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Drowning is the third leading cause of unintentional injury death; accounting

for 7% of all injuries. Over 90% of the estimated 322,000 annual global

drowning deaths occur in low-and middle-income countries. Although the

burden of drowning is believed to be highest in the WHO-African region, data

collection and surveillance for drowning in African countries is limited. Drowning

prevention strategies require adequate data on the burden and circumstances

of drowning to help ensure data-driven prevention efforts. The World Health

Organization recommends that all countries take steps to improve drowning data

so that prevention strategies can be context-specific.

In bid to contribute to data driven interventions, we carried out a two-phased study in Uganda. The study was conducted in 60 districts of Uganda for a period of 2.5 years (from January 1st, 2016 to June 30th, 2018). In the first phase, records concerning 1,435 drowning cases were found in the 60 study districts. Other than stating that the individual had drowned, there was very little information that could potentially guide prevention efforts.

The second phase was limited to only 14 of the initial 60 districts. In the 14 districts,

a total of 2,066 drowning cases were identified by community health workers and

confirmed through individual interviews with witnesses/family members/friends

and survivors of drowning. Most (1,332; 64%) of these were deaths. Using the

community approach, as opposed to official records, revealed more than three

times the number of drowning deaths in the same 14 districts. Almost half of all

people who drowned were engaged in an occupational activity at the time of the


These results show that drowning is a major cause of premature death in Uganda,

especially among young adults whose livelihoods depend on water activities.

However, most drownings are preventable through policies and regulations that

reduce exposure to drowning risk, and institution of interventions to ensure safety

around water. Drowning is a multisectoral issue, and all stakeholders (local and

national government, water transport, water sport, education, fishing, health, and

law enforcement) should coordinate to develop a national water safety strategy

and action plan. The strategy could address matters of leadership coordination,

funding, advocacy, awareness raising, prioritization, target setting, and monitoring

and evaluation.