Prevention of Drowning by Community-Based Intervention: Implications for Low- and Middle- Income Countries

BACKGROUND Drowning is a serious but neglected health problem in low-and middle-income countries. OBJECTIVES To describe the effectiveness of drowning prevention program on the reduction of drowning mortality rates in rural settings at the north of Iran, and guide its replication elsewhere. PATIENTS AND METHODS This interventional design included pre- and post-intervention observations in the rural area of the Caspian Sea coastline without a comparison community. Cross-sectional data were collected at pre- and post-intervention phases. Outcome evaluation was based on a four-year period (March 2005-March 2009) utilizing drowning registry data for the north of Iran. RESULTS The implementation program increased the rate of membership in an organization responsible for promoting safety in high risk areas near the Caspian Sea. Compared to a WHO standardized population, drowning incidence in rural areas of the study demonstrated a continuous decrease in age-specific drowning rate among the oldest victims with a gradual decline during the implementation. In the study area, the epidemiological aspects of the study population were exposed and contributing factors were highlighted. CONCLUSIONS This study showed that the promotion of passive interventions had a greater effect on drowning rate than that of active interventions.