Background Globally, thousands of children lose their lives to unintentional injuries every year. Injuries occurring at home to under 5s (burns, falls, poisoning) can be prevented through providing safety equipment e.g. barriers and childproof containers. Although studies have shown significant reductions in child injuries most have been conducted in high-income countries. Child injuries encompass complex social determinants of health that require researchers to move beyond traditional study designs carrying out research on end-users to a systems-thinking approach that works with the communities through mutual learning and co-design. Community-Based Participatory Research (CBPR) is an approach that prioritises translating knowledge to action in a manner that enables researchers to work equitably and ethically in long-term partnerships with the community.

Methods We present findings from an innovative CBPR study that integrated quantitative and qualitative methods to empower mothers, carers and local engineers to take mutual ownership of the research and help develop solutions that were culturally appropriate and feasible.

Results The journey from conceptualisation to dissemination is presented demonstrating how, through an iterative systems-thinking approach, the research design was continuously adapted to reflect new knowledge gained. Local engineers worked with the research team co-designing a set of safety interventions with the mothers themselves. Ways in which the local economy could be supported through the use of locally sourced materials and skills were investigated.

Conclusion To our knowledge, this is one of the first studies highlighting the importance of integrating CBPR with a systems-thinking co-design approach to child unintentional injury prevention in low-income settings.