Objective/setting To provide a population-based analysis of childhood road traffic injuries (RTI) in two communities of the greater Accra region of Ghana, with the goal of establishing an RTI incidence baseline in these communities and to identify RTI characteristics in order to model a targeted injury prevention programme.

Study design Geographical cluster sampling was performed in two separate communities with household surveys administered in person to determine a denominator. The guardian responsible for any household members below the age of 15 years involved in an RTI within the previous 12 months received an in-depth questionnaire. Demographics, incident characteristics, medical attention, injuries and disability days were noted. These are described and compared with injury severity and age-specific tendencies.

Results 5128 children were interviewed in 60 clusters. Of them, 172 were involved in an RTI within the previous 12 months. This resulted in a rate of 34 RTI/1000 person-years, and 43 RTI/1000 person-years in the 5–14-year-old age group. RTI involving a mini-bus taxi, as a pedestrian, correlated with a disability of greater than 30 days, as did fractures. 35.8% of injuries occurred at sunset. Most RTI occurred on a highway and involved the lower extremities. There were two deaths resulting in an incidence of 39.0/100 000 person-years.

Conclusion Childhood RTI in this urban west African setting are a major source of disability. Specific injury circumstances are reviewed in detail. This study provides baseline incidence data that may be used to measure injury prevention efforts and to validate secondary data sources.