Background The accelerated annual increase of car ownership by over 10% in Vietnamese families has brought to light the alarming absence of regulatory frameworks governing Child Restraint Systems (CRS). Particularly concerning is the widespread practice of allowing young children to occupy the front seat without any safety measures. A 2019 observational study underscored the gravity of this issue, revealing that a mere 4 out of 10,000 vehicles were equipped with child safety seats, and a staggering 95% of drivers perceived such seats as unnecessary.

Objective This study was conducted to amass compelling evidence supporting the formulation of comprehensive policies concerning Child Restraint Systems in Vietnam.

Methods Conducted as a mixed-method study during the period of 2021 - 2022, the research employed various methodologies including literature reviews, market surveys, parental Knowledge, Attitudes, and Practices (KAP) assessments, on-site observations of CRS usage, and key informant interviews with relevant stakeholders.

Results An observational study involving 14,924 private cars, of which 7.4% had children aged 0 to 10, revealed that over 42% of parents permit their children to sit in the front seat, with 19.2% being held by an adult. The utilization of Child Restraint Systems (CRS) is notably low across all three observed cities (Ho Chi Minh City, Hanoi, and Da Nang), accounting for only 1.3%, with the highest usage in Hanoi at 2.6%, and a mere 0.4% in Da Nang. Surveying 756 parents and caregivers indicated that over 50% possessed prior knowledge of CRS. Regarding the safest seating position for children in cars, 36% believed the back seat to be the safest, 28% opted for the front seat, and 27.8% considered specialized safety devices as most appropriate. Regarding the necessity of mandatory CRS regulations, a significant 75.4% expressed support for such legislation.

Conclusions The series of studies conducted unveiled critical insights into the existing state of CRS utilization, encompassing market availability, parental KAP, and on-site observations of CRS usage. This evidence has played a pivotal role in advocating for policy development, providing lawmakers and stakeholders with a robust factual basis for comprehensive Child Restraint System regulations.