The need to tackle the child injury epidemic
Injury is the number one cause of death for children in every Member State in Europe, not cancer, not respiratory or heart illnesses, or meningitis. Child injury accounts for 36% of all deaths and has the largest environmental burden of disease, with an average of 20,000 deaths for children less than 15 years of age, every year. That is 3 children dying from injury every hour.
Children in low and middle income countries are at 4 times the risk of dying from injuries than children in high income countries within Europe, with a ten fold difference between countries with the highest and lowest injury death rates. If all countries in Europe had the same child injury death rate as Sweden (3.6 per 100,000), over 15,000 child deaths could be prevented.
New publication promotes what works in child injury prevention
Injuries to children could be reduced if proven safety strategies were adopted and implemented across all European countries. A new publication, the “Child Safety Good Practice Guide; Good investments in unintentional child injury prevention and safety promotion“ launched June 26th by the European Child Safety Alliance, provides guidance on what those proven effective strategies are.
With so much to do to address the safety of European children and so little time and limited resources, there is a need to focus on good investments, those strategies that are most likely to reduce childhood unintentional injuries.
The Guide builds on previous work by the Alliance and child safety researchers from around the globe and is a further step in supporting Member States in moving toward evidence-based good practice. Its purpose is to enable Member States to examine strategy options for unintentional child injury, move away from what has ‘always been done’ and move toward good investments - strategies that are known to work or have the greatest probability of success. These strategies are in the broad approaches of environmental and product modification; legislation, regulation and enforcement; promoting use of safety devices; supportive home visits; community based interventions; and education and skills development.
Proven good practice works
Injury is predictable and preventable. Research has shown that there are practices that reduce injury death and disability, most often through a combined approach of education, engineering and enforcement measures. Action needs to be taken to adopt and implement what has been proven to work - the good practices.
· Injuries from road accidents have been more than halved for example with reduced speed limits, traffic calming, safer car fronts for pedestrians and cyclists, child passenger restraintsiand bicycle helmets, where these measures have been enforced.
· Drowning deaths have been reduced with the use of pool fencing and personal floatation devices.
· Burns and scalds have been more than halved with the use of smoke detectors, water temperature regulators, child resistant cigarette lighters, and clothing that does not easily catch on fire or burns more slowly.
· Fall injuries and deaths have been reduced with the use of window and balcony guards and stair gates.
As well, but to a lesser extent, reduction of serious head injuries in playgrounds through the relationship between height of equipment and impact absorbing surfacing in playgrounds.
· Poisonings have also been reduced by one third using child resistant packaging, safe storage units and education programmes.
· Choking, suffocation and strangulation have been reduced with product and environment modifications/redesign that have been researched and prepared for standards and regulations.
Evidence also exists that many of these proven best practice strategies are also cost effective and provide a large opportunity to save lives and money.
€ 1 spent on smoke alarms saves € 69 € 1 spent on bicycle helmets saves € 29 € 1 spent on child safety seats saves € 32 € 1 spent on road safety improvements saves € 3 € 1 spent on prevention counselling by paediatricians saves € 10 € 1 spent on poison control services saves € 7
Why do we not implement good practice?
There are several reasons why good practice fails to be selected and implemented. The most common challenges include: resistance to change from what is currently being done; competing priorities; failure to plan solutions effectively; lack of capacity or expertise; and a lack of time or resources to undertake the proven good practice.
The Convention on the Rights of the Child, the most universally embraced human rights treaty in history states that the child has the right to the highest attainable level of health and the right to a safe environment.
Therefore, we have a duty to ensure children’s rights to safety. It is imperative for society to ensure the safety of children as a fundamental human right. The convention also states “in all actions concerning children...the best interests of the child shall be a primary consideration”: that means actions to improve the lives of children should take precedence over the blocking arguments used by vested interests, such as “this measure will be too expensive” or “the time is not right for that action.”
Political climate is ready to invest in child safety
Many governmental commitments have been made in the past to support child injury prevention, but never have so many agencies and countries officially and in public signed their responsibility to honour these declarations and resolutions as recently.
· World Health Assembly and United Nations resolutions on violence and traffic safety
· Regional Committee Resolution on Children’s Environment and Health Action Plan for Europe: priority goal 2 to reduce injuries
· Regional Committee Resolution on Prevention of injuries in the WHO European Region
· Regional Committee Resolution on a European strategy for child and adolescent health and development; including injury
· European Commission Communication and Council Recommendation for injuries
In addition their has been Ministry of Health focal points for injury established in Member States, a United Nations Secretary General’s study on violence against children, a UNICEF regional consultation meeting and commitment to address violence and injuries to children, development of a global strategy for Child Injury Prevention released this year and a World and European Report on Child Injury Prevention slated for 2008.
Seize the time for commitment and action
“If we are truly sincere about caring for children than we will all need to meet our commitments and take real action to protect and promote their health and safety, which includes allocation of money, people and policy now against other vested interests,” states Joanne Vincenten, Director of the European Child Safety Alliance.
“Let us deal with what is killing our children today - injury.” The timing is right. Proven good practice strategies, including cost effective strategies and examples of those strategies in action exist, government commitments have been made to support action, momentum is building throughout Europe and children need our actions to now follow our words.
It is hoped that by ensuring awareness of evidence-based good practice strategies the injury prevention community can better encourage policy makers to adopt these strategies into their setting and begin work to implements. However, if the injury prevention community is to make the best use of limited resources and have the greatest impact on the lives of European children, action and commitment is required on many levels. Thus action and commitment to ensure good practice is the focus of investments is needed by international organisations, the European Commission and national governments, injury researchers and injury practitioners themselves.
