Injuries in children are a serious health problem that has not received the attention it deserves.
Road traffic injuries are the commonest cause of death in children aged 1-18 years in Malaysia and also a leading cause of disability for children.
Between 900 to 1000 children, below the age of 18 years, die every year on the road in Malaysia (Sharon LL, Amar-Singh HSS, Tan Pui-San, Lina Hashim. A Review of Child Road Safety Efforts in Malaysia. Clinical Research Center Perak, 2012).
Four times as many (~4,000) each year get significantly injured, so as to result in a permanent disability. Injury rates have gradually risen over time and existing national prevention campaigns have been inadequate for children.
Carrying a child on your lap is hazardous as you add your body’s momentum to the child and, during a crash, this will worsen the injuries sustained.
The use of child safety seats (child restraint systems) is vital to protect children carried in car. International data shows that the use of child safety seats in cars can reduced deaths and injuries from between 70-80 per cent. Other child restraint systems like the use of booster seats with seat beats can reduce the risk for serious injury by 45-50 per cent for older children.
Currently, from a number of studies, between 15-25 per cent of parents in Malaysia use child safety seats for children under 5 years in Malaysia. In one study, conducted in 2016 by the Clinical Research Center Perak, of 966 vehicles carrying children under the age of 5 years, only 15 per cent has a car seat in place (see image: Plate 1).
It is hence vital that we have legislation to enforce the use of child safety seats (child restraint systems). As a nation we are long overdue for implementing a compulsory car seat legislation and programme.
No doubt such a move will have its challenges and obstacles, but the rewards to child safety and mortality reduction are enormous. We would like to share a number of issues that need to be considered as well as suggestions for making this policy successful for the safety of our children.
Ensuring The Child Safety Seat Is Used and Used Correctly
In the study mentioned above (see image: Plate 1) of the families with a child safety seat, 43 per cent of children under 5 years were NOT in the seat. The seat was used to store shopping, toys and goods. This defeats the purpose of have a child safety seat to protect your child.
Of the parents who were using the child safety seat, about half did not use it correctly, hence not providing adequate protection to their children. Hence not only legislation but enforcement is necessary to make sure that those that have a child safety seat actually use it and use it correctly.
It also means that child safety seat manufacturers, government agencies, NGOs and the general public have a role to educate parents on the proper use of these items as well as encourage their use.
Ensuring The Child Safety Seat Purchased Is Reliable
Child safety seats are not cheap and reliable ones cost approximately RM400-500. Hence many parents will resort to buying them online.
In another study, conducted in 2018 by the Clinical Research Center Perak (see image: Plate 2), of 193 parents with newborn children, 88 per cent of them were aware of the need for child safety seats and 57 per cent had already purchased a device for their current baby.
The majority paid RM250 for the child safety seat, many buying them from online portals. Not all the child safety seats (child restraint systems) sold on these online portals are reliable or safe to use.
It is vital we educate parents on how to purchase a good, quality child safety seat. Relevant government agencies should work with online shopping portals that deliver to Malaysia to only sell reliable devices.
Ensuring That The Most Vulnerable Child Is Protected
We understand that one of the most important issues in the implementation of mandatory child safety seats is large-sized families.
While we understand that this issue cannot be easily reconciled, authorities should enforce that families, at the very least, have the youngest child or infant protected by a car safety seat.
In the long term we must ensure that all children are transported in a car safety seat, whatever the size of the family.
Measures We Can Take to Promote The Use of Child Safety Seats (Child Restraint Systems)
Our research shows that more than 90 per cent of parents interviewed want compulsory child safety seat legislation (see image: Plate 2). But some require assistance to make the implementation happen.
There are a number of viable mechanisms to promote the use of child safety seats (child restraint systems). One mechanism that has been used in the past is a car seat rental programme. In the 1990s the two of us assisted Automobile Association of Malaysia’s launch of their car seat rental programme.
Car seat rental may be useful for a segment of the population. It is also vital that the government remove any import tax on child safety seats (child restraint systems) to make them more affordable.
Possibly, the most powerful mechanism is to ensure that all automobile manufacturers offer a child safety seat as a mandatory (compulsory) accessory with the purchase of every car.
This is to be done without increasing the price of the car. It should be seen as part of the corporate social responsibility of each automobile maker.
Currently, most car manufacturers make a decent (sizable) profit from the consumer and it is time to give back. We proposed this to the then transport minister in the early 1990s but sadly the idea was dismissed as impractical.
The issue was that some who buy cars do not have children. But this suggestion is very viable and those who do not have children can easily give the device away to grandchildren or donate it to friends, family or those who cannot afford such devices.
We appeal to the government to enforce a child safety seat provision as a mandatory accessory with the purchase of every new car.
Finally it time for Malaysians to step up. Those with old but serviceable devices can give them to poorer parents. We can also support each other by buying them as a gift for a young couple that is having a new baby.
Organisations and companies can use their corporate social responsibility mechanisms to support poorer families. Taxis and e-hailing vehicles could be encouraged to have a child safety seat in their boot for use.
To go one step further, the e-hailing application should have options for request of child seats/s.
In summary, no child in car should be transported in a vehicle without a child restraint system. We need the sale of reliable devices that are affordable with mechanisms to support poorer families.
Making it a mandatory with the purchase of a new car is a vital mechanism.
Our long overdue legislation to support this programme has arrived and Malaysians need to embrace it for the benefit of our children.
In some countries your newborn baby cannot go home from the postnatal ward (hospital) after delivery without a child safety seat and that is the standard that we should strive for in Malaysia.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.