A growing body of evidence has recognised cities as optimum sites in which to conduct injury prevention research. However, there appears to be an absence of a systematic review of city-level studies in the literature. International experience has shown that injury prevention programmes coordinated at city level can have a significant impact in reducing injuries, and this has important implications for local economic growth and business investment. This overview includes available South African and international city-level studies emphasising those city-level initiatives that focused on the prevention and control of violence. It also highlights the challenges and opportunities that have emerged from the implementation of injury prevention programmes at city level. A key finding is that documented city-level injury prevention initiatives are scarce, and that evaluation, a critical component of any injury prevention programme, is missing from those articles that do exist. Without an evaluation of the implemented initiative there is no accurate way to accurately the initiative's success in reducing injury-related morbidity and mortality, or its ability to enhance the adoption of safety practices. This indicates a clear need for more investment in evaluating injury prevention strategies at city level. Intervention methods piloted at city level were not reflected in the literature, illustrating a lack of collaboration between science and society, policing and research, and the prevention sector in general. By drawing on the lessons provided by international city-level injury prevention initiatives, the article concludes by suggesting the possible replication of cost-effective preventive measures, and evaluates some of the strategies for the conceptualisation and implementation of city-level injury prevention initiatives in South Africa.
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