This study will consist of ten in-depth country case studies examining how specific drowning prevention activities have been implemented. Using a document review and key informant interviews, we will analyze the implementation pathways for both drowning prevention interventions and cross cutting strategies, drawing on both implementation science and policy implementation theories to trace the implementation pathways for each country and to identify common barriers and enablers to inform future drowning prevention efforts.
This resource will capture and share implementation pathways for the delivery of selected drowning prevention interventions from multiple countries. The guide will document the approaches a country has taken to developing and implementing drowning prevention interventions, with a particular focus on cross-cutting supportive strategies.
- To understand how selected countries have implemented specific drowning prevention interventions, map implementation pathways of interventions, and identify key lessons learned.
- To identify how supporting strategies have driven standardized and sustained ‘downstream’ community action for drowning prevention, as well as greater ‘upstream’ coordination and buy-in among decision makers.
- To identify enabling factors and barriers in the planning, execution, and sustainability of efforts, exploring the contextual factors influencing implementation success or failure.
- To document stakeholder involvement, policy integration, funding mechanisms, and monitoring practices.
Study Design
A multiple case study design will be employed using a standardized data collection protocol across all ten countries. Each case study will be treated as a separate unit of analysis, with cross-case analysis conducted at the end. The data collection and analysis for the cases will aim to trace the historical journey of each country case in developing and implementing drowning prevention interventions. Cross-case analysis will focus on common barriers and enablers to implementation and distilling these into practical and actionable lessons learned.
Sampling
Countries were purposively selected by a WHO multi-stakeholder working group of drowning prevention experts.
The final country selection criteria were as follows:
- Selected countries have diverse geographic, economic and governance structures
- Selected countries deliver multiple recommended interventions for drowning prevention
- Selected countries may have national and/or subnational coverage of interventions
Key Informant Interviews
Story of the country’s implementation
Digging deeper into implementation experiences
Capturing key takeaways from the informant’s perspective
Snowball sampling
Analysis Approach
Analysis should be iterative and ideally, start concurrently with the interviews. This will allow for iteration and refinement of causal chains developing through the interview, with findings fed back into the interview process to dig deeper and probe on emerging themes.
Transcripts will be anonymized and coded using qualitative data analysis software (e.g., NVivo).
- Thematic analysis within each country case to identify key themes.
- Cross-case synthesis using a framework approach to compare and contrast implementation experiences.
- Triangulation of data sources (interviews, documents, observations) to ensure validity.
Final outputs
WHO publishes practical guidance document: Pathways towards drowning prevention, a resource to drive systematic action.
Duration: 2024-2025
Funding Agency: World Health Organization
