A comprehensive view of factors influencing child passenger safety in low- and middle-income countries

Despite the recent decline in child deaths caused by road traffic crashes in high income countries, low- and middle-income countries (LMIC) have yet to experience a similar trend. Children are among the most vulnerable of road users accounting for 30–40 % of all road traffic deaths in LMICs, 50 % of which are vehicle occupants. Previous research suggests that children ages 0–9 are the second most vulnerable age group in Ghana with 54 % of the children being fatally injured in injury-related crashes. However, little has been done to identify the associated factors influencing injury severity outcomes for child passengers in Ghana. This study investigates the factors that are associated with the various injury severity outcomes for child vehicle occupants less than 9 years old involved in road crashes in Ghana from 2014 to 2020. Results indicate that older child passengers (aged 5–8) were associated with lower injury severities compared to younger passengers. Additionally, crashes in which the driver sustained more severe injuries resulted in a higher likelihood of the child passengers sustaining a fatal injury. Findings from this research emphasize the issue of child passenger safety and support transportation policy and decision making to reduce risks of injury for child passengers. • Child passengers younger than 5 years are more likely to sustain higher severity injury than their older counterpart. • Child motorcycle pillions and those ejected in a crash are more likely to sustain severe or fatal injuries. • Child passengers are more likely to sustain fatal injury in crashes that the driver sustains at least a severe injury.