New Zealand has the highest rate of driveway accidents in the developed world years after a report said it was lagging behind in effective accident prevention programmes.

The report published in the New Zealand Medical Journal in 2002 showed New Zealand was behind its closest neighbours in developing accident prevention programmes for children on driveways.

It showed about 38 per cent of the 77 children injured on driveways over a 45-month period lived in a state house and none of the driveways was fenced.

Six children died and researchers urged Housing New Zealand - and other landlords - to fence driveways from play areas to protect children.

Despite the report, last month's NZMJ Digest said it was to "our shame" that New Zealand still has the highest reported rate of driveway accidents in the OECD.

By December 2005 a further 93 children had been injured and nine killed in the Auckland region alone.

This week, 21-month-old Isabella Thompson was accidentally run over at her home near Hamilton.

Less than a day later a 21-month-old was run over at a marae near Waihi. She is in a stable but improving condition at Auckland's Starship hospital.

Christchurch Hospital paediatrician Professor Spencer Beasley said home design where garages were typically at the back of properties, away from the house, with residents having to reverse to exit was a "major contributing factor" in accidents.

"One of the reasons our rates are much higher than other countries relates primarily to the design of our homes," he said.

"People need to be encouraged to design residential suburbs in a way that children are separated from reversing cars."

He said local legislators needed to be aware that those at greatest risk tended to be from the lowest socio-economic groups and were least likely to be able to afford the structural changes to their houses and driveways.

The same group were also unlikely to own cars with proximity sensors or rear cameras.

Professor Beasley said community awareness could be raised through parent education classes starting at the time of antenatal classes.

Safekids director Ann Weaver said the organisation has been working with Housing New Zealand and the Auckland City Council about safer driveway designs.

Housing NZ ensures driveways in new developments have sight lines and clear visibility. It could not be contacted yesterday but has said previously that the fencing of driveways of new and existing properties "is looked at on a case-by-case basis".

Ms Weaver said parents still needed to actively supervise their children with cars around.

"We know it's predominantly 2-year-old children who get killed and we know it happens in the summer months because kids are outside then.

"Two-year-olds move really fast ... if you are moving your car then an adult needs to be supervising young children."

Ms Weaver said a group established to focus solely on driveway safety had had some success in the Auckland region with no instances of driveway injuries last year in Auckland.

She said there are plans to take the programme nationwide.

"We think that education does work," she said.

"If we can reduce or eliminate driveway instances in Auckland and we can replicate that throughout the country then we will be doing well."