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Steps of developing injury control program. Identify size of the injury problem.Determine specific circumstances of injury (risk factors).Identify possible preventive measures.Prioritize intervention programs: (size of the problems, likelihood of success, constraints, additional benefits).Imp
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1. INJURY STATISTICS AND CONTROL PROGRAM IN EGYPT“Strengths & Weaknesses” Dr. Hesham Fathey El-Sayed
Faculty of Medicine
Suez Canal University, Egypt
3. Essential features of successful injury control program
7. AGE DESTRIBUTION &DEATH RATE OF INJURY DEATHS
8. Distribution of Road Traffic Fatalities by Mode of Transport
9. Weaknesses of the Egyptian Injuries Death Records 25% of the reported injury deaths had unidentified cause (CAPMAS, 1997).
(Verbal Autopsy Study- Hamam & Elsayed 1999)
Injury deaths were misclassified as other causes than injuries in 26% of injury deaths
Under-registration of RTA is 46% in vital statistics of Ministry of Health, and 57% in traffic police records (Capture Recapture Method).
Estimated injury death rate in Egypt estimated as 43/100,000 instead of the reported rate of 32/100,000.
11. Strengths & Weaknesses of the Health Facilities Injuries Records in Egypt The Newly developed Injury Registry Program in the MOHP (2002).
Injury surveys conducted in different parts of the country (Universities &MOHP).
Registry program did not include all health facilities, and even University Hospitals.
Poor recording system in most of the health facilities, even university hospitals (40% unidentified cause of trauma) (El-Sayed et,al, 2001).
15. Scope for the Response to Injuries Change thinking about injuries to scientific approach as preventable health problem.
Scientific bases for injury prevention:
Structural framework of time and vector, host and environment (Haddon’s matrix).
Risk response:
Health education & works with legislation.
Public Health Approach:
Surveillance, risk factors, interventions & implementation.
16. Intervention Strategies for Injury Control Education.
Legislation.
Product design.
Environmental Modification.
Taxation.
17. Egyptian Response to the Injury Problem Increasing recognition of injuries as priority health problem in Egypt.
Acknowledgement of injury targets in MOHP and Universities programs.
Recognition of injuries as manifestation of inequalities (political pressure).
Working with International Organizations:
MOHP/WHO/EMRO RTI Health Day 2004, Injury Surveillance Program, International Injury Control Meetings, IPIFA, Safe Community project, NGOs.)
But limited action; Few additional resources.
20. Egyptian Activities for RTI Control National campaign on RTI by MOHP (1997).
Decree for free emergency care by private and investment hospitals.
Establishing emergency medical centers along highways.
Forming the National Council for Traffic Safety.
Universities and MOH programs and courses for Emergency and Injury care (ATLS, ACLS).
21. Injury Control Program of MOHP 1- Standardization of registration
2- Training medical professionals and health workers on registration and data management.
3- Training primary health care workers on Injury control and prevention programs
22. Injury Control Program of MOHP (2) 4- Training health workers at emergency departments and ambulance services (life saving centers) on secondary and tertiary prevention programs.
5- Development of emergency and curative care facilities.
6- National road injury control campaign in 1997 with other concerned ministries.
23. Injury Control Program of MOHP (3) 7- Implementation of injury surveillance system at the national level.
8- MOHP collaboration with WHO on the development of program for safety promotion and injury surveillance.
9- Printing safety awareness posters and guidelines for kids and families
10- Safety awareness signs on high ways in collaboration with Ministry of Transport.
25. Egyptian Efforts for RTI Control “Golden hour in trauma care: for PHC physicians”
26. Injury Control Program in Ismailia Schools, Egypt
27. Recommendations for RTI control strategies Based on local evidence and research.
Taking into account existing social, political, and economic considerations.
Legislations that should:
Convince the public.
Enforcement, swiftness and severity..
Attitude of law enforcement personnel.
28. Recommendations (Cont.) for RTI control strategies Address special factors:
Urban development.
Vulnerable road users:
Pedestrians especially children and older people.
Two wheelers users (bicycles, motorcycles, etc.).
Public transport.
Poor communities (equity challenges).
29. Recommendations (Cont.) for Injury Control Training of medical staff and the public on injury care:
Train all hospitals medical staff including physicians, nurses, and paramedