A systematic approach to injury policy assessment: introducing the assessment of child injury prevention policies (A-CHIPP)

Correspondence to Dr Olakunle Alonge, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; [email protected]

Introduction

Injuries accounted for 5 million lives lost in 2015, and 14% of these deaths occurred among children 15 years old or younger.¹ While proportionate mortality due to other childhood causes is on the decline, proportionate mortality due to childhood injuries is either rising or has remained at the same level.^{2 3} Unintentional injuries, including drowning (20.2%), road traffic injuries (19.8%), falls (7.1%), burns (6.5%) and poisoning (4.3%) are the leading causes of injury deaths in this age group.¹ Over 90% of these deaths occur in low-income and middle-income countries (LMICs).

There are evidence-supported interventions for addressing the burden of child injuries.^{4 5} However, a systematic evaluation of policies incorporating these interventions in LMICs is lacking, compared with the experience in high-income countries (HIC).⁴ Between 2007 and 2012, comparative assessments of the status of policy response to child injuries in Europe were published as ‘Child Safety Report Cards’ for member countries.^{6 7} The assessments examined the extent to which countries adopted evidence-supported interventions for addressing child injuries at the national level, and were useful for advocacy and mobilising resources for addressing the burden of child injuries in the region.⁸ Similar efforts have been undertaken in other high-income regions and these efforts have been accompanied by a decline in the child injury rates in these places.^{9 10} The lack of a systematic evaluation on existing child injury policies has contributed to the limited policy response, and the lack of effective strategies for addressing the growing burden of child injuries in LMICs.^{11 12}

The policy gap in LMIC s regarding child injuries prevention may also be attributable to donor priorities in these countries.^13–15 Over the last two decades, various stakeholders have prioritised systematic evaluations and routine assessment of policies and interventions for addressing other major causes of childhood illnesses.^16–18 Child injury interventions and policies have however attracted little investment over the same period from donors and governments.¹⁹ This lack of attention to child injury policies in LMICs contributes to inequalities in global child injury rates.^{4 20 21}

A child injury prevention policy assessment...