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India Towards Zero Drowning
628 How drowning data is collected in low- and middle-income countries (LMICs): a scoping review
  1. Nibedita S Ray-Bennett1,
  2. Lasith Dissanayake2,
  3. Winifred Ekezie3,
  4. Lauren Macleod2,
  5. Tom Mecrow4,
  6. Colleen Saunders5,
  7. Rebecca Sindall4,
  8. Frederick Oporia6,
  9. Aminur Rahman7
  1. 1Avoidable Deaths Network, School of Business, University of Leicester, UK
  2. 2Avoidable Deaths Network, Institute for Environmental Futures and School of Business, University of Leicester, UK
  3. 3Avoidable Deaths Network, School of Lifesciences, University of Leicester, UK
  4. 4Royal National Lifeboat Institution, UK
  5. 5 Department of Family, Community and Emergency Care, University of Cape Town, South Africa
  6. 6Trauma, Injuries, and Disability Unit, School of Public Health, Makerere University, Kampala, Uganda
  7. 7Centre for Injury Prevention and Research, Bangladesh

Abstract

Background Drowning is a neglected public health problem. An estimated 236,000 fatal drownings took place in 2019, and 90% of these deaths occurred in low- and middle-income countries (LMICs). Fatal and nonfatal drowning are under-reported in LMICs, and there is a need to improve local-level data collection procedures. The Verbal Autopsy (VA) instrument is often used to capture the “cause of death” in LMIC settings compared to the “circumstances” surrounding deaths. Understanding the “causes and circumstances” surrounding fatal and nonfatal drowning is vital to inform context-specific interventions.

Objective To understand the extent to which “causes and circumstances” surrounding fatal and nonfatal drowning data are captured by the studies that use VA instruments and what challenges and opportunities lie in improving this instrument.

Methods From August to September 2023, 14 electronic databases, four academic search engines, and nine grey literature sources were searched. Articles published in English after December 31st 2011, were included.

Results A total of 11,455 publications were identified. After screening and assessing eligibility, 17 publications were included. Of these, eight used VA, and nine used non-VA instruments. Of the eight studies that used VA instruments (e.g.: WHO standardised VA instrument 2012/2016, PHMRC shortened VA questionnaire), only two studies captured fatal drowning and the remaining studies captured all causes of death. Furthermore, of these two studies, only one study captured the “causes and circumstances” of fatal drowning. No studies were found on nonfatal drowning. Challenges regarding the VA instruments were validation bias, reliability bias, recall bias, information bias, misclassification bias, missing records, and time consumption. Opportunities include overcoming these identified challenges, using the ‘open narrative’ section of the VA instrument, and reducing the number of questions in the VA instrument.

Conclusions The findings indicate that more studies are needed to capture the “causes and circumstances” of both fatal and nonfatal drowning using VA instruments so that context-specific interventions can be implemented and the actual burden of severe injury and lifelong disability can be understood. The findings also have implications for WHO, INDEPTH Network, and PHMRC to update their VA instruments to address the identified challenges and improve local-level data collection procedures.

  • Fatal and nonfatal drowning
  • LMICs
  • Verbal Autopsy.

https://doi.org/10.1136/injuryprev-2024-SAFETY.314

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