A qualitative study to assess dynamics of major injuries in children and adolescents of a rural area of Delhi

Background: Childhood injury constitutes a grave public health problem. Most of the unintentional injuries and their consequences are preventable. Present study highlights the dynamics related to major injuries in children. Methods: This is part of a prospective research conducted over 16 months, on 397 children and adolescents of rural Delhi. Present report includes those with major injuries. Data was collected by in-depth interview of subjects with major injuries, and their guardians. Results: Five major injuries occurred during study period. Thus incidence of major injuries was 1.26/100 children/year and proportion of major injuries out of total injury events was 2.89%. There was no fatality or disability. Socio-demographic risk score was high for 4 out of the 5 children. All subjects were adolescents, of whom 3 were boys and 2 girls. All injuries were of locomotor system, with two cases having multiple glass-cut injuries in addition. All injury events had occurred when subjects were away from home, of which three occurred on road, due to unclean surroundings in one case and two by motor vehicle accidents due to inexperienced drivers, of less than legal age for driving, and on alcohol. Treatment was taken from secondary care hospitals by all injured subjects. Mean cost of treatment was Rs.5,009/-, with total out-of-pocket expenditure being Rs.7,212/- (mean=Rs.2,404/-). Mean time to recovery was a little over 1 month (32 days). Conclusions: All the major injuries that occurred in the study population could have been prevented by taking responsibility at various levels.