Road traffic injuries: a new agenda for child health.

This paper reviews literature related to morbidity and mortality in South Asian children due to Road Traffic Injuries (RTIs), almost all of which are preventable. In South Asia after males 15-44 years, RTIs are most common in children 0-15 years old. Under-five fatality rates are about six times higher than in the developed world. Most injuries in low income countries occur in urban areas, where pedestrians, passengers, and cyclists account for around 90% of deaths due to RTIs. This higher fatality among pedestrians is probably due to wider traffic mix and lack of safe pedestrian walking areas. The WHO estimates that RTIs cost countries between 1 and 2% of their Gross Domestic Product. This has critical financial consequences. Vital statistics in South Asia are not reliable, and this leads to an underestimation of the magnitude of RTIs that hampers efforts for its acceptance as a preventable public health problem. Rapid urbanization, high motorization rates and failure to institute preventive measures predict a substantial increase in road traffic deaths in the coming years. Creating a safer environment is important. Use of child passenger restraints, bicycle helmets and targeted education campaigns are effective preventive measures. Legislation and implementation of traffic rules and regulations, road engineering and safe pedestrian areas would help reduce injuries. These measures are in accordance with the WHO's five-year strategy to address RTIs worldwide. This strategy includes national and local capacity building, inclusion of RTI in the public health agendas in the world for prevention and control of the health consequences. Child health in South Asia needs to integrate the new challenge of road traffic injuries for the region. It is critical that interventions for reducing this burden are developed, tested and implemented.