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Child and Adolescent Road Safety in South Asia
Low to lower-middle income nations bear 78 per cent of child road traffic injuries. Conversely high-income countries with robust safety measures account for just 3 per cent. This report outlines South Asia’s status country profiles assessment tools and guidance for effective action under the Safe Systems framework regarding child and adolescent road injuries. In 2019 injuries accounted for at least 9 per cent of the 12.2 million deaths in South Asia with approximately a quarter attributed to road traffic collisions. Among children and adolescents 171468 died from injuries with 29859 due to road traffic collisions the primary cause of injury-related death alongside drowning. The overall road traffic death rate was 6 per 100000 population though Afghanistan reported rates exceeding 16 per 100000. The region lost 2.5 million disability-adjusted life years (DALYs) due to such collisions among those under 20. With over 708 million children and adolescents in South Asia urgent governmental action is imperative given the substantial economic impact estimated to be billions of US dollars or 0.3 to 7.5 per cent of GDP. This report is intended to provide relevant information about the burden risk factors and interventions to address road traffic injuries among children and adolescents in the region. The target audience includes UNICEF staff in country and regional offices country level road safety and public health practitioners policy makers advocates and academics.
What puts children and adolescents more at risk?
Children and adolescents are more vulnerable to road traffic injuries than adults for a range of reasons. These reasons or risk factors can be classified as being non-modifiable or modifiable. In addition there are post-crash factors that place children at elevated risk of preventable serious injury or death in the event of being involved in road traffic crash.
Introduction
The 2018 WHO Global Status Report on Road Safety called for a ‘shift in the current child health agenda which has largely neglected road safety’ (1). The call for this shift is not new having been a central theme of the 2008 ‘World report on child injury prevention’ (2) but the burden of road trauma on the lives of children and their families continues to be huge. Road traffic injuries are a leading cause of death to children and young people worldwide (3).
What are good practices?
It is recommended that strategic planning for child and adolescent road safety follow three principles of best practice: Adopt a Safe Systems approach employ evidence-based child-specific strategies (alongside evidence-based all ages strategies) and include cost-effective interventions where possible. These principles are outlined below – and further details can be found in the documents listed in the section ‘Global attention and resources for regional action on child and adolescent road safety.
Why road traffic collisions need to be addressed
As the world struggles to address multiple global health issues it is possible to overlook the causes of death and disability that might be considered endemic. Road traffic injuries (RTIs) have been a leading cause of death of children over the age of one for many decades but we are now equipped with ample evidence to reduce this preventable cause of death and disability.
Child and adolescent road traffic situation in South Asia
The South Asian nations under the regional office of South Asia (Afghanistan Bangladesh Bhutan India Maldives Nepal Pakistan and Sri Lanka) have an estimated combined population of 1.856 billion or just under a quarter of the world’s 7.9 billion. This includes 708054 million children and young people under the age of 20.
Acknowledgements
This child and adolescent road safety report is a product of the UNICEF Regional Office of South Asia. The report was researched and prepared by Margie Peden Jane Elkington and Pratishtha Singh of The George Institute for Global Health.
Country profiles
Country specific information is included in the following profiles. The data included have been obtained from published information (see Appendix) and through a brief survey completed by UNICEF country surveys.
What should be done?
In order to reduce road traffic injuries and deaths among children in the nations of South Asia road safety decision-makers and practitioners should agree a strategic approach that will optimize lives saved while simultaneously addressing practical considerations costs and local policy and planning contexts.
Introduction
At a time when an unwarranted fear of the African migrant in the Sahel and across the Mediterranean Sea had taken over public narratives on immigration the first edition of the Africa Migration Report was published to change dominant discourses. The imperative was clear: we must “protect the millions of people who have been forcibly displaced by conflict and disaster and create opportunities for Pan-African solidarity rather than constrain them” (African Union and IOM 2020:10). This urgency remains as critical today as it was then because African people are on the move across the continent in search of both safety and opportunities. Beyond disasters and conflicts migration has always been “woven into the DNA of African communities economies and societies” (ibid.:3).
