The World Health Organization (WHO) Manifesto for Safe Communities states that "All human beings have an equal right to health and safety". The emphasis of the Safe Communities approach is on collaboration, partnership and community capacity building to reduce the incidence of injury and promote injury-reducing behaviours. Approximately 150 communities throughout the world have been designated as 'Safe Communities', in countries as diverse as Sweden, Australia, China, South Africa and the Czech Republic. Programmes target high-risk groups or environments and promote safety for vulnerable groups. They range from bicycle helmet promotion in Sweden to anti-violence programmes in South Africa, traffic safety initiatives in South Korea and indigenous community injury prevention programmes in New Zealand.

The review authors identified that only 21 of the Safe Communities have been the subject of controlled injury outcome evaluations. These communities are from two geographical regions: the European countries of Austria, Sweden and Norway and the Pacific nations of Australia and New Zealand, both of which have relative economic wealth, higher health standards and lower injury rates than many other parts of the world. Although positive injury rate reductions were reported for some communities, the overall results varied substantially and overall do not provide a clear answer to the question of whether the adoption of the Safe Communities model leads to a significant reduction in injury. Limited information is available about how the programmes were implemented, their impact on injury risk factors and sustainability. There were also substantial methodology limitations associated with most of the included evaluations. No evaluations were available from other parts of the world, particularly those with lower economic and health standards.