Frequently asked questions:

Most current swimming curricula and training programs are longer and more extensive.  Why is SwimSafe only 20 lessons?
SwimSafe teaches survival swimming, a very basic level of swimming that has the singular goal of preventing drowning. Operational research and evidence from the extensive trials show that SwimSafe does this safely and effectively.

Most traditional swimming programs focus on the acquisition of several specific strokes used in both recreational and competitive swimming (e.g. crawl, sidestroke, backstroke, etc.). These require more time to learn and are intended to train the child in rapid, efficient self-propulsion through the water for the purpose of recreation or often to increase skill in competition. These are mainly designed by coaches and trainers in water sports. There is very good evidence of the effectiveness of these programs in helping children achieve fitness and competitive goals, however there is no evidence that they prevent drowning in the daily lives of children in low and middle income countries (LMICs).

SwimSafe was designed as a public health intervention rather than a recreational or sporting competition program. It is exclusively designed to provide protection from drowning in children in LMICs. The public health design goals were safety, effectiveness in preventing drowning and efficiency of the training process.  There are almost two billion children in LMICs at daily risk of drowning and the child drowning rates in LMICs are ten or twenty times those in HICs. An intervention must be safely and quickly learned to be an effective intervention that is efficient enough for use on a national and regional scale. For these reasons, the SwimSafe curriculum is delivered in 20 lessons.

Why doesn’t SwimSafe have extensive final testing and a “trial” at the end where the children are placed in a real-world setting for drowning, such as having to swim in shoes and clothes, as would often occur?

The development process for the program has incorporated all of these into the curricula. The case-control studies were based on ‘real life drowning’ for children across Asia. The natural swimming skills that were described by the anthropologic research were ‘real-world’ and the description and matching of them with existing skills builds this effect into the SwimSafe program.

The training program is a skill-based program where each skill is proven to have been achieved sequentially and the effective chaining of these individual skills is tested at intervals during the training process. Finally, the successful use of all of them is required before competence is certified.

The three year cohort study in Bangladesh was conducted using this skill-based approach and competency attainment methodology. It allows for the most efficient training process with the least amount of time required. This is key for a public health intervention that must be applied on a national scale and cover millions of children effectively.

What about children younger than 4 years of age? There are many programs in wealthy countries that teach very young children, even infants to swim. Why does SwimSafe ignore these children when they could participate?

There is very good evidence that in the real world, swim teaching for children under four is not an effective public health intervention.

First, these programs require enormous resource commitments such as in-ground pools, certified instructors with very low instructor student ratios (often 1:1) and these are not present in most LMICs.  In many countries, there is only one pool in the capital and no pools in rural areas, nor is there a certified swim-training infrastructure.

Secondly, in these programs, ‘swimming’ occurs in a very controlled environment with a trusted parent present and highly involved. This is very different from the real world environment where most drowning occurs in LMICs.  The case-control studies and survival analysis of the mortality cohorts in the large national and provincial studies provide ample evidence that in the real world of LMICs where immersion is sudden, unexpected and usually when alone, children under 4 are unable to save themselves and drown.

Thirdly, these infants and very young children are usually ‘above-average’ in terms of motor and mental development. Any program that can be implemented on a national and regional scale must be safe and effective for all children participating. It is usually after the fourth year of life that virtually all children have achieved the motor and mental development necessary to safely participate.

The extensive ‘real world’ testing done in the very large rural cohort in Bangladesh provides hard evidence that SwimSafe is effective. Equally important, it also showed it to be safe for children as young as four years of age. In a country such as Bangladesh, rural children are often well below growth norms due to malnutrition. This was one key parameter for safety validation to allow SwimSafe to be a public health intervention.

Is there a need for further training following SwimSafe Advanced Qualification?

We believe so, but think the existing water safety, sports and competition system is more suited for providing it than the SwimSafe program.

SwimSafe is designed to protect against drowning in all children, so it must cover all children, regardless of their talent or interest in further training. It is only the most basic level of swimming.  We have found many of the children who become certified as SwimSafe have a natural talent and their parents have an interest in further training.

We encourage parents to make use of the existing professional water safety and swim training institutions to help their child progress in more advanced skills.  We think there are solid public health benefits from this, as there is good evidence to support the positive health effects of safe, recreational and competitive swimming.

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Preventing child drowning in Asia through teaching survival swimming skills

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