Child Drowning

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Bangladesh Jiangxi China Cambodia Bangladesh Jiangxi China Cambodia Bangladesh Jiangxi China Cambodia Bangladesh Jiangxi China Cambodia Bangladesh Jiangxi China Cambodia Bangladesh Jiangxi China Cambodia Rate per 100,000 same-aged peer who does not have swimming, rescue or resuscitation skills. They drown in the community, but without any rescue from community members. The two scenarios require different intervention approaches. For the children who escape supervision and drown close to home, the interventions must focus on parents, caretakers and the home environment. The intervention for older children who drown further from the home must focus on children themselves as the drowning occurs when they are without caretakers and alone or with sameaged peers in the community. Figure 11: Rates of fatal and non-fatal drowning among children, by country and age group 300 250 Non-fatal Fatal 200 150 100 50 0 Infant 1-4 5-9 10-14 15-17 0-17 Source: Data from the countries included the Bangladesh Health and Injury Survey (BHIS) 2002, Cambodia Accident and Injury Survey (CAIS) 2006 and Jiangxi (China) Injury Survey (JIS) 2005 and weighted composite based on the size of child population. Figure 11 shows drowning rates, both fatal and non-fatal, by country and stage of childhood. The ratio of fatal to non-fatal drowning averaged over the three countries is approximately 1:1. It is very different in HICs like Australia where the ratio is 1:4. The difference in the ratio is because in Australia, as well as other HICs, many drowning events are prevented from becoming fatal. This is in part due to large numbers of lifeguards in high-utilization recreational areas, a high prevalence in the community of bystanders with training in rescue and resuscitation skills and the immediate availability of emergency medical services in the community. 25 25 Kreisfeld, R. and G. Henley (March 2008). ‘Deaths and hospitalisations due to drowning, Australia 1999-00 to 2003-04’, in AIHW Injury Research and Statistics Series No. 39. Canberra. 36
Table 6 shows the severity of the non-fatal drowning events in Bangladesh, Cambodia, China (Jiangxi Province) and Thailand. Table 6: Severity of non-fatal child drowning events, by country, children 0-17 years old Country Surveyed Moderate: Sought medical care/missed at least one day school or work Major: Hospitalized 1-9 days Injury Severity Levels Serious: Hospitalized more than 9 days Severe: Permanent physical disability Proportion of non-fatal drowning in total injury morbidity Bangladesh 94% 6% 7.2% Cambodia 79% 15% 4% 2% 1.0% Jiangxi, China 81% 15% 4% 0.5% Thailand 62% 31% 7% 1.4% Source: Survey data from the countries included, Bangladesh Health and Injury Survey (BHIS) 2002, Cambodia Accident and Injury Survey (CAIS) 2006, Jiangxi (China) Injury Survey (JIS) 2005 and Thailand National Injury Survey (TNIS) 2003. In all the countries surveyed, the overwhelming majority of non-fatal drowning cases were classified as moderate, which is the least severe category. This underscores the nature of child drowning in LMICs where drowning either kills children or leaves them relatively unharmed. This is primarily due to the lack of trained responders in the community, which means that no rescue and resuscitation occurs and a drowning child is left to rescue him or herself. It is notable that in Thailand the severity distribution is different, with less than two thirds (62 per cent) of non-fatal drowning in the moderate category, and with almost one third (31 per cent) in the major category and 7 per cent in the serious category. In contrast to Bangladesh, Cambodia and Jiangxi Province, China, which are categorized as low income, Thailand is now a middle-income country. That stage of development is characterized by an education system that may allow more community members to be first responders and a development level has expanded emergency response outreach capacity from hospitals into communities. 37
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 and 34: A second conclusion is that the cur
Page 35: Cumulative proportion Drowning rate
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

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