Preventing Child Drowning in the Philippines: The Need to Address the Determinants of Health

Preventing Child Drowning in Indonesia: A Community-Informed Health Promotion Perspective

Child drowning is a significant public health issue in Indonesia; however, there remains a lack of understanding within communities of the risks and how to prevent it. This qualitative study aimed to explore existing and suggested actions undertaken by parents and communities to prevent child drowning. Seven focus group discussions were conducted, comprising 62 participants, with parents of children below 5 years and village community leaders from seven villages on Lombok Island, West Nusa Tenggara, Indonesia. Participants were recruited with purposive and snowball sampling methods. The thematic analysis used both deductive, applying the Health Belief Model and the Health Promotion Framework, and inductive approaches. The results highlighted the focus that participants placed on individual-focused, behavioral drowning interventions, particularly through swimming lessons for school-age children and educational programs on life-saving skills for parents and community members. While participants acknowledged the importance of midstream interventions, such as safety measures around water bodies and community-based safe places for children, alongside population-based upstream interventions such as advocating for policies, regulations, and intergovernmental agency collaboration, there was limited understanding on the roles of the education and health departments in preventing child drowning. Participants reported inconsistent and insufficient implementation of swimming lessons in schools. Further research into formal integration of swimming training into school curricula and its impact on reducing child drowning rates, development of contextually relevant water safety promotion approaches, and alignment of cross-sector partnerships is imperative to ensure effective and sustainable drowning prevention efforts in Indonesia.

Global burden of drowning and risk factors across 204 countries from 1990 to 2021

Drowning is a major global public health issue with marked variations in incidence, mortality, and disability-adjusted life years (DALYs) across regions, age groups, and sexes. Although previous studies have examined global trends in drowning, few have comprehensively analyzed regional and national disparities while addressing potential reporting biases and confounding factors. Data from the Global Burden of Disease (GBD) Study 2021, focusing on drowning-related incidence, death rates, and DALYs, and examined trends from 1990 to 2021 across various regions and countries. The study used age-standardized rates to assess trends and risk factors associated with drowning. In 2021, there were 856.1 thousand drowning cases globally, leading to 274.2 thousand deaths and 15.7 million DALYs. Age-standardized rates showed significant reductions since 1990: incidence decreased by 51.5% to 11.1, deaths by 60.9% to 3.6, and DALYs by 67.3% to 211.9. Solomon Islands, Belarus, and Ukraine had the highest incidence rates, while Nauru, Central African Republic, and Marshall Islands reported the highest death and DALYs rates. DALYs rates were highest in children aged 0-5 years and declined with age. A negative correlation was observed between SDI and DALYs rates. Key risk factors included occupational injuries (13.2%), high temperature (4.6%), and alcohol use (1.7%), while low temperature had a negative contribution (-10.6%). Despite reductions, drowning remains a major public health issue, especially in low-SDI countries. Targeted interventions addressing Occupational injuries, High temperature and Alcohol use are essential to further reduce drowning-related morbidity and mortality.

Application of the PRECEDE-PROCEED model in the development of evidence-informed interventions for drowning prevention: a mixed-methods study protocol

INTRODUCTION

Drowning is a global public health threat, disproportionately impacting low-income and middle-income countries. In the Philippines, it is estimated that more than 5200 people die from drowning per annum. This number is likely to be higher than currently estimated with the inclusion of disaster-related and transportation-related drowning. Drowning is preventable if appropriate preventive interventions are put in place which redress known risk factors.

METHODS AND ANALYSIS

This study uses the PRECEDE-PROCEED model (PPM), an eight-step health promotion planning and evaluation model for building and improving intervention programmes. This mixed-methods study, which can be used in any location, will be implemented in Los Baňos, Laguna, Philippines, identified as an area of concern for drowning. Using the PPM, data on drowning will be collected from death records, community observation, key informant interviews, focus group discussions and community survey. A range of analytical methods will be used to explore drowning data including univariate and χ² analyses, analysis of variance, relative risk and calculating rates using population data. The quantitative data and themes drawn from qualitative data will be used to populate the first four phases of the PPM. Following the data collection, the remaining stages of the PPM will be designed and implemented in the barangay (village) with the highest drowning rate.

ETHICS AND DISSEMINATION

This study has obtained ethical clearance from the University of the Philippines Manila Research Ethics Board (UPMREB 2017-425-01). Study findings will be disseminated through workshops and presentations to the local community as well as through peer-reviewed literature and conference presentations. The PPM has rarely been applied to drowning prevention and it is the aim that the study described in this protocol is expanded across other areas of the Philippines and to other countries with a high drowning burden to inform prevention efforts.

Child Injury Prevention: It Is Time to Address the Determinants of Health

Injuries, although almost entirely preventable, accounted for more than 4 [...].