Background:
Drowning is the major cause of mortality among children aged 1-4 years in Bangladesh. The COVID-19 pandemic impacted personal and family practices, which may have an influence on drowning prevention measures either directly or indirectly. To prevent child drowning in rural Bangladesh, the CIPRB is intervening with a package that includes Anchals (community-daycare facilities), family education, community sensitization, and stakeholder awareness. Approximately 32,202 rural children were unable to access Anchal supervision services due to the shutdown of over 1,775 Anchals during the pandemic. The purpose of the study was to explore the COVID-19 impact of child drowning in rural Bangladesh before and during the pandemic.

Methodology:
Passive surveillance was carried out in 45 unions in rural Bangladesh between March 2019 and February 2021, encompassing approximately one million inhabitants. A pre-tested, structured questionnaire was used to collect information on fatal drowning events.

Findings:
Before COVID-19 (March 22, 2019–March 21, 2020), the fatal drowning rate among children who attended creches was 72.1/100,000 per year. The fatal drowning rate increased to 108.7/100,000 people per year during COVID-19 (March 22, 2020-March 21, 2021). The fatal drowning rates among creche children increased over 1.5 times, and the majority of drownings happened near dwellers homes. As per government instruction, all crèche-enrolled children could not participate in the crèches activities, and the parents or primary caregivers also could not supervise them. Boys had higher rates, and the majority of drownings happened near dwellers homes. Ponds and ditches were the most common drowning locations (73.7%), and nearly all drownings (86%) happened throughout the day between 9:00 a.m. and 18:00 p.m.

Conclusion:
Comparing rates in the intervening areas prior to the pandemic, the fatal drowning rate during the pandemic was consistently higher. Higher rates of child drowning may have resulted from a lack of child supervision services. The methodology used in this study may allow researchers to differentiate between COVID-19s pre- and post-impact on child drowning in Bangladesh and other similar settings.

Recommendations:
Future approaches to prevent child drowning should concentrate on providing intervention, especially through ECCD-integrated supervision services, to increase child safety and reduce the fatality rate from drowning among young children.