An observational survey of child car safety practices in private pre-primary and primary schools in two local government areas of Lagos State, Nigeria.

OBJECTIVE To describe child car safety practices among children aged 0-8 years. Eight schools from two local government areas (LGAs) were selected by simple random sampling. Passenger cars were observed for child seating position and restraint use at each selected school as children were being dropped off in the morning. RESULTS Observed child restraint use was very low, as was the rate of appropriate restraint for age (10.8% and 4.2%, respectively, in Eti-Osa, and 7.0% and 1.8% in Ikeja). Child restraint use decreased with increasing age group from 25% in those below 1 year, to 12% in those aged 1-3 years, and 7.4% in those aged 4-8 years. A large proportion of restrained passengers were inappropriately restrained in a seatbelt alone. Front seating among observed child passengers was not as high as in studies from similar environments (9.4% and 17.5% in Eti-Osa and Ikeja, respectively). Factors associated with child restraint use were number of child passengers in car, and whether or not the driver wore a seatbelt. Seating position of the child was significantly associated with the relationship of the driver to the child, and driver's gender. CONCLUSION The level of child restraint use observed in this study is unacceptably low. The relatively low prevalence of front seating while riding in cars should however be further reduced. The study recommends the enactment of specific country legislation on the use of child restraints, accompanied by multifaceted intervention programmes to improve the availability and use of child car safety seats and booster seats.