Public health interventions to prevent children drowning: an updated systematic review

Abstract

Aim Injuries are a leading cause of death and disability for children and young people worldwide and a significant public health challenge. This updated review identifies and assesses public health interventions designed to prevent child drowning. It aimed to evaluate the global scope of literature and examine contributions made to the evidence since the last review was published. Subject and methods The review follows processes established in previous reviews and recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Articles were peer-reviewed, published in English between 2011 and 2023 and described and evaluated child drowning primary prevention interventions. Fifteen databases were searched, and articles were managed in Endnote and Rayyan.AI. The MetaQAT framework was applied to quality appraisal. Results We included a final sample of n = 43 studies. Most studies were from high-income countries and applied quantitative intervention designs. Just under half targeted children, most at the population level. Approximately one in three studies used behavioural theory to guide intervention development. Few studies reported formative research. Conclusion The past decade has seen a threefold increase in the number of papers describing public health interventions to prevent children drowning. Despite this increase, interventions remain primarily educational, focusing on behavioural strategies. A call for more comprehensive and systems-level interventions that tackle the upstream determinants of child drowning is timely.