recommended for preschool and school-aged children in high income countries (HIC; Committee on Injury Violence andPoison Prevention, 2010a, 2010b;Hyder, Borse et al, 2008). Research studies of preschool aged children in HIC revealed that participation in formal swimming lessons was associated with a reduction in the risk of drowning (Asher, Rivara, Felix, Vance, & Dunne, 1995;Brenner et al, 2009;Yang, Nong, Li, Feng, & Lo, 2007).…”

Bangladesh Health System and the Millennium Development Goals: Strategic Policy Options for Sustained Progress in Maternal and Child Health

“…A particular priority is reducing neonatal mortality rate which currently stands at 32 per 1,000 live births while the target was to reach 21 per 1,000 live births by the year 2015 [6].Another challenge is childhood injuries, especially drowning, which has emerged as a pressing public health issue responsible for a full quarter of the deaths among children between 1-4 years of age [18][19][20]. A third priority is reducing childhood diarrhea and pneumonia through improved family and community hygiene and care practices and expanded access to appropriate treatment.…”

Approaches for Beach Safety and Education in Ghana: A Case Study for Developing Countries with a Surf Coast

“…Many LMICs are situated in tropical and subtropical geographic regions with long stretches of coastline often exposed to high energy open ocean wave conditions. While much of the existing literature on drowning in LMICs has focused on inland and child drowning (e.g., Peden & McGee, 2003;Hyder et al, 2008;Rahman et al 2009;2012;Brenner & Taneja, 2010), less attention has been given to the extent and nature of beach drowning in these regions (Suresh Kumar Shetty & Shetty, 2007). Little is known about the nature and cause of beach drowning in LMICs and data on the number of drowning incidents are largely nonexistent.…”