Affordability and Availability of Child Restraints in an Under-Served Population in South Africa

Area of Science:

• Public Health
• Road Safety
• Pediatric Injury Prevention

Background:

• Child road traffic injuries are a significant global health issue, disproportionately affecting middle-income countries like South Africa.
• Injury death rates for children under 5 are 41 per 100,000, and for 5-14 year olds, 24.5 per 100,000.
• Despite the known effectiveness of child restraint systems (CRS), their usage rates remain low in South Africa, with limited understanding of barriers in low- and middle-income countries.

Purpose of the Study:

• To assess the usage rates of child restraint systems (CRS) among child passengers in Cape Town.
• To explore parental knowledge and perceptions regarding child restraint legislation, ownership, and cost.
• To identify barriers to the adoption and consistent use of CRS in South Africa.

Main Methods:

• Observational studies were conducted in seven Cape Town suburbs over three months.
• Parent and carer surveys were administered to gather data on knowledge and perceptions.
• Factors associated with higher CRS use, such as driver seatbelt use and single child occupancy, were analyzed.

Main Results:

• Only 7.8% of child passengers were observed to be correctly restrained in a CRS.
• While 92% of surveyed parents knew of child restraint legislation, only 32% could correctly state age requirements and penalties.
• Primary reasons cited for not owning a CRS were high cost and the belief that adult seatbelts were sufficient.

Conclusions:

• Stricter legislation, increased fines, and enhanced enforcement of both adult seatbelt and CRS use are recommended.
• Initiatives such as subsidized CRS, borrowing schemes, and targeted social marketing are crucial for increasing CRS ownership and use.
• Addressing cost barriers and improving public understanding of CRS benefits are essential for reducing child road traffic injuries.