Publications

Special Series on Child Injury no.2

This paper presents a more detailed description of the survey methodology for technical specialists interested in understanding the major differences between the surveys and the methods previously used to estimate child deaths. A detailed description is provided for survey governance, sampling design, survey instruments, the classification scheme for mortality and morbidity measured in the surveys, the fieldwork procedure, the analytic framework, weighting and adjustments, and survey costs. Following this, a number of methodological lessons are addressed, such as: the need to count all children and not only those under five years of age; the need to count all clearly identifiable causes of death in those same groups; the need to count morbidity as well as mortality; and the need to count the deaths in the community where they occur to avoid the various biases associated with facility-based counting. A number of examples from the surveys are shown to illuminate the issues so that they are clear to non-technical readers.

Special Series on Child Injury no.3

This paper presents a detailed description of the survey results which were introduced in the Overview Paper. Detailed results are presented first for proportional mortality in children by age group for a population-weighted composite of the surveys, and then for the individual surveys. Following this, detailed results are presented for fatal injury by national or sub-national area, region (urban/rural), and gender for the 0-17 age group. After this the types of fatal injury that occur in the different stages of childhood are presented. The second part of the paper presents both fatal and nonfatal injury by type of injury for the composite of the surveys as well as the individual surveys themselves. The results show that the leading causes of nonfatal injury differ from those of fatal injury, and the greatest burden is caused by the more serious categories of nonfatal injury. Finally, the ratio of the two leading causes of fatal injury in children, drowning and road accidents, are presented for each of the surveys. Drowning is shown to be the leading cause of fatal childhood injury in each survey. The paper concludes with a discussion of the major issues highlighted by the results of the surveys.

Special Series on Child Injury no.4

This paper presents a summary of the findings of the national and sub-national surveys and discusses the implications of the results on child health policy and programmes.The principal finding is that injury has generally been unrecognized as a leading cause of child death. This is largely because the previous estimates of child mortality causality were unable to include injury due to technical issues. The surveys provide convincing evidence that injury is a leading cause of child death after infancy and the types of injury vary with the age group of the child. Similar convincing evidence shows that it is a leading cause of serious morbidity and permanent disability in children The implications discussed are 1) the need to develop an effective measure of child mortality that includes all ages of childhood; 2) prevention of mortality and serious morbidity from injury in children will require a life-cycle approach; 3) continued progress on child survival programming in children under five years of age will require injury reductions; 4) that drowning is the single injury cause responsible for about half of all injury deaths and targeting it for reduction would be an efficient strategy; and 5) there are efficient strategies for targeting other sub-types of child injury as well.