Keeping afloat: a case study tracing the emergence of drowning prevention as a health issue in Bangladesh 1999-2017

Identifying opportunities for multisectoral action for drowning prevention: a scoping review

Background

Drowning is a complex health issue, where global agendas call for greater emphasis on multisectoral action, and engagement with sectors not yet involved in prevention efforts. Here, we explored the conceptual boundaries of drowning prevention in peer-review and grey literature, by reviewing the contexts, interventions, terminologies, concepts, planning models, and sector involvement, to identify opportunities for multisectoral action.

Methods

We applied scoping review method and have reported against Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews checklist. We searched four electronic databases for peer-reviewed articles published on 1 January 2005 and 31 December 2020 and five databases for grey literature published on 1 January 2014 and 31 December 2020. We applied the search term “drowning,” and charted data addressing our research questions.

Results

We included 737 peer-reviewed articles and 68 grey documents. Peer-publications reported situational assessments (n=478, 64.86%) and intervention research (n=259, 35.14%). Drowning was reported in the context of injury (n=157, 21.30%), commonly in childhood injury (n=72, 9.77%), mortality studies (n=60, 8.14%) and in grey documents addressing adolescent, child, environmental, occupational and urban health, refugee and migrant safety and disaster. Intervention research was mapped to World Health Organization recommended actions. The leading sectors in interventions were health, leisure, education and emergency services.

Conclusion

Although drowning is often described as a major health issue, the sectors and stakeholders involved are multifarious. The interventions are more often initiated by non-health sectors, meaning multisectoral action is critical. Framing drowning prevention to reinforce cobenefits for other health and development agendas could strengthen multisectoral action. Greater investment in partnerships with non-health sectors, encouraging joint planning and implementation, and creating systems for increased accountability should be a priority in future years.

Tracing the emergence of drowning prevention on the global health and development agenda: a policy analysis

Drowning has been a neglected health issue, largely absent from the global health and development discourse, until the UN General Assembly adopted its first resolution on global drowning prevention in 2021. This policy analysis examines the role of issue characteristics, actor power, ideas, and political contexts in the emergence of drowning prevention, and it also identifies opportunities for future actions. We identified three factors crucial to enhancing prioritisation: (1) methodological advancements in population-representative data and evidence for effective interventions; (2) reframing drowning prevention in health and sustainable development terms with an elevated focus on high burdens in low-income and middle-income contexts; and (3) political advocacy by a small coalition. Ensuring that the UN resolution on global drowning prevention is a catalyst for action requires positioning of drowning prevention within global health and sustainable development agendas; strengthening of capacity for multisectoral action; expansion of research measuring burden and identifying solutions in diverse contexts; and incorporation of inclusive global governance, commitments, and mechanisms that hold stakeholders to account.

"I Want to See a Drowning-Free Philippines": A Qualitative Study of the Current Situation, Key Challenges and Future Recommendations for Drowning Prevention in the Philippines

Drowning is described as a public health challenge by the World Health Organization. This challenge faces the Philippines where drowning claims an average of 3276 lives annually (3.50/100,000 population). However, no research comprehensively documents prevention strategies implemented by government and non-government agencies at a national or local level in the Philippines. This study aimed to qualitatively explore the current situation and key challenges of preventing drowning in the Philippines through key informant interviews and make recommendations to guide prevention efforts. Interviews were conducted among government and non-government agencies involved in drowning prevention using purposive sampling. Qualitative data collected were thematically analyzed. Findings indicate government and non-government agencies implement drowning prevention programs or strategies based on the mandate of their institutions. Most commonly cited were activities related to education or information awareness, emergency and disaster preparedness, and swimming skills. It was revealed that each agency was relatively unaware of the drowning prevention programs of other agencies. A multisector approach is needed to develop coordinated and comprehensive programs and activities aimed at preventing drowning. In this way, duplication will be avoided and the minimal resources available will be used effectively to reduce the burden of drowning in the Philippines.