RT Journal Article SR Electronic T1 Determining child drowning mortality in the Sundarbans, India: applying the community knowledge approach JF Injury Prevention JO Inj Prev FD BMJ Publishing Group Ltd SP 413 OP 418 DO 10.1136/injuryprev-2020-043911 VO 27 IS 5 A1 Medhavi Gupta A1 Soumyadeep Bhaumik A1 Sujoy Roy A1 Ranjan Kanti Panda A1 Margaret Peden A1 Jagnoor Jagnoor YR 2021 UL http://injuryprevention.bmj.com/content/27/5/413.abstract AB Background The Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region.Methods A community-based survey was conducted in the Sundarbans to determine the drowning mortality rate for children aged 1 to 4 years and 5 to 9 years. A community knowledge approach was used. Meetings were held with community residents and key informants to identify drowning deaths in the population. Identified deaths were verified by the child’s household through a structured survey, inquiring on the circumstances around the drowning death.Results The drowning mortality rate for children aged 1 to 4 years was 243.8 per 100 000 children and for 5 to 9 years was 38.8 per 100 000 children. 58.0% of deaths were among children aged 1 to 2 years. No differences in rates between boys and girls were found. Most children drowned in ponds within 50 metres of their homes. Children were usually unaccompanied with their primary caretaker engaged in household work. A minority of children were treated by formal health providers.Conclusions Drowning is a major cause of death among children in the Sundarbans, particularly those aged 1 to 4 years. Interventions keeping children in safe spaces away from water are urgently required. The results illustrate how routine data collection systems grossly underestimate drowning deaths, emphasising the importance of community-based surveys in capturing these deaths in rural low- and middle-income country contexts. The community knowledge approach provides a low-resource, validated methodology for this purpose.Data are available upon reasonable request. Data will be shared upon reasonable request by contacting the Corresponding Author (jjagnoor1@georgeinstitute.org.in).