Final list of the most effective river drowning prevention strategies, country context, levels of evidence and level on the hierarchy of control (n=13)
| Strategy | Average score (%) | Effective in both HICs and LMICs (%) | % Aware of evidence supporting strategy | Hierarchy of control level |
| Barriers between child play areas and rivers | 75.0 | 71.4 | 71.4 | Engineering |
| River safety education including recognition and awareness of hazards | 69.7 | 92.9 | 32.1 | Education |
| Raise awareness of the risks of drowning from alcohol | 61.9 | 67.9 | 50.0 | Low-order |
| Prohibiting/Restricting alcohol use | 53.6 | 50.0 | 32.1 | Elimination |
| Close flooded roads and/or use physical barriers (such as booms) | 50.0 | 57.1 | 57.1 | Engineering/Elimination |
| Swim/recreate/wash/bathe only in designated safe places | 40.6 | 75.0 | 39.3 | Low-order |
| Build safe and accessible infrastructure such as bridges | 40.5 | 78.6 | 50.0 | Engineering |
| Do not engage in water recreation alone | 38.8 | 82.1 | 32.1 | Elimination/Administrative |
| Wear a life jacket | 38.8 | 57.1 | 82.1 | PPE |
| Learn to swim with a focus on survival swimming skills | 35.3 | 85.7 | 78.6 | Low-order |
| Community-wide rescue and resuscitation skills | 24.6 | 82.1 | 32.1 | Low-order |
| Caregivers maintaining active supervision | 22.0 | 82.1 | 82.1 | Administrative |
| Designing the urban landscape to improve safety | 19.2 | 60.7 | 39.3 | Engineering |
HICs, high-income countries; LMICs, low-income and middle-income countries; PPE, personal protective equipment.