Background The Child Safety in Motor Vehicles Act in the Philippines prohibits children under 12 years from sitting in the front seat of motor vehicles and mandates appropriate child restraint systems (CRS) use. While the Act has not been fully implemented, it has received media backlash and has been framed as ‘anti-poor’ among the public.

Objective Assess the accessibility, affordability, and quality of CRS sold in the Philippines.

Methods CRS were observed in 44 randomly selected physical stores across Manila, Pasay, and Quezon City. A census approach was taken to capture online postings of CRS in the most popular e-commerce sites in the Philippines. Descriptive statistical analyses were conducted, and frequencies and percentages of the number, type, prices, and product standards of CRS were reported.

Results The number of CRS observed at physical stores was lower (N=91) compared to CRS being sold at the e-commerce sites (N=4,334). The mean prices of CRS sold on the online market were remarkably higher (105 USD – 482 USD) than the price in physical stores (7 USD – 260 USD). All the CRS observed in physical stores had product standards indicated by means of a license, certificate, or sticker, whereas only 10% of CRS sold online had product standards indicated. The majority (71%) of CRS sold online did not specify dates of manufacture and expiry, while 81% of the CRS observed in physical stores had manufacture dates and 31% had expiry dates indicated. Maximum height limits were less commonly specified among the CRS observed across both physical (20%) and online (3%) stores.

Conclusion While CRS are available in both the physical and online markets, those sold online were more expensive, thus ‘anti-poor’, and lacked verification of quality. This could deter CRS use and pose an increased risk for road traffic injuries among children traveling in motor vehicles. Multisectoral coordination is required to set adequate quality control regulations for CRS sold online, equitable prices, and provide financial incentives to improve CRS affordability and quality. In addition, coordinated media campaigns are needed to increase awareness about the effectiveness of CRS in reducing fatal and non-fatal injuries.