Background Over 875 000 deaths occur annually in children under the age of 18 due to unintentional injuries. Children under 5 years spend the predominant part of their day at home—an environment that poses the greatest amount of risk for their safety. Despite this risk, home-based injury prevention campaigns are primarily a westernised concept. Understanding caretaker perceptions of home safety and injury risks in low-income countries is central to effective prevention efforts.

Aims/Objective/Purpose The objective of this study was to understand caretaker perceptions of childhood home safety, injury risk, and optimal mechanisms for dissemination of childhood home safety prevention information in Karachi, Pakistan.

Methods In-depth interviews and focus group discussions were conducted with caretakers in multiple communities in Karachi, Pakistan. Data were coded by two independent coders, themes were identified, and a theoretical framework was developed.

Results/Outcome Thirty in-depth interviews and ten focus group discussions were conducted. Caretakers correctly identified risk factors and home safety hazards; however, they noted several barriers to addressing them such as financial hardship, lack of decision-making power as women, pressure from extended family living in the household, and lack of simple safety solutions. Caretakers felt that community campaigns via TV/radio could help change household attitudes toward prioritising child safety.

Significance/Contribution to the Field Caretakers in low-income countries like Pakistan are aware of home injury risks and safety hazards for children under 5; however, lack of community awareness and financial constraints make change difficult. Social campaigns should target decision-makers within households and emphasise low-cost solutions.