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Mahapatra T. Public health perspectives on childhood injuries around the world: A commentary. Ann Trop Med Public Health 2015;8:233-4
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Mahapatra T. Public health perspectives on childhood injuries around the world: A commentary. Ann Trop Med Public Health [serial online] 2015 [cited 2017 Nov 14];8:233-4. Available from: https://www.atmph.org/text.asp?2015/8/6/233/162664
Every year around the world, millions of children die from unintentional injuries, which are mostly preventable. Such injuries have become a major public health threat in recent times, more so in the developing countries (leading to more than 95% global deaths from childhood injuries). Apart from the needless deaths, morbidities associated with childhood injuries are also very high. Moreover, millions of children with nonfatal injuries are compelled to survive with various degrees of chronic physical, developmental, behavioral, and emotional disabilities, which have a huge social and economic impact. Furthermore, the healthcare expenditure associated with these injuries also poses a great threat to the already stretched healthcare system, especially in resource-poor settings.
As per World Health Organization (WHO) estimates, unintentional injuries accounted for more than 630,000 deaths among children aged less than 15 years in 2011. Worldwide injures are the number one killer of children aged 1-19 years. , Analysis of 2010 Global Burden Disease (GBD) data indicated that about 12% of 5.1 million global deaths among 1-19-year-old children were attributed to unintentional injuries. More than half of all deaths were reported from sub-Saharan African (68/100,000 population) and South Asian (36.4/100,000 population) countries. The most common causes of childhood injuries leading to death were road traffic accidents, drowning, burns, falls, and poisoning. Except for burns, the risk of such injuries is higher among male children compared to female children.  Despite such sobering figures, childhood injuries have received less than optimum attention from global health planners.
Another point of concern is that children are disproportionately affected by injuries because of striking differences between rich and poor countries in terms of socioeconomic development, emergency preparedness, safety measures, legislation and enforcement, living conditions, healthcare infrastructure, access to healthcare systems, geographic diversities, climatic conditions, awareness in the general public and treating physicians, and cultural beliefs,. As per the WHO 2008 World Report on Child Injury Prevention estimates, the risk of dying from unintentional injuries (burns, drowning, and falls) was 3.4 times higher among children in low-income countries than those in high-income countries. Because of the persistent burden of communicable diseases and malnutrition in developing countries, the mortality and morbidity associated with common childhood injuries were never a health priority for global policy makers. 
Beyond these structural barriers, there are some sociodemographic characteristics that put children at higher risk for injuries in the least-developed countries of the world. A recent review by Balan et al. on unintentional injuries among children in resource-poor settings indicated age, gender, and socioeconomic conditions as some of the significant predictors of injury-related vulnerability among children in poor countries. A marked gender inequality was observed in patterns of childhood injuries worldwide. Male children, being more impulsive and having greater liberty to explore the outer world, were at higher odds for all types of injuries. On the other hand, for female children, having more social restrictions and being exposed to unsafe cooking practices at home while helping their mothers, the burden of fire-related injuries was relatively high. Additionally, in countries such as India and Bangladesh, due to domestic violence and differential treatment-seeking behaviors among families, a girl child was more likely to die following a fatal injury than a boy. ,, Further, a significant association was also observed between age and type of injury. The most common causes of injuries among young children aged below 5 years at home were poisoning (kerosene, phenyl, other cleaning materials and household agents), burn, and fall. As older children were more mobile and thus had more exposure to environmental risks, chances of being involved in road traffic accidents were found to be higher among them. Prior research also indicated that risk of death from injuries increased with age. The likelihood of deaths from injuries increased with an advance in age, being the highest among 15-19-year-olds (12.6% among 1-4-year-olds and 28.8% among 15-19-year-olds). ,,, Socioeconomic conditions seemed to be negatively associated with the risk of childhood injuries, as evidenced from previous studies. A combination of factors, such as lack of supervision, improper storage of risky household materials, unsafe cooking practices, poor education of mothers, and poor households, pointed to greater vulnerability to injuries in children both inside and outside their home environment. , Therefore, while designing policies for the safety of children, these issues should be taken into consideration for achieving optimum success in poor countries worldwide.
Given their extreme inquisitiveness, risk-taking behaviors, low perception of danger, and physiological development, children are more susceptible to accidents. It appears, judging from previous studies, that most of these childhood injuries can be prevented if culturally competent interventions are adopted, tailored to the specific needs of each specific community. Moreover, raising awareness among parents, caregivers, and the general public is essential to prevent such childhood injuries.
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Source of Support: None, Conflict of Interest: None