Background Child injury at home has become a growing concern in developing countries. This project aims to evaluate the effectiveness of two intervention strategies—home-based safety tutorial program and educational pamphlet—to reduce in-home hazards for unintentional child injuries within the home in Malaysia.

Methods We conducted a prospective cluster randomised controlled trial in Hulu Langat district, Malaysia. We randomised 59 clusters to two study arms (30 for tutorial and 29 for pamphlet) with 30 households per cluster. On an initial household visit, a baseline home safety hazard assessment was conducted, followed by the intervention and two follow-up visits at 2 and 4 months. The outcome measures are in-home hazards for child injuries, and incidence of child home injuries.

Results The study enrolled 1170 households, with 13324 children 1–5 years of age. Overall, almost 40% (5061) of children experienced an injury at home in the 3 months preceding our initial visit. The three most common types of injuries reported were falls (86.2%), poisoning (2.9%), and animal bites (2.1%). The most common types of safety hazards for such injuries observed were having pedestal fan within reach of children in living/sleeping area (tutorial: 45% vs. pamphlet: 46%, p = 0.13), presence of open buckets of water (45% vs. 44%), and having lock of the bathroom door within reach of children (41% vs. 45%). Adjusting for socio-demographic factors at household level and caregiver characteristics, estimates of a generalised linear model fit showed that presence of open buckets of water significantly predicts child injuries (OR = 1.8, 95% CI: 1.4–2.4).

Conclusions The study improves understanding of the burden of household injuries among children in a Malaysian district, and findings can guide intervention strategies for addressing home injuries among children. Materials and interventions developed in this study can be adapted to other settings.