Prevention of unintentional injuries at home in children younger than 5 years in Ramallah District: a case study approach

Abstract

BackgroundUnintentional child injuries are a growing public health problem, representing a major cause of mortality, morbidity, and disability worldwide. Injuries are a substantial burden on health-care systems, particularly in low-income countries. We aimed to explore the perceptions and practices of parents, health professionals, and key individuals about the prevention of home-related unintentional injuries in children younger than 5 years, and the potential factors that might affect such practices. MethodsWe followed a case study approach, whereby we interviewed four parents from four households (one parent from each) in each of the three different settings within Ramallah District (camp, rural, and urban), and observed the rooms in their houses for potential hazards at a single timepoint using a standardised checklist. We interviewed 24 health professionals who worked with children in a primary health-care setting, and nine senior managers within organisations concerned with children's safety. We analysed data using inductive thematic analysis. FindingsWe recorded many hazards in all settings (48 in camp settings, 43 in rural settings, and 39 in urban settings). Parents attempted to prevent injuries to children in the home, and we noted many similarities between the perspectives of parents within the three settings. However, many factors affected their practice, mainly related to lack of awareness and low financial status. Environmental factors affected injury prevention, including the physical environment of the house, sociocultural environment (eg, belief in fatalism), and governmental policy (eg, lack of home safety regulations). 18 of the 24 health professionals and five of the nine senior managers interviewed were positive about prevention of home injuries, but workload and lack of training were the main barriers to their practice in this area. InterpretationThe causes of child home injuries are embedded within families' culture and social and economic status, and are affected by government policies. Interventions to prevent home injuries in Ramallah District should acknowledge these factors to increase the potential for success. FundingThe University of Nottingham, Birzeit University.