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Strengthening Violence and Injury Surveillance: Challenges and Opportunities in the Eastern Caribbean

Strengthening Violence and Injury Surveillance: Challenges and Opportunities in the Eastern Caribbean. Meeting of International Collaborative Effort on Injury Statistics Cuernavaca, Mexico, June 1-3, 2005 Presentation- Patricia Brandon. USA. Bermuda. Bahamas. Turks &. Caicos. Is.

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Strengthening Violence and Injury Surveillance: Challenges and Opportunities in the Eastern Caribbean

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  1. Strengthening Violence and Injury Surveillance: Challenges and Opportunities in the Eastern Caribbean Meeting of International Collaborative Effort on Injury Statistics Cuernavaca, Mexico, June 1-3, 2005 Presentation- Patricia Brandon

  2. USA Bermuda Bahamas Turks & Caicos Is. Cayman Is. Br. Virgin Anguilla Is. St. Kitts St.Maarten Belize Jamaica Nevis Antigua Montserrat Dominica Saba Eustatius St. Lucia Curacao St. Vincent Aruba Barbados Grenada Bonaire Trinidad & Tobago Guyana Suriname MAP OF THE CARIBBEAN

  3. Defining the Caribbean: • A Matter of History, Geography, Political Economy: • Network of Island and Mainland Countries • Varying geophysical characteristics • Differing socio-economic political arrangements • Multilingual and multiethnic populations • 4000 to 15, million population

  4. PAHO/CPC CARICOM OECS Anguilla The BVI Antigua & Barbuda Dominica Grenada St Kitts Saint Lucia St Vincent Montserrat Martinique Guadeloupe French Guiana Bahamas Barbados Belize Guyana Haiti Jamaica Suriname Trinidad Turks & Caicos Cayman Islands Bermuda CARIBBEAN COMPLEXITIES

  5. Injuries: A Growing Caribbean Concern • Increase in interpersonal violence • Decrease in social safety • Disruption and costs of hospital services • Financial drain on hospital services • Use and dissemination of findings of various studies by various interest groups, • Lifelong costs of injuries for rehabilitation, incarceration, social support • Mortality, morbidity and social sector data of varying quality.

  6. Injury Surveillance: Infrastructural Challenges • Small infrastructure of public sector Ministries in small countries • Lack of specific policy and plan for national information system and coordinated sector components • Absence of an information system plan for the ‘health sector’: • Articulated purpose and components

  7. Injury Surveillance: Infrastructural Challenges • Small epidemiological-information units: • A unit of one ‘epidemiologist’ • Staff with varying degrees of training • Responsible for coordinating production, analysis, dissemination of all national and international health sector commitments

  8. Injury Surveillance: Infrastructural Challenges • Small epidemiological-information units: • Roles and responsibilities at data collection at various levels of sector not clearly defined • Communicable disease surveillance • NCD, Behavioral Surveillance • Contact tracing • All emergent diseases: SARS, etc • Dedicated financial resources for information management: miniscule or lacking

  9. Injury Surveillance: Technical Challenges • Low perception by non health sectors of relevance of their information to health. • Non-standardization of definitions and categories used by various sectors to classify the data items: • Definition of injury varied. • Latitude of interpretation within sectors (police) • Variation in categories between countries

  10. Injury Surveillance: Technical Challenges • Variations in grouping of the ages by sector and departments or agencies within a sector. • Incomplete reporting and documentation • Omissions of age and sex, road user • Coding difficult due to incompletion • Coding to nature of injury than external cause. • Etc

  11. Injury Surveillance: Opportunities • Identification of need to strengthen national health information systems in the PAHO/WHO Common Country for 2006-2010 • PAHO/CPC Proposal for Medium Term Plan for Strengthening National Health Information Systems • Caribbean Guidelines for Coordinated Injury Surveillance (adapted from the WHO Guidelines)

  12. Injury Surveillance: Opportunities • The Region experience of Jamaica and the nascent work of Dominica: a learning opportunity. • Building capacity through virtual training. • ICE - Meeting an opportunity for partnerships: sharing information, mutual technical support.

  13. Leading causes of death for CAREC-member countries, 2000

  14. Leading causes of death by potential years of life lost, 2000

  15. Homicides • Rates vary from 6.1 (Grenada), and 6.9 (Antigua) to 21.9 (St. Vincent) and 23.9 (Saint Lucia) • Have increased, especially in the past e years - 36% increase in Antigua, 59% increase in Saint Lucia • Victims tend to be males aged 25-34 years, although Saint Lucia victims now aged 20-24 years

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