DefinePK

Abstract

The United Nations Convention on the Right of the Child states that the child has the right to the highest attainable level of health and the right to a safe environment.1 Moreover, mortality in infancy and childhood serve as good indicators of the population well being. Injuries are currently a leading cause of death and disability in the world and account for more than five million deaths each year.2 A large majority of these deaths occur in low and middle income countries, where 90% of the world's population resides and where injury prevention is an emerging field.What is the leading cause of death among children and adolescents? Not AIDS, not cancer or diabetes, not cystic fibrosis or heart disease, and certainly not meningitis. For most countries in the developed world, and increasingly in the developing world as well, about one half of all deaths after the first year of life are due to injuries. Many people - professional and lay - are astonished by these figures.Injuries among children must be considered a major public health problem. Injuries are the most common cause of death for children aged 1-14 years in developed nations, accounting for around 40% of all child deaths and the fourth leading cause of death for all ages combined.3 In the United States, injuries cause approximately 23,000 paediatric deaths annually and are responsible for more deaths than all other childhood diseases combined.4 Deaths in childhood from injuries exceed childhood deaths from all other causes combined.4 Paediatric injuries should be viewed, as preventable, but such prevention requires the active participation of health care providers.Traditionally infectious diseases have been the leading cause of death especially among children. However with the efforts of local health departments and international organizations such as World Health Organization, infectious diseases have been substantially controlled and injuries have become the number one cause of death in children and young adults in many high income countries.5 Similar transitions have been started in many lesser-developed countries.   Yet this major public health problem receives relatively little attention in developing countries. This response is in part due to lack of population-based and national estimates of injuries in developing countries. Like other developing countries, mortality and morbidity from preventable causes are major health issues in Pakistan. According to a burden of disease study, injuries are the second leading cause of disability, the 11th leading cause of premature mortality, and the fifth leading cause of overall healthy years of life lost per 1000 people.6 Few studies have estimated the injuries in Pakistan7,8 and a recent study found an overall annual incidence of all unintentional injuries of 45.9 (CI: 39.3-52.5) per 1000 per year over five years of age, by using the National Health Survey of Pakistan (NHSP 1990-94).9 The research on injuries in Pakistan has mainly focused on injuries in adults. While children (age