Trends of drowning mortality in Vietnam: evidence from the national injury mortality surveillance system.

OBJECTIVE: To describe the trends of drowning mortality in Vietnam over time and to identify socioeconomic characteristics associated with higher drowning mortality at the provincial level. METHODS: We analysed data from the Ministry of Health injury mortality surveillance system from 1 January 2009 to 31 December 2013. The surveillance covers more than 11 000 commune health centres in all provinces of Vietnam. For provincial population and socioeconomic characteristics, we extracted data from the National census 2009, the Population change and family planning surveys in 2011 and 2013. Multilevel linear models were used to identify provincial characteristics associated with higher mortality rates. RESULTS: Over the 5-year period between 2009 and 2013, 31 232 drowning deaths were reported, equivalent to a 5-year average of 6246 drowning deaths. During this period, drowning mortality rate decreased 7.2/100 000 to 6.9/100 000 (p=0.035). Of six major geographical regions, Northern midland, Central highland and Mekong delta were those with highest mortality rates. In all regions, children aged 1-4 years had the highest mortality rates, followed by those aged 5-9 and 10-14 years. At provincial level, having a coastline was not associated with higher mortality rate. Provinces with larger population size and greater proportion of poor households were statistically significantly associated with higher mortality rates (p=0.042 and 0.006, respectively). CONCLUSION: While some gains have been made in reducing drowning mortality, child deaths due to drowning in Vietnam remain alarmingly high. Targeted scale-up of known effective interventions such as child supervision and basic survival skills are needed for reducing child mortality due to drowning, particularly in socioeconomically disadvantaged provinces.