School children form majority of injured children on Ghanaian roads. The objective was to observe the road use behaviour of public primary school pupils in Ablekuma Education Circuit, Accra. This unobtrusive observational study targeted Primary one to six pupils. Five behaviours were studied: Walking while crossing road; Stopping at the kerb; Looking left-right-left before crossing; Keep looking left-right-left while crossing and Facing traffic while walking. 882 pupils on their way to or from school were observed from eight schools. A little over two in three children stopped at the kerb before crossing the road while almost three in four children looked for cars before stepping off the kerb. A little over three in four children walked while crossing and less than one in four children kept looking while crossing. Not looking for cars before crossing, not facing on-coming traffic and not keeping looking for cars while crossing, were more associated with boys than girls (p < 0.001; 95%CI in all cases). Girls behaved significantly more safely than boys. In stopping at the kerb, there was no difference in gender behaviour (p < 0.135; 95%CI). Child Road Safety Education in Schools and Communities is recommended.
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