Background Drowning is the leading cause of death among 1–4 years-old children in Bangladesh. The COVID-19 pandemic significantly altered personal and family behaviors that may directly or indirectly impact drowning-prevention activities. The CIPRB is intervening with a package consisting of the Anchals (community-daycare centers), family-education, community-sensitization, and stakeholder-awareness to prevent child-drowning <5children in rural Bangladesh. Due to the closure of over 3,000 Anchals in pandemic, approximately 70,000 rural children were unable to access Anchal supervision services. The study’s aim was to examine the COVID-19 impact of child-drowning in rural Bangladesh before and during the pandemic.

Methods Between March 2019-February 2021, passive surveillance was conducted in 45-unions in rural Bangladesh, covering nearly one-million people. Information on fatal-drowning events was collected by using a pre-tested structured questionnaire.

Results Compared to the pre-pandemic year, fatal-drowning rates were 70.8% higher. Before the pandemic, the under-5 fatal-drowning rate was 16.6/100,000/year; 95% CI 10.2–26.9, while during the pandemic, the rate was 38.4/100,000/year; 95% CI 27.8–52.9. Boys (61.4%) had higher rates, and the majority of drownings happened near dwellers’ homes. Ponds and ditches were the most common drowning locations (69.1%), and nearly all drownings (98%) happened throughout the day between 09:00–17:00.

Conclusion The fatal-drowning rate during the pandemic was consistently higher compared to the rates in the intervening areas before the pandemic. The absence of child supervision services might have caused higher rates of child-drowning.

Learning Outcomes Using this study approach could provide a means to quantify the pre-and-post COVID-19 impact on drowning globally.