Provision of basic swimming and water safety skills in low-resource environments: barriers and facilitators of use of WHO practical guidance.

Introduction: WHO guidance supports implementation of drowning prevention interventions. This study aimed to examine barriers and facilitators of use of WHO guidance on basic swimming and water safety skills in low-resource settings, gathering insights inform codesign of technical resources.

Methods: Mixed methods were used comprising WHO guidance gap analysis, participant surveys and thematic analysis of workshop discussions (17 participants and 13 countries). WHO document analysis and analysis of pre-workshop survey responses were combined to identify topic areas where additional guidance was required. Inductive thematic analysis of workshop discussions spanned current practice, challenges and opportunities. Postworkshop anonymous evaluation forms were also analysed.

Results: Four topic areas were identified that required additional technical guidance to support implementation: Site Safety Auditing; Medical Screening of Participants; Informed Consent and Emergency Action Planning. Barriers broadly spanned a lack of trained personnel and equipment as well as a lack of community understanding and varying support from external agencies. Opportunities identified included partnering with local organisations with specific expertise (ie, medical, emergency planning), improving programme administration and challenging traditional community practices (ie, informed consent, superstitions). Participants agreed the workshop would lead to changes in practice, however this remains to be confirmed.

Discussion: Additional technical resources to address gaps and support implementation were suggested and should now be developed, implemented and evaluated.

Conclusion: This study identified additional technical resources and the development of a community of practice to support effective teaching of school age children swimming and water safety skills in low-resource settings.