Adapting WHO drowning prevention strategies for children in Indonesia: barriers, enablers, and policy perspectives for LMICs

Drowning is among the top five causes of child mortality in some parts of Indonesia yet remains neglected in national health policy. This study explored how World Health Organization (WHO)-recommended drowning prevention strategies can be adapted in Indonesia through seven focus group discussions with 62 parents of children under five and community leaders across coastal and inland villages in West Nusa Tenggara Province. Participants identified barriers including financial constraints, rural inaccessibility, and sociocultural norms, alongside enablers such as community support for swimming lessons, supervised childcare, and first-aid training. Findings highlight the need for affordable and culturally appropriate interventions. Policy priorities include integrating swimming lessons into school curricula, subsidising community-based swimming programs, establishing supervised childcare centres, expanding first-aid training for community members as bystanders, and strengthening cross-sector coordination.