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Developing Policies on Injuries and Violence Prevention. Etienne Krug, MD, MPH Director, Department of Injuries and Violence Prevention, World Health Organization. Leading causes of death, both sexes, 2002. > 5,000,000 deaths per year.
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Developing Policies on Injuries and Violence Prevention Etienne Krug, MD, MPH Director, Department of Injuries and Violence Prevention, World Health Organization
Leading causes of death, both sexes, 2002 > 5,000,000 deaths per year Source: Global Burden of Disease Project for 2002, Version 5
Recommendation 1: Create, implement and monitor, a national action plan for violence prevention Recommendation 3: Prepare a national road safety strategy and action plan
2003 - Implementing the recommendations of the World report on violence and health, WHA56.24 2004 - Road traffic safety and health, WHA57.10 2005 – Prevention of injuries in the European Region, EUR/RC55/R9
Traffic injury prevention UN passes historic resolution on Road Safety United Nations General Assembly 2005 - Resolution A/60/L.8 "Improving global road safety"
Examples • Child Safety Action Plan for Europe • Austria: Action Plan for Unintentional Injury • Netherlands: Sustainable safety • Finland: Action Programme to Prevent Intimate Partner and Domestic Violence 2004–2007 • Norway: Road Safety in Norway, Strategy 2002–2011 • Latvia: National action plan for reduction of poverty and social exclusion
Review of policy documents • 192 Documents
Review of policy documents • 192 Documents • Titles varied: 1/3 plans of action or strategic plans; ¼ strategies; rest, policies or programmes or other names.
Review of policy documents • 192 Documents • Titles varied: 1/3 plans of action or strategic plans; ¼ strategies; rest, policies or programmes or other names. • Date: < 1/5 between 1985 and 1999; most between 2000 and 2005.
Review of policy documents • 192 Documents • Titles varied: 1/3 plans of action or strategic plans; ¼ strategies; rest, policies or programmes or other names. • Date: < 1/5 between 1985 and 1999; most between 2000 and 2005. • Multi sectoriality: ¼ multi-sectoral government wide plans. Rest mainly from one sector, most commonly health (1/3), transport (1/3), or police/justice (<10%).
Review of policy documents • Origin: 35 countries in all continents. Canada (32), Australia (29), the United Kingdom (27), and the USA (25). • Scope: • 4 documents addressed all types of injuries and violence • 34 focused on all types of unintentional injuries • Most focused on a subtype of violence or injuries
Conclusions • seems to be a surge in the number of countries producing policy documents • only small proportion have comprehensive documents (e.g. multi sectoral plan of action) • focus often only on a subtype of injuries • most documents produced by one sector
3 phases • Phase 1: design process • Phase 2: formulation • Phase 3: approval and endorsement
Document Process Phase 1: design process
Phase 1: design process • Assessment • Contact stakeholders • Define process • Appoint focal persons and leadership
"A safe New Zealand – injury free" Phase 2: formulation • Goal
E.g. Australia: National Road Safety Strategy 2001–2010 National Road Safety Action Plan 2001– 2002 Phase 2: formulation • Goal • Time frame
human rights, social justice and equity, right to health care, respect for the individual’s dignity and autonomy, cultural appropriateness, gender, community involvement, … • national constitution & health policies; international treaties and resolutions • public health approach; intersectoral collaboration Phase 2: formulation • Goal • Time frame • Principles
Reduce number of children killed or seriously injured by 50% and people killed or seriously injured in road accidents by 40% (UK) By 2010, road deaths should be reduced by at least 50% and injuries by 40% compared with the 1986 baseline figures (NL) Decrease the mortality, number of disabled and handicapped people due to injury (Mongolia) Phase 2: formulation • Goal • Time frame • Principles • Objectives
number of car crashes decreased by 50% in 5 years • set/enforce speed limits (e.g.: reduce average speed on highways to 80 km/h by 2007) • enforce alcohol impairment laws • regulate drivers’ hours of work in commercial and public transport. Phase 2: formulation • Goal • Time frame • Principles • Objectives • Interventions
Phase 2: formulation • Goal • Time frame • Principles • Objectives • Interventions • Lead agency
Phase 2: formulation • Goal • Time frame • Principles • Objectives • Interventions • Lead agency • Monitoring
3 phases • Phase 1: design process • Phase 2: formulation • Phase 3: approval and endorsement
Warning policy documents alone are not enough • real political commitment • appropriate levels of funding • monitor and review regularly • adapt when needed
Conclusions • Injuries and violence prevention requires well-targeted and coordinated multisectoral efforts • resolutions and world reports have invited governments to develop national policy documents for that purpose • many countries still have to start • process is very important • new guidelines
1st Global UN ROAD SAFETY WEEK 2007 23-29 April Young road users