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Mar-11-2008 09:25printcomments

Drowning, Homicide and Suicide Leading Killers for Children in Asia

Nearly half of all child deaths included in the studies happened after the age of five.

kids in asia
Children in Asia are at great risk of dying from injuries such as drowning and road accidents according to research by UNICEF and The Alliance for Safe Children.
Photo courtesy: mothersfightingforothers

(BANGKOK) - Children in Asia are at great risk of dying from injuries such as drowning and road accidents according to research by UNICEF and The Alliance for Safe Children.

Surveys from Bangladesh, China, the Philippines, Thailand and Vietnam reveal that injury is the leading cause of death and disability among children older than one year of age in these countries, with drowning taking the heaviest toll.

A child born in Asia is still at greatest risk of dying in the first month of life. But the survey findings confirm what has often been known within communities across the region: that the risk of dying from injury increases after infancy as children grow more independent and interact with their environment and as the threat of death from infectious and non-communicable diseases falls. Nearly half of all child deaths included in the studies happened after the age of five. The most easily preventable causes were suffocation and drowning which mostly occurred in children under five years of age.

The research, conducted over the last seven years, was spearheaded by UNICEF and The Alliance for Safe Children (TASC), working in partnership with local public health teams. Responses were gathered from face-to-face interviews done with more than half a million households covering more than 2 million people in the five countries. For the first time ever in the countries covered, the causes of death and disability among a representative sample of all children up to 18 years were reliably recorded. The results highlight injury – in its different forms – as an acute menace to children’s lives. Over the past few decades, Asia has made major progress in cutting the number of deaths among children-under five, with extended vaccination coverage, better access to sanitation and good hygiene and improvements in nutrition playing a critical role.

“This evidence overwhelmingly confirms that injury is and has been a major killer. It is now time to make it a public health necessity and to reverse the tide of child injury related deaths” said Pete Peterson, President of TASC.

Findings from the five-country household surveys indicate that the causes of injury differ by age group and are associated with exposure to different types of risks:

• Infants younger than 1 year have limited exposure to injury because mothers and caregivers tend to provide a protective environment. While the child is dependent upon them, the risks are limited to choking, suffocation and falls.

• Toddlers aged 1-4 years, exposed to hazards in and around the home, are at greatest risk of drowning.

• School-aged children aged 5–9 years spend a lot of time outside the home, either in school or engaged in social activities, and are thus at greatest risk from drowning and road traffic accidents.

• Adolescents aged 10–17 years are navigating the difficult transition to adulthood and are thus more exposed to risk-taking behaviour in addition to exposure to violence.

Alarmingly, most of the surveys indicated that intentional injury -- homicide and suicide -- was the leading cause of death among adolescents. Taking into account the difficulty and sensitivity in collecting such information through interviews, the researchers believe that even this new reported incidence is likely to underestimate the magnitude of the problem.

The national surveys relied on large sample sizes to enable reliable identification of causes of death and their breakdown by categories such as age, sex and urban or rural location. The data collected looked at deaths from all causes in the previous three years as well as all circumstances that required children and adults to miss work or school or to be hospitalized from injury in the previous year.

Many injuries, especially those that are fatal, are rarely reported to hospitals. As a result the cause of these deaths is often missing from national health statistics and civil registry systems. This creates a major challenges to accurately monitor child mortality, especially among children 5 years and older, and it underscores the need for adequate systems to track and record births and children’s deaths.

“If we are ultimately going to meet the Millennium Development Goal to reduce child mortality, it is imperative that we take action to address the causes of childhood injury,” said Anupama Rao Singh, Regional Director of UNICEF East Asia and Pacific. “We know that with a judicious mix of public health interventions - from investing more in awareness campaigns to equipping children and their parents with knowledge and skills - we can prevent the majority of these deaths.”

UNICEF and TASC are calling for better systems to record births and deaths as well as the expansion of child injury prevention programmes. These include campaigns for better road safety to lessen road traffic accidents, increased supervision and swimming lessons for children to prevent drowning and household safety education to prevent suffocation, falls, poisoning and animal bites.

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Sean Flynn was a photojournalist in Vietnam, taken captive in 1970 in Cambodia and never seen again.