H.E. Dr. Ayman Abu Laban. - Arab Children Health Congress

Role of WHO & UNICEF
in Defining Priorities of National Policy
in Child Injury Prevention and Child Safety
Presented by: Dr. Ayman Abu Laban
Representative, UNICEF Gulf Area Office

Outline
‣ Child Injuries:
• A Major Public Health Concern
• A Global Picture
• The Situation in the UAE
• A Comparison
• Missing from Child Survival Strategies
‣ Efforts to Influence National Policy
‣ Stakeholders
‣ Priorities of National Policy
‣ Challenges in Child Injury Prevention
‣ A Call for Action
‣ International Contributions
‣ The World Report on Child Injury Prevention
‣ The Preventability of Child Injury
‣ Injury Prevention Strategies and Approaches
‣ The Sweden Experience

Child Injuries: A Major Public Health Concern
• Injury and violence kill approximately 950,000 child and young
people under the age of 18 each year
• Unintentional injuries account for almost 90% of these cases,
that is hundred children dying needlessly every hour of every
day Source: WH O (2008), Global Burden of Disease: 2004 update.
• Patterns of child injury are influenced by age, gender,
socioeconomic and environmental factors.

Child Injuries: A Global Picture
Leading Causes of Death in Children, Both Sexes, World 2004:

Child Injuries: The Situation in the UAE
Reported Child Death in UAE by Age Group and Type of Injury:
Source: Accident and Emergency Nursing (2007) 15, 228–233

Child Injuries: A Comparison
Injury Mortality among Children in UAE Compared to Other
Countries (1991-1995):
A. Bener et al. 2007, Trends in childhood injury mortality in a developing country: United Arab Emirates. Accident and Emergency Nursing 228-233

Child Injuries: Missing from Child Survival
Strategies
• Child injuries have been neglected for many years, and are largely
absent from child survival initiatives on the global agenda
Programs targeting child survival
Child injury and violence prevention programs need to be
integrated into child survival broad strategies to avoid the loss of
large investments in child health care

International Contributions

The World Report on Child Injury Prevention
The World Health Organization (WHO) and the United
Nations Children’s Fund (UNICEF) recognize injuries as
one of the leading killers of children.
UNICEF and WHO and other partners have set out to
elevate child injury to a priority by launching the :
•World Report on Child Injury Prevention (directed at
researchers, public health specialists, practitioners and
academics)
•Summary of the report containing the main messages
and recommendations (directed to policy makers and
development agencies)
•A version aimed at children

The Preventability of Child Injury
• Child injuries can greatly be prevented or at least controlled
• For each area of child injury there are proven ways to reduce both the
likelihood and severity of injury

Injury Prevention Strategies and Approaches
• Legislation and enforcement
• Product modification
• Environmental modification
• Supportive home visits and
promotion of safety devices
• Education, skills development and behavior change
• Community-based projects
• Emergency, medical care, and rehabilitation

The Sweden Experience
• Many high-income countries have been able to reduce their
child injury deaths by up to 50% over the past three decades by
implementing multi-sectoral, multipronged approaches to child
injury prevention.
• In Sweden, rather than organizing one central campaign, their
efforts were directed at influencing existing groups to pursue
child safety within their own sphere of interest and expertise.

The Sweden Experience
Trends in Child Injuries, (1969–1999)

Efforts to Influence National Policy
UNICEF seeks to reduce injuries among children and young people by
supporting countries in five key areas:

Stakeholders
• Different partners and agents of change have to be identified
bringing in a wide range of sectors for different levels of
programming that will create opportunities for funding and joint
programs.
• Concerned groups should be brought in from government, the
private sector, nongovernmental organizations, the media and
the general public.

Priorities of National Policy
Primary Actions:
• Identify an agency to lead child injury
prevention and management
• Ensure sufficient funds and human
resources for child injury prevention
efforts
• Establish a proper surveillance system
and injury prevention research
• Develop a multi-sectoral plan of action
• Strengthen the health system,
rehabilitation and support services

Priorities of National Policy
Legislation:
• Legislate and enforce laws and policies that
oblige drivers, schools and developers to
provide children with safe environment
• Safe schools (child proof classes, playgrounds and bathrooms)
• Safe public places and playgrounds
• Safe sports and recreational facilities
• Increase fines for locating children in car’s front
seat or not using the car seat.
• Abstain from giving developers construction
permission, unless they have a plan for safety
measurement
• Pool fencing
• Window guards
• Fenced construction areas
• Mandate chemical producers to lower the level
of toxicity in their product

Priorities of National Policy
Education and Awareness:
•Teach injury prevention at school from a
young age
•Support child injury prevention media
campaigns
•Include children and young people in the
implementation of projects at the national
and local levels
•Create hotline for aid and awareness

Challenges in Child Injury Prevention
• Injuries are still thought to be due to fate
• Poor data on the patterns of injury incidence
• Limited human capacity to address the issue
• Lack of funding to support prevention efforts
• Lack of political commitment and understanding
• Limited evaluation of “what works” in low-income and middleincome
countries
• Poor collaboration between agencies to address child injuries in a
coherent manner

A Call for Action
• Even if only few of the proven strategies
discussed were universally implemented
around the world, nearly half a million
child deaths could be prevented each
year – that is more than 1000 children’s
lives saved each day
• A national strategy needs to be developed to set ambitious but
realistic targets for at least five or ten years. It should have
measurable outcomes and sufficient funding to develop,
implement, manage, monitor and evaluate interventions to
strengthen national and local commitment and action.

Thank You