Background Globally, around 950 000 children under age of 18 years die due to injury and violence each year. The rate of child injury death is 3.4 times higher in low- and middle-income countries than in high-income countries.

Objectives To study injury mortality patterns among children under 5 years of age in Pakistan.

Methods DHS in Pakistan was conducted from September 2006 till February 2007. It included 95 000 households. Child Verbal Autopsy Questionnaires (CVAQs) was administered to households which had death of a child under age 5 from January 2005 onwards. A total of 3232 CVAQs were administered, of which 3101 were completed.

Results The main causes of child deaths (the probability of dying between the first and fifth birthday) were diarrhoea (17.7%), pneumonia (16.9%) and injuries (11%). Out of 3101, 90 (2.9%) injury mortalities were reported in children under 5 years. Ratio of injury mortality in urban versus rural areas was 1:3.5. Respondents were mostly parents (67.7%) and illiterate (74.6%). Injury mortalities were common between ages of 15 years (77.8%) and among males (52.2%). Overall, mortality was due to drowning 20 (22.2%), road traffic injuries RTIs 11 (12.2%), fall 11 (12.2%). Mortality in children under 1 year was commonly due to RTIs (5.6%). Frequent injury mortalities between 1 and 5 years were drowning 18 (25.7%) and fall 11 (15.7%). RTIs (19.1%) in boys and drowning (30.2%) in girls were common causes of mortality.

Conclusion Injuries are the third most common cause of mortality in Pakistani children between ages 1 and 5 years.