Child Drowning

5. BUILDING A GLOBAL PLATFORM FOR DROWNING PREVENTION
Drowning is a significant, preventable cause of death among children in LMICs. The challenge is to
transform this previously unidentified public health issue from a neglected issue to one addressed by
national, regional or global level programmes.
The challenges include:
Scaling-up a package of effective drowning interventions into national, regional and global
programmes.
Building drowning prevention capacity at all levels of the development continuum.
Stimulating and sustaining investment in drowning prevention interventions and activities.
Managing the shift from a scarcity of funds to a programme of well-targeted and
coordinated investments.
Incorporating research into programme design and implementation.
The process must recognize the considerable differences between implementing drowning prevention
strategies in LMICs as compared to HICs. In the latter group of countries, lifesaving agencies, drowning
prevention councils and governments provide a strong platform for drowning prevention. This capacity
is lacking in LMICs and requires that drowning prevention efforts focus for the time being on the
community, home, family and individual, while the necessary social, governmental and governance
structures are developed.
5.1 SCALING-UP DROWNING INTERVENTIONS INTO NATIONAL, REGIONAL AND GLOBAL
PROGRAMMES
Reduction of each major cause of early child mortality required effective interventions delivered on a
large, population-based scale in rural LMICs. Earlier interventions such as immunizations, breastfeeding
and oral rehydration therapy were developed and shown to be effective at low cost. Sustained use of
these interventions then led to the decline in early child mortality in LMICs. A reduction in drowning in
LMICs should be no different.
Research from PRECISE demonstrates the efficacy and cost-effectiveness of a number of key drowning
interventions. While each intervention has individual promise and application, it is important to note
that they were designed and delivered as part of an integrated package of drowning interventions
within a community. In terms of cost-effectiveness and the number of child deaths prevented, this
package compared favourably to other child survival interventions.
Adopting an integrated approach has helped address many of the challenges for implementing
drowning interventions at a community level. When viewed as an integrated package of drowning
interventions, several factors should guide future programme expansion. These factors include the role
of the community in identifying drowning risk and selecting or initiating interventions, the need to
respond to drowning risk across age groups with a range of interventions rather than any single
measure, and the need for the types of supporting community-based systems often found in larger
scale community development interventions. Such an integrated package is reliant on both the strength
of the individual interventions and the degree to which community acceptance and support for
implementation has been achieved. Not visible, but equally important, are the supporting mechanisms,
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