Children in developing countries are exposed to greater risk of fatality, serious injury, or disability, during road travel due to lack of awareness and absence of laws on children road safety measures such as the use of child restraints in vehicles. In most of the developing countries, it is not required by law, to use child car seats and therefore are rarely used. Research studies have been repeatedly showing significant efficacy of child car seats, if properly used, in preventing serious injuries and fatalities in young children during road accidents, due to restraining the children occupants against the ejection from the vehicle.

Like many other developing countries, there is currently no legislation, in Pakistan, mandating the use of child car seats. Children exposure to traffic and risk of being involved in a traffic accident have been greatly increased in the country, over the past few years, due to increased number of vehicles, vehicle fleet, and trend of pre-schools and day care facilities. However, the awareness of parents regarding importance of safely traveling with infants and young children has not increased. Qualified and affluent parents have also been observed showing negligence in using the car child seats for their children.

In this context, the objectives of this study were to investigate the level of awareness and usage of child car seats in Pakistan as well as to explore the need and interventions for conducting effective awareness campaigns or educational programs for parents in the country. Total 214 vehicles with children occupants and 385 children were observed at several schools, day-care centers, and pediatric departments in hospitals within 3 cities of Pakistan.