Background Drowning is a global public health problem of children. Drowning affects all age groups, but children 1–4 years appear the greatest risk. In high-income countries (HICs) various child drowning prevention measures have been advocated. However, prevention efforts in low- and middle-income countries are almost non-existent.

Objectives The objectives of the paper are to review different child drown prevention approaches of both high and low- and middle-income countries and to recommend global strategies.

Methods An extensive literature review, both scientific articles and gray reports, was carried out to document effective approaches for childhood drowning prevention in both high and low income countries.

Results In HICs various drowning prevention measures including pool fencing, pool fencing legislation, parent education, close supervision of young children, use of personal devices, laws on alcohol use, cardiopulmonary resuscitation and swimming instruction have been proven effective. However, in LMICs there is scarcity of proven interventions. The recent intervention study ‘PRECISE’ in Bangladesh generated some evidence of child drowning prevention; where the crèche for young children 1–4 years and survival swimming for 4–10-year-old children were found 80% and 96% protective respectively.

Significance Child drowning is preventable even in resource poor settings. Considering the socio-economic and geographical differences many of the prevention approaches of HICs are not applicable to LMIC settings Therefore, interventions need to be set according to individual country context.