Understanding the burden and circumstances of fatal drowning in Ghana: results from a nationally representative study

Drowning death rates in Africa are estimated to be among the highest globally; however, the true burden remains unclear due to limited data. This study provides the first nationally representative estimates of fatal drowning in Ghana and examines circumstances surrounding these deaths. All districts in Ghana were stratified into coastal, inland water, or dry categories. Fifty-two districts (representing approximately 28% of the national population) were randomly selected from the three strata using proportional to population size sampling. Trained data collectors identified all fatal drowning cases from January 2019 to December 2021 in each district through administrative sources and community informants. Data collectors conducted structured interviews with friends, family, or witnesses of people who drowned to collect information on the circumstances of the drowning incident. A total of 1,134 fatal drowning cases were identified. After weighting, the national fatal drowning rate for Ghana was estimated to be 4.4 per 100,000 per year. Drowning rates varied by district (0.0–26.3 per 100,000). After weighting, rates were highest among adults aged 20–34 years (4.5 per 100,000), adults aged 35–49 years (4.4 per 100,000) and adolescents and young adults aged 15–19 years (3.5 per 100,000). Rates among males (7.4 per 100,000) were approximately five times as high as rates among females (1.4 per 100,000). Among sample districts, fatal drowning most frequently occurred in rivers (31%) and the ocean (18%) with the most common activities being swimming (35%) and traveling near water (15%). Drowning is a substantial and underrecognized cause of premature death in Ghana. Results of this study highlight the need for tailored interventions, including increased access to swimming lessons and safer boating practices, and environmental modifications that reduce unintended water access, such as maintaining appropriate covers on septic and water tanks.