Preventing Child Drowning in the Philippines: The Need to Address the Determinants of Health.

Drowning is a public health issue in the Philippines, with children at significantly increased risk. Determinants of health (DoH) such as education, socio-economic status, ethnicity, and urbanization are factors that impact drowning risk. As drowning is a multisectoral issue, a national drowning prevention plan can drive collaboration with relevant stakeholders. This study reports trends in unintentional child (0-14 years) drowning in the Philippines (incidence, rates, and trends over time for fatal and non-fatal (years lived with a disability (YLDs) and disability adjusted life years (DALYs) from 2008-2017 and conducts an analysis of the Philippines' Multisector Action Plan (MSAP) on Drowning Prevention. From 2008-2017, 27,928 (95%UI [Uncertainty Interval]: 22,794-33,828) children aged 0-14 years died from drowning (52.7% aged 5-14 years old). Rates of drowning have declined among both age groups, with greater reductions seen among 0-4 year olds (y = -0.3368x + 13.035; R2 = 0.9588). The MSAP has 12 child drowning-specific activities and 20 activities were identified where DoH will need to be considered during development and implementation. The MSAP activities, and work done to prevent drowning more generally, must consider DoH such as education, urbanization, water and sanitation health, and safe water transportation. A national drowning surveillance system and investment in research in the Philippines are recommended.

Child drowning prevention in the Philippines: the beginning of a conversation.

This study describes a process to explore factors which contribute to child-drowning deaths and allows the development of appropriate strategies to prevent similar deaths in a selected site in the Northern Philippines. Data collection techniques used in obtaining baseline data include: review of drowning mortality records; key informant interviews; focus group discussions; and community walk-throughs. Risk factors identified which could or did contribute to drowning events were: proximity to bodies of water; inadequate child supervision; lack of information/awareness of prevention strategies; and lack of drowning prevention programme(s). Measures on how to prevent drowning deaths were explored and initial interventions were implemented through a committee convened by the community. These interventions include: community education sessions; capability building measures; redesigning of community wells; development of playpens; and use of barriers. Community engagement is a crucial element in the development and implementation of any health programme. This study demonstrates that by engaging and working with the community action occurs, however, there is a need to conduct further evaluation activities to determine if the actions by the community continued beyond the project and have resulted in a decrease in drowning. One of the strengths of the process described is that it is culturally appropriate and site-specific and allows the community to find the solutions itself. Exploration and delivery of further projects in larger areas is required to reduce drowning in the Philippines. An imperative is the evaluation which will provide valuable information on whether barriers are a sustainable and acceptable means of prevention to the community in the long term.

The status on non-communicable disease prevention and control in the Philippines: A systematic review

OBJECTIVE: This paper aims to provide concise background information regarding the state of noncommunicable diseases (NCDs) and their risk factors as well as the existing efforts to address them in the Philippines in the last 25 years. METHODS: A desk review of documents and literature review as well as analyses of available statistical data and several consultations with involved government agencies have been made to come up with summary figures and tables.RESULTS: NCDs as well as metabolic conditions that can potentially lead to NCDs are on the rise in the last score of years. The Philippines, through the Department of Health, has been visionary in leading various projects and activities to fight NCDs over the last two decades, and its efforts are slowly paying off: the prevalence of tobacco use and that of hypertension have decreased over the last 5 years. NCD mortality (including premature deaths) and prevalence of behavioral risk factors, however, generally remain high, and the Philippines needs to accelerate whole-of-society and whole-of-government actions to sustain the gains and attain its NCD targets in the next 10 years or so. CONCLUSION: The need to strengthen health system interventions and promote accountability of various sectors in addressing NCDs and its risk factors in the country arises. The development of a multisectoral action plan on NCD prevention and control is needed to halt the rise of NCDs in the country.

Knowledge, attitudes and practices of parents in an urban coastal community on preventing childhood drowning

OBJECTIVE:To describe the knowledge, attitudes and practices of parents in an urban coastal community on drowning prevention.METHODS: A descriptive cross-sectional study design was used in the study. Systematic random sampling was used and 431 parents were included as respondents in the study. A questionnaire that was developed and pre-tested was used to determine the knowledge, attitudes and practices on drowning prevention among parents in households with at least one child. RESULTS: The respondents' knowledge on general aspects of drowning such as its preventability and to whom and where it could happen seems to be sufficient (67-99%). Awareness of drowning prevention programs and activities in the barangay is quite low, and awareness of any legislation is even lower. The respondents seem to have positive attitudes toward supervising children while swimming or playing in high risk areas, in buying and wearing flotation devices, and participating in drowning prevention measures. Although 60 % claimed to have supervised their children while swimming in the sea, river, lake or swimming pools, more respondents (67 % - 88%) had admitted that their children had never worn flotation devices when they swim or play in most bodies of water. More than 93% of the parents have not participated in any program or activity on drowning prevention. CONCLUSIONS: The study seems to show that, in the surveyed coastal community, there is a high level of knowledge in terms of the general aspects of drowning and there are positive attitudes in terms of measures and activities to prevent drowning. However, this has not translated to similarly appropriate levels of drowning prevention practices.