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Enabling factors and barriers to the sustainability and scale-up of drowning reduction interventions in Vietnam: a qualitative assessment
  1. Jagnoor Jagnoor1,
  2. Aliki Christou1,2,
  3. Cuong Pham3,
  4. Rebecca Q Ivers1,4,
  5. Ha Nguyen1,5
  1. 1 Injury Division, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
  2. 2 Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  3. 3 Centre for Injury Policy and Prevention Research, Hanoi School of Public Health, Hanoi, Vietnam
  4. 4 School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
  5. 5 John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Jagnoor Jagnoor, Injury Division, George Institute for Global Health, Sydney, NSW 2042, Australia; jjagnoor{at}


Background Vietnam has some of the highest rates of drowning deaths in the Western Pacific Region, particularly among children aged 19 years or younger. Several policies aimed at drowning prevention have been developed over the last decade; however, despite policy support, generally these have not been sustained beyond a pilot phase or have been limited to small geographical regions. The present study aims to explore barriers and facilitators for sustainability and scale-up of drowning prevention initiatives in Vietnam, identifying ways forward for future implementation.

Methods This was a qualitative study using semistructured indepth interviews with key stakeholders (n=12) engaged in drowning prevention in Vietnam. The Framework Method was used to analyse the data drawing on Schell’s theoretical framework for public health programme sustainability. The Framework Method is most commonly used for the thematic analysis of semistructured interview transcripts, particularly as the data were fairly homogeneous.

Results Four key factors were identified that facilitated implementation of drowning reduction activities in Vietnam. Strong political support at all levels, underpinned by policy; effective partnerships with the community; widespread communication; and programme adaptation to local contexts and application of innovative approaches, for example, strengthening organisational capacity in limited resource settings, were the key enablers. Barriers include the instability of the funding sources; inadequate programme evaluations to generate evidence of effectiveness and lack of consistent and timely data collection; and insufficient strategic planning for long-term implementation of drowning prevention interventions.

Conclusion Ensuring the sustainability and scale-up of drowning prevention programmes in Vietnam requires a continued focus on enablers such as on community engagement, communication activities and partnership approaches, and importantly concerted efforts to mobilise resources for continued long-term funding, improvements in planning and intersectoral coordination, and ensuring that future programmes are robustly evaluated for effectiveness.

  • drowning
  • low-middle income country
  • qualitative research
  • policy
  • implementation / translation

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  • Contributors JJ and HN designed the study. HN led the data collection and analysis. JJ and AC contributed to the coding of transcripts. All coauthors contributed to the interpretation of data and the manuscript.

  • Funding This study was funded by the Royal National Lifeboat Institution (RNLI), UK.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.