India faces urgent child road safety crisis, UNICEF report reveals

A national roadmap for child and adolescent road safety in India, released on February 4 by UNICEF in collaboration with the WHO Collaborating Centre for Injury Prevention and Safety at NIMHANS, highlights alarming figures on road traffic injuries (RTIs) among children.

According to the report, RTIs are now the leading cause of death among children and adolescents in India, accounting for 10% of all road crash fatalities.

"Every day, nearly 45 children under 18 lose their lives in road crashes across the country. In 2022 alone, 16,443 fatalities were recorded in this age group, though actual numbers maybe 20% higher due to underreporting," said Gautham Melur Sukumar, Additional Professor of Epidemiology and Head of the WHO Collaborating Centre for Injury Prevention and Safety at NIMHANS.

He added that around five million children suffer non-fatal injuries requiring hospitalization annually.

The report provides a comprehensive review of the current state of child and adolescent road safety in India, detailing risks, trends, and contributing factors. Findings show that between 2011 and 2022, an estimated 198,236 children and adolescents lost their lives in road crashes. Notably, 75% of these fatalities occurred among 14- to 17-year-olds, and the numbers more than doubled in this group over the past decade.

Vivek Singh, Officer-in-Charge of Health at UNICEF India, emphasized the vulnerability of children to severe injuries, stating, "Nearly 50% of child road crash deaths occur at the scene, with head injuries being the most common, followed by injuries to the lower body. Given the alarming rise in fatalities, UNICEF is stepping up efforts to ensure safer mobility for children."

Experts at the launch event pointed to multiple factors contributing to the crisis, including unsafe road conditions, lack of helmet use, and deficiencies in child restraint systems (CRS). "Correct helmet usage among children and adolescents ranges from just 10-50% in urban areas to a mere 2-5% in rural regions. CRS adoption in Indian cities is also extremely low," said Gururaj G, former director of NIMHANS.

The report also highlights shortcomings in vehicle safety, with more than half of the top 25 safety-rated cars in India receiving a child-occupant safety rating of just three stars or less. Additionally, pedestrian safety remains a significant concern, as over half of Indian children walk to school, and one-third of all child pedestrian fatalities occur at traffic intersections.

Zoya Ali Rizvi, Deputy Commissioner at the Ministry of Health and Family Welfare, underscored the need for improved trauma care facilities. "Children involved in road crashes often sustain severe injuries, making access to an ICU critical for survival. However, a recent AIIMS Delhi study found that only 20% of large government hospitals in India have pediatric ICU facilities."

Pratima Murthy, Director of NIMHANS, outlined the institution's role in injury prevention and trauma care. "Apart from preventive efforts, there is an urgent need for state-of-the-art polytrauma centres capable of handling both adult and pediatric road crash injuries—at least one for every three to five districts. NIMHANS is also planning a Level 1 polytrauma centre in North Bengaluru."

The report identifies key challenges, including the absence of fully functional road safety boards, limited funding, inadequate data systems, and poor inter-sectoral coordination. It also proposes a multi-sectoral action plan focusing on road safety management, vehicular regulations, school road safety initiatives, and post-crash care, urging government authorities, stakeholders, and the public to take immediate action.