Background Unintentional injuries are a growing global public health problem that causes mortality, morbidity and disability among children. These injuries are most common among under-fives and form a significant burden on healthcare systems, particularly in low and middle income countries. Parents, health professionals, and key peoples have a major role to play in the prevention of home injuries, as expressed in many international reports. In Palestine there is a paucity of research in this area. Moreover, most previous studies adopted quantitative approaches to investigate particular aspects of injuries. Therefore, this study aimed to explore parents’, health professionals’, and key people’s perceptions and practices regarding the prevention of home injuries among children aged under-five years, and the potential factors that might influence such practice in Ramallah district.

Methods A case study approach was followed, whereby three parental case studies scenarios were obtained from those who live in camp, rural, and urban settings within Ramallah District. Semi-structured interviews were undertaken with twelve mothers in three setting and their homes were observed (four mothers in each setting). The context that surrounds them was investigated by interviewing twenty-four health professionals who worked with children in a primary health care setting, and nine key people who worked as senior level managers within organisations concerned with children. The derived data were analysed using thematic analysis, and a template was used for the analysis of multiple case studies.

Results Parents were involved in trying to prevent child home injuries and many similarities were noticed between the perspectives of parents within the three case studies. However, many factors affected their practice and these were mainly related to lack of awareness and low financial status. Environmental factors influenced injury prevention, including: the physical environment of the house, socio-cultural environment (e.g. belief in fatalism), as well as governmental policy (e.g. lack of home safety regulations). Most of the health professionals and half of the senior managers interviewed were positive toward preventing home injuries, but workload and lack of training were the main barriers to their practice in this area.

Conclusion The evidence from this thesis shows that the causes of home injuries in Ramallah District are embedded within the families’ culture, social and economic status, and are influenced by government policies and the surrounding physical environment. The study supports the usage of multiple intervention strategies within a holistic approach that acknowledge these factors to prevent any future home injuries.