Child Drowning

(iii)
Methodology:
Most surveys had differing recall periods, resulting in a difference in calculated rates. The
recall periods ranged from a few weeks to several months to a year.
For surveys with recall periods of less than a year, different methods were used to convert
the periods to annual rates, resulting in incomparable rates.
Most surveys used different definitions of fatal drowning, such as immediately fatal; fatal
within 24 hours; drowning in water only; drowning in any liquid. The dissimilar outcomes
measured could not be compared.
Most surveys used different definitions of severity in non-fatal drowning, such as
hospitalization; missing school for a half day; missing school for one day; or seeking any
medical care. Non-fatal outcomes therefore could not be compared.
(iv)
Information for prevention:
Almost none of the surveys collected information on antecedent events or risk factors
other than age and sex.
The drowning rates cannot be understood without taking into consideration the context of
occurrence, predisposing factors, occupational connections, or linkage to aquatic transport.
The lack of adequate survey data has led to drowning being counted mainly at hospitals and clinics.
However, fatally drowned children are rarely brought to a health facility so the estimates are unreliable.
Few hospitals can provide reliable information on rapid causes of death, especially when the deaths
occur in communities that are distant from the hospital. This is the case with drowning, which means
that the majority of drowning cases go unrecorded.
Over the past decade a series of national and sub-national surveys have been conducted by TASC in
collaboration with UNICEF country offices in Bangladesh, Cambodia, China, Thailand and Viet Nam. The
surveys were conducted with the technical capacity in epidemiology, demography and statistics
developed at the national and local levels in most countries in Asia over the past 20 years. They have
shown the overall scale of child drowning and its scope at the different stages of childhood and have
highlighted the need to undertake intervention research on drowning in children as an urgent priority.
In each country the survey counted deaths in the community and classified them by cause, including
infectious (communicable) diseases, non-communicable diseases, injury and a category called ‘unable to
determine’. The surveys also counted serious and disabling injury events. The surveys had very large
sample sizes, on the order of 100,000 households, and were able to examine causes of death in the
different age groups of childhood and adulthood. The survey instruments were standardized, with
common definitions of age groups, recall periods, risk factors, behavioural factors, circumstances and
outcomes facilitating comparison across countries.
The countries surveyed span the gamut of development. They include countries classified as low income
as well as middle income, countries with low and high child mortality rates, and countries in East and
South Asia with the differing socio-cultural characteristics of each sub-region.
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