**5. Conclusions**

The Sundarbans are a high-risk region for child drowning, and we aimed to identify the mechanisms and considerations for the implementation of drowning reduction programs in the region. We found that program design should consider contextual factors such as geography, cultural beliefs around drowning, skillsets of local people and household-level needs. It was found feasible to leverage governmen<sup>t</sup> programs such as ASHA workers and SHGs for program recruitment and implementation, while the optimisation of Anganwadi centres for the provision of childcare may be challenging due to poor resourcing and permissions required. Community-based young clubs were also possible implementers of programs. Program development and implementation should involve a range of stakeholders such as local governmen<sup>t</sup> members, block and district-level health and development officials, community leaders and residents. The results show that the development of drowning reduction programs in rural LMIC contexts should be catered to the local social and environmental context to ensure acceptability and feasibility.

**Supplementary Materials:** The following are available online at http://www.mdpi.com/2227-9067/7/12/291/s1, Table S1: Consolidated criteria for reporting qualitative studies (COREQ): 32-item checklist, Table S2: Illustrative quotations by theme.

**Author Contributions:** M.G. and J.J. conceptualised and designed the study. M.G. developed the data collection tools with support from J.J., S.R. and R.P. S.R. and R.P. coordinated and supervised data collection and quality maintenance activities. M.G. and P.K. carried out the analysis. M.G. drafted the manuscript with inputs from P.K. and J.J. All authors have read and agreed to the published version of the manuscript.

**Funding:** This project was supported by the University of New South Wales through the Research Training Program Scholarship (awarded to M.G., no award number) and National Health and Medical Research Council (Australia) Early Career Fellowship funding (awarded to J.J., Application ID: APP1104745).

**Acknowledgments:** We would like to acknowledge and thank the Royal National Lifeboat Institution for their guidance and support.

**Conflicts of Interest:** The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

**Data Availability:** Due to the qualitative nature of data collection, some participants may be identifiable from the contextual factors presented in the transcript. Data will be shared by the corresponding author on reasonable request.
