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Child Safety Report Cards: inconsistency in policy adoption across 31 countries

Countries need to increase adoption of proven child safety policies to protect Europe’s most vulnerable citizens and future society

STRASBOURG, France, 12 June 2012 – Injury is the leading cause of death, disability, burden and inequity for children in Europe. It remains a leading cause of death for children and adolescents in every Member State in Europe, with some of the lowest and highest country death rates for child injury in the developed world.

“A child dies every hour of every day in the EU as a result of an injury”, says Joanne Vincenten, Director of the European Child Safety Alliance. “Consistent use of proven prevention strategies across the EU could save most of these lives.  It would also save billions of Euros spent each year on treating injuries and would allow children and adolescents to grow up to be healthy and active contributors to future economic growth in Europe.”

Released today are Child Safety Report Cards for 31 countries and a European Summary Report Card that score countries on their level of adoption, implementation and enforcement of over 100 proven strategies and policies to prevent unintentional injury – good practices known to save children’s lives.

This is the third round of report card assessments to be conducted by the European Child Safety Alliance, with 18 countries participating in 2007, 26 in 2009 and now 31 in 2012. A trend analysis for countries participating from 2007 to 2012 found a significant improvement in overall country scores. Encouragingly some of the greatest improvements are in countries where investments in prevention have been made in the last five years (e.g., Czech Republic, Finland, Hungary, Scotland and Spain). A decrease in overall score since 2009 in Greece probably reflects the economic crisis in that country and may signal a risk of erosion in the progress made on child safety in other countries as austerity measures are put into place.

Overall countries have greater uptake of transport related policies than those related to the prevention of home injuries. As home injuries are a leading cause of child injury hospitalisations and emergency room visits, efforts to enhance the adoption, implementation and enforcement of proven policies to reduce drowning, falls, burns and scalds, poisonings and choking/strangulation need to be given the same level of commitment and resourcing as transport related policies.

To date no country has adopted all the recommended safety measures. There is room for improvement across all countries, particularly given the inequalities between countries with over 6 times difference in unintentional injury rates between countries with the highest and lowest rates.  Differences between countries’ overall report card scores are also large, ranging from 14.5 to 45 points out of a possible 60 points. “The burden of childhood injuries falls disproportionately on children from disadvantaged groups and in countries undergoing the greatest socioeconomic changes”, states Dr. Dinesh Sethi of the World Health Organisation. “This unequal distribution of injuries threatens to further widen the gap in health inequalities between and within countries and causes social injustice.”

Examples of inconsistent adoption across the 31 participating countries highlighted by the Child Safety Report Cards include:

  • Only 13 countries (42%) have a national helmet law requiring use of a bicycle helmet while cycling, with seven of those laws coming into effect since the first report card assessments. However, only 8/13 report that the law is fully implemented and enforced. 
  • No country has a law requiring children to use a rear facing child passenger restraint to age 4, although this is normal practice in Sweden where child passenger deaths in this age group have been reduced to almost zero.
  • Only 7 countries (23%) have a national law requiring barrier fencing for private pools, but in only one (France) is the law fully implemented and enforced and that law allows a choice of prevention measures of which barrier fencing is only one.
  • Only 15 countries (48%) have a national law requiring child resistant packaging of medications and of those, three report the law is not fully implemented and enforced
  • Only 16 countries (52%) have a national law requiring environmental changes to prevent children from falling out of windows in buildings with more than one storey/level (e.g. window guards), but for over half of those the law only applies to new buildings or renovations.

European Commissioner for Health and Consumer Policy, John Dalli, acknowledges the great burden that child injury places on children in the EU. “I believe we must do everything we can to ensure the safety of the youngest and most vulnerable members of our society across Europe. This is why the EU Health programme supports initiatives to reduce accidents and injuries.  Deaths caused as a result of childhood injury cause unimaginable suffering for the families left behind. The European Union and its Member States must cooperate and act to ensure the right of all children to safety.  The uptake of evidenced based strategies shown in these report cards can help in improving child safety.“ 

The addition of four new countries for the 2012 Child Safety Report Cards means there is now a baseline measure of the uptake of proven safety policies in all 27 EU Member States (plus Croatia, Iceland, Israel, and Norway) from which progress over time can be measured.  However that is not enough – current efforts at evaluating progress are hampered because few policies are currently monitored as to their impact.

Impact assessment of policy is crucial but it just isn’t happening”, states Malcolm Harbour MEP, Chairman of the Internal Market and Consumer Protection Committee. “Monitoring needs to be incorporated before a policy is put in place to ensure that the necessary data for measuring impact are available. This will require the cooperation and commitment of many sectors, but it is a critical gap right now and without it we cannot demonstrate which child safety policies are having the most effect.”

Protecting children is an investment that will save money now and in the future. "Injuries and accidents are a significant problem for children in the region and it is time governments put in place more focused interventions to address this issue.  UNICEF is supporting countries to empower families to protect their children", states Octavian Bivol, UNICEF Regional Health Advisor for CEECIS.

To date investment in child injury prevention from all relevant sectors at the national and European levels has not been commensurate with the size of the problem. Ensuring children’s right to safety will provide support to raise the level of health, well being and growth for European children and society at large.

For further information, please contact:

Joanne Vincenten, Director, European Child Safety Alliance
Mobile + 49 160 533 7016



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