Background Unintentional home injury is an important cause of death and disability among young children in Nepal. However, there is a lack of knowledge to inform culturally appropriate interventions to reduce home injuries.

Objectives To explore the potential for home environmental change at a community level to prevent unintentional home injury in children and identify the barriers and facilitators to change. Methods: Focus groups (FGs) were conducted with mothers, fathers, teachers, school students and community health volunteers in rural areas of the Makwanpur district in Nepal. Groups were conducted in Nepali language. The discussions were recorded, transcribed, translated into English and analysed thematically using NVIVO.

Findings Five FGs, involving 47 participants, were completed. Four major themes with multiple sub-themes were identified: Home injury and associated hazards; Potential home environmental changes; Barriers and Facilitators of home environmental change. The findings highlight the Makwanpur communities’ perceived inevitability of child injury. Despite this, participants were able to describe a range of strategies for environmental change to make homes safe for children. These included adapting the home and installing safety equipment, removing hazardous objects or restricting the child’s access to those hazards and changing behaviours to improve safety in the home. Barriers to implementation included lack of awareness about injury risk management, limited finances, hilly topography, poor quality housing and lack of ownership of responsibility for injury prevention. Facilitators for home environmental changes included raising community awareness, acquiring resources and financial support and involving the family and community.

Conclusions This study identified a range of potential environmental changes to reduce home injuries for young children, and enabled understanding of factors that may help or hinder their implementation.

Policy implications Those developing home injury prevention interventions should engage with communities to identify the environmental changes that are locally and culturally relevant.