Piloting a portable pool-based survival swim programme in Kerala, India

BACKGROUND: programme in two schools in the high-burden state of Kerala, India, and assessed for feasibility of implementation in this context. METHODS: Children aged 5-12 years with no swimming ability were enrolled in 12 sessions which taught float and swim skills in portable pools. Quantitative performance was assessed at baseline and endline against international standards, including the 30-second float and 25-metre swim. Qualitative data from participants, implementers and policy stakeholders assessed feasibility and acceptability. Data was analysed against the Acceptability, Practicability, Effectiveness, Affordability, Safety, Equity (APEASE) framework to assess context suitability and opportunities for scalability. RESULTS: 309 children participated, of which 68% attended all sessions and were assessed at endline. Of these, 15.9% passed all criteria though 53.1% swam at least 10 m. Lower success was attributed to an inadequate number of classes. The programme was found to be acceptable and feasible to implement, provided long-term funding was identified for instructor salaries and pool maintenance. Lower performance was identified in younger children aged 6-7 years and girls. Younger children may have experienced discomfort due to chlorine and water depth, affecting learning. The infrastructure cost per pool was US$3600, and the running cost per student was US$8. No safety issues were identified. CONCLUSIONS: pilot provided insights on how a broader drowning-prevention programme may be sustained in a school setting in high-risk LMIC regions.