Child Drowning

INTRODUCTION
Children living in developing countries today inhabit a world that is very different from just a half a
century ago. Globally, the infant mortality rate (IMR), a measure of the proportion of infants born who
survive the first and most critical year of life, has decreased from 127 per 1,000 live births in 1960 to 40
per 1,000 live births in 2010. 1 This two-thirds decrease has led to an increase in life expectancy from 56
years in 1970 to 70 years in 2010. 2 Over 30 years of investments in communicable disease prevention
and nutritional interventions have resulted in large reductions in the number of deaths caused by these
diseases and conditions.
The same is not true of child injury because there have not been similar investments in prevention. As a
result, injury is now a leading cause of death, permanent disability and serious morbidity for children in
low- and middle-income countries (LMICs) in Asia. This threatens the gains already achieved at such
great cost in preventing other causes of sickness and death among children, and puts at risk continued
advances in survival and protection.
Previous papers in this series examined child injury in LMICs in Asia. One conclusion was that one
particular cause of injury − drowning − was of such significance that it deserved to be addressed with
the highest priority. 3 This current paper examines the epidemic of child drowning in Asian LMICs and
presents evidence on each of the following points to underpin why drowning deserves to be targeted as
a significant priority:
Drowning is a leading cause of injury for all children; it occurs in early and later childhood and
affects both boys and girls. It is a leading cause of death of children after infancy (1- 17 years).
Drowning may be a serious impediment to achieving Millennium Development Goal (MDG) 4
of a two-thirds reduction in child mortality, in countries not yet achieving the goal, now only
three years away.
Drowning reduces the impact of other child interventions. Children who drown have often
already received immunizations, vitamin A supplementation and other nutritional support.
They have often benefited from early childhood development programmes and primary
schooling. All these investments are lost when a child drowns.
There are effective drowning interventions that work in all stages of childhood and are of
similar cost-effectiveness as classical child survival interventions.
This paper begins with an overview of the numbers of children who drown each year in LMICs in Asia
and the circumstances in which the drowning occurs. Building on that knowledge, the paper presents
evidence that drowning is preventable at low cost with proven interventions that have shown to be
sustainable in low-resource settings. Finally, the paper argues that drowning interventions need to be
applied in the same manner as interventions for other child survival and protection programmes. When
applied as large-scale intervention programmes, for example in the same manner as the expanded
programme on immunization (EPI) or control of diarrhoeal diseases (CDD), child drowning programmes
can be expected to result in large reductions in child drowning rates, which lead to more rapid
reductions in early child mortality.
1
Data for 1960: United Nations Children’s Fund (2005). The State of the World’s Children 2005. New York: UNICEF. Table 1, p. 106; data for 2010:
United Nations Children’s Fund (2012). The State of the World’s Children 2012. New York: UNICEF. Table 1.
2
Data for 1970: United Nations Children’s Fund (2000). The State of the World’s Children 2000. New York: UNICEF. Table 5, p. 103; Data for 2010:
United Nations Children’s Fund (2012). The State of the World’s Children 2012. New York: UNICEF. Table 1.
3 See: Linnan, M. et al. (2007). ‘Child Mortality and Injury in Asia: Survey methods’, Innocenti Working Paper, No. 2007-05, Special Series on Child
Injury. Florence: UNICEF Innocenti Research Centre.
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