Missing migrants in and from Africa: A look into the data and policy gaps
More than 12000 deaths during migration have been documented in Africa since 2014 and at least 20000 African nationals have died or disappeared during migration worldwide. While these figures are certainly a gross underestimate of the true number of missing migrants in the African context they nonetheless indicate the urgency of addressing this issue. This chapter discusses the far-reaching impacts that these disappearances and deaths have on families and communities on the continent and beyond and urges action on three core areas: prevention of further deaths and disappearances; resolution of cases of missing migrants (including the identification of unknown bodies whose migratory status is undetermined); and support for families directly impacted by these tragedies. With tens of thousands of Africans directly affected by these tragedies across the continent the time for Africa to take the lead on resolving the crisis of missing migrants is now.
Acknowledgements
This second edition of the Africa Migration Report (AMR II) is a joint product of the African Union Commission (AUC) and the International Organization for Migration (IOM).
Human mobility trends in Africa: A snapshot of available evidence
Building on various data sources this chapter provides an overview of the main migration trends in Africa examines the impact of the COVID-19 pandemic on human mobility across the continent and analyses emerging and future needs to enhance the availability and quality of migration data. In 2020 in Africa there were an estimated 25.1 million international migrants which translated into having 1.9 per cent of the African population – or around one in 50 people – living outside of the country in which they were born. One of the key characteristics of African migration is that the majority of African international migrants do not leave the continent and mostly engage in intra-African migration. Refugee movements and internal displacements are also key features of African migration. The chapter further examines the need to enhance the collection and analysis of high-quality disaggregated accurate timely and reliable data which are crucial to ensure evidence-based policy and programming and provide insights or predictions about future trends. In recent years considerable progress has been made in this regard in Africa. However more investment in strengthening data ecosystems is needed while innovation closer collaboration and better coordination remain essential to respond to emerging data demands.
Foreword
The world is moving away from the anxieties and uncertainties of the COVID-19 pandemic though Africa is still confronted by remnants of the unprecedented scale of challenges that the pandemic brought. This second edition of the Africa Migration Report (AMR) highlights the fact that migration and human mobility were at the core of the global response as border posts became a focus for health policy decisions and travel restrictions.
Human mobility and climate change in Africa
Across Africa seasonal mobility has long been used as an adaptation mechanism to deal with climate variability as well as a risk management strategy to manage in unpredictable and extreme environments. Disasters the adverse effects of climate change and environmental degradation combined with structural factors however led to the erosion of pastoralism and undermined the mobility of transhumant herds. At the same time new displacements were triggered and millions more have moved or are seeking to move in a changing climate. In that context the African Union and the International Organization for Migration signed in 2022 a three year agreement to strengthen policies and institutional frameworks consistent with the United Nations 2030 Agenda for Sustainable Development and the African Union Agenda 2063. One of the key thematic areas of this agreement addresses migration and climate change. This chapter looks at the interlinkages between human mobility disasters the adverse effects of climate change and environmental degradation in Africa. It further looks at the policy advances made by the African Union and by regional and national bodies as well as at the challenges and gaps that remain. Finally the chapter looks at solutions implemented for people to move for people on the move and for people to stay in a changing climate in Africa.
Regional integration and migration governance in Africa
Cooperation on migration governance in Africa has been shaped through key policies adopted by the African Union regional economic communities (RECs) and national governments. The three levels at which migration governance policies are framed and implemented are through cooperation between African Union Member States between REC member States and through relations between respective governments. The importance of migrations is indicated by the fact that free movement of persons is one of the eight dimensions used to rank the progress of RECs and African countries in regional integration in the Africa Union’s Multidimensional Regional Integration Index (African Union 2021). This chapter summarizes and analyses the various governance policies in place explores some of the emerging opportunities and challenges presented by rising international migration within and from Africa and suggests policy options to take advantage of the opportunities and confront the challenges presented by greater volumes of migration.
Free movement of persons, informal trade and the African continental free trade area
Nearly 85.8 per cent of Africa’s employed population works in the informal sector. In some countries in sub-Saharan Africa the informal sector accounts for over 90 per cent of employment while informal output is as high as 62 per cent of official GDP. Despite this large size and its contribution to the growth of African economies the sector remains significantly untapped. The African Continental Free Trade Area (AfCFTA) can play a significant role in optimizing the benefits of informal trade particularly informal cross-border trade. For this to happen however the AfCFTA would need to be accompanied by the liberalization of the movement of persons across borders through the elimination or at least the reduction of the stringent travel requirements. This chapter analyses how the AfCFTA impacts informal trade particularly informal cross-border trade. It also highlights how the free movement of persons can help Africa maximize the benefits of informal cross-border trade and in the long run integrate the sector into formal structures of trade for sustainable economic growth.