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Unintentional injury deaths among children younger than 5 years of age in India: a nationally representative study
  1. Jagnoor Jagnoor1,2,
  2. Diego G Bassani1,
  3. Lisa Keay2,
  4. Rebecca Q Ivers2,
  5. J S Thakur3,
  6. G Gururaj4,
  7. Prabhat Jha1,
  8. for the Million Death Study Collaborators
  1. 1Centre for Global Health Research, Li Ka Shing Knowledge Institute, St Michael's Hospital, and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
  2. 2The George Institute for Global Health and Sydney School of Public Health, University of Sydney, Sydney, Australia
  3. 3School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  4. 4National Institute of Mental Health and Neuro Sciences, WHO Collaborating Centre for Injury Prevention and Safety Promotion, Bangalore, India
  1. Correspondence to Professor Prabhat Jha, Centre for Global Health Research, LKSKI St. Michael's Hospital 30 Bond Street, Toronto, M5B 1W8, Canada; cghr{at}


Objective To determine the mortality burden associated with unintentional injuries among children younger than 5 years of age in India.

Methods The Registrar General of India conducted verbal autopsy for all deaths occurring in 2001–2003 in a nationally representative sample of over 1.1 million homes. These verbal autopsy reports were coded by two of 130 trained physicians, who independently assigned an ICD-10 code to each death. Discrepancies were resolved through reconciliation and, if necessary, adjudication. The probability of death during the first 5 years of life (per 100 000 live births) was estimated from the 2005 United Nations' population and death estimates for India, to which the proportions of deaths from the mortality study were applied.

Results Unintentional injuries were the sixth leading cause of death among children under 5 years of age. In 2005, unintentional injuries led to 82 000 deaths (99% CI 71 000 to 88 000) among children under 5 years of age, a mortality rate per 100 000 live births (MR) of 302 (99% CI 262 to 323). Mortality was higher in rural areas (MR=339, 99% CI 282 to 351), mostly due to more drowning deaths, than in urban areas (MR=173, 99% CI 120 to 237), where falls were the leading cause of child injury mortality.

Conclusion Unintentional injuries, specifically drowning and falls, lead to substantial mortality in children younger than 5 years of age in India. There is a need for continued monitoring of the injury burden and investigation of risk factors for evidence-based effective injury prevention programmes.

  • Child
  • developing nations
  • public health
  • surveillance

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  • See Editorial, p 145

  • Funding External funding is from the Fogarty International Center of the US National Institutes of Health (grant R01 TW05991–01]), Canadian Institute of Health Research (CIHR; IEG-53506), International Research Development Centre (Grant 102172), and Li Ka Shing Knowledge Institute St Michael's Hospital, University of Toronto (CGHR support). PJ is supported by the Canada Research Chair program.

  • Competing interests None.

  • Ethics approval The SRS enrolment is on a voluntary basis, and its confidentiality and consent procedures are defined as part of the Registration of Births and Deaths Act, 1969. Oral consent was obtained in the first SRS sample frame. The study has been approved by the review boards of the Post-Graduate Institute of Medical Education and Research, St Michael's Hospital, and the Indian Council of Medical Research's Health Ministry's Screening Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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