Child Drowning

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2. HOW AND WHY CHILDREN DROWN IN LMICS IN ASIA For the sake of brevity, this paper addresses the proportion of child mortality in Asian LMICs caused by drowning. It does not include non-fatal drowning. Non-fatal drowning occurs at approximately the same rates as fatal drowning, in similar circumstances and with similar causes. Non-fatal drowning is included in several of the figures in this section to highlight the fact that the overall drowning burden is twice as large as that of fatal drowning. 2.1 HOW CHILDREN DROWN IN LMICS IN ASIA AND IMPLICATIONS FOR PREVENTION There are many similarities for drowning among children aged 0-17 years in all the countries surveyed. The following apply to all the countries: Most children drown before age four. Most children drown in rural areas. More males drown than females, especially after age five. Before age four, 80 per cent of children drown at or within 20 metres of the home. After age four, more than 90 per cent of children drown 100 metres or more from home. For children of all ages, 75 per cent drown between the hours of 8 a.m. to 4 p.m. Less than 5 per cent drown at night between 8 p.m. and 6 a.m. For children of all ages, 90 per cent drown in sunny weather, 5 per cent during rainy weather, and 5 per cent during flooding from monsoons. For children over age four, 95 per cent drown while engaging in non-recreational activities or daily activities, 5 per cent during recreation and less than 2 per cent in pre-planned swimming activity. Ship/ferry accidents are not a substantial factor in overall child drowning deaths. Swimming pools are not a factor in child drowning deaths. Table 5: Median age of drowning by country surveyed Country Bangladesh Cambodia Jiangxi, China Thailand Viet Nam Median age at drowning (years) 2.3 3.7 3.5 3.8 3.9 Source: Authors calculations from the data. Table 5 shows the age by which half of all child drowning has occurred. Most drowning occurs very early in childhood. To make a major reduction in fatal drowning, interventions need to begin as early in a child’s life as possible. Figure 9 shows the proportion of drowning, both fatal and non-fatal, that occurs among children of different ages. 34
Cumulative proportion <strong>Drowning</strong> rate per 100,000 Figure 9: Cumulative proportion of fatal and non-fatal drowning among children, by age 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Fatal Non fatal infant 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Age (years) Source: Data from composite of survey countries: Bangladesh 2002, Cambodia 2006, China (Jiangxi Province) 2005, Thailand 2003 and Viet Nam 2001. The distribution of fatal drowning is mirrored in distribution of non-fatal drowning. One clear message of the graph is the later in childhood intervention is begun, the less effective it will be in addressing all children at risk of drowning. The yellow line shows that the median age of drowning under which half of all fatal child drowning occurs is three years old. The green line shows that two thirds of all fatal drowning in childhood has occurred by five years of age. Since interventions are different for very young children and older children, from a prevention perspective there are two different scenarios to address. Figure 10 shows the distribution in the two age groups. Figure 10: Fatal drowning rates among children, by age and place of occurrence 120 In or near home Away from home and In the community 100 80 60 40 20 0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Age (years) Source: Survey data, population weighted composite of Bangladesh 2002, Cambodia 2006, China (Beijing 2004, Jiangxi 2005), Thailand 2003 and Viet Nam 2001. <strong>Drowning</strong> occurs throughout childhood. However, there are two separate epidemics: one affects children under four years of age and accounts for the majority of drowning. It occurs because very young children escape caretaker supervision and drown in unprotected water sources within 20 metres of the home. Their caretakers are often unaware of the drowning for an hour or longer. The second is for older children who drown further from home, 100 metres or more, where they swim alone or with a 35
Page 1 and 2: UNICEF Office of Research Child Dro
Page 3 and 4: THE UNICEF OFFICE OF RESEARCH In 19
Page 5 and 6: TABLE OF CONTENTS Executive Summary
Page 7 and 8: EXECUTIVE SUMMARY Childhood drownin
Page 9 and 10: Household survey findings Drowning
Page 11 and 12: Loss of health and social investmen
Page 13 and 14: INTRODUCTION Children living in dev
Page 15 and 16: (iii) Methodology: Most surveys ha
Page 17 and 18: Proportion of drowning Figure 1: Dr
Page 19 and 20: In high-income countries (HICs), be
Page 21 and 22: Table 2: ICD-10 drowning (1997) W65
Page 23 and 24: - had no data reported, or none rep
Page 25 and 26: data from multiple sources includin
Page 27 and 28: A combination of these approaches i
Page 29 and 30: Mortality rate/1,000 Drownng propor
Page 31 and 32: Figure 7: Mortality among children
Page 33: A second conclusion is that the cur
Page 37 and 38: Table 6 shows the severity of the n
Page 39 and 40: Bangladesh Jiangxi China Cambodia B
Page 41 and 42: 1. Drowning risks are higher when c
Page 43 and 44: Rate per 100,000 Figure 17: Cause o
Page 45 and 46: Figure 19: Resuscitation received b
Page 47 and 48: drowning. It states: “Unprecedent
Page 49 and 50: esult, children fall in and drown,
Page 51 and 52: Drowning rate per 100,000 2.6 LEVEL
Page 53 and 54: 3. EVIDENCE FOR PREVENTION It is of
Page 55 and 56: drowning is a leading but preventab
Page 57 and 58: Mortality Rate (per 1,000) Figure 2
Page 59 and 60: The analysis allowed examination of
Page 61 and 62: Table 9: Number of children needed
Page 63 and 64: The intervention developed a formal
Page 65 and 66: immediate resuscitation is discusse
Page 67 and 68: 2011) has 107 indicators, but does
Page 69 and 70: systems and standards, and manageme
Page 71 and 72: 5.3 STIMULATING AND SUSTAINING INVE
Page 73 and 74: effective against ‘other diseases
Page 75 and 76: ANNEX: LIST OF CONTRIBUTORS This pa
Page 77 and 78: STAFF AND VOLUNTEERS OF THE ROYAL L

Child Drowning

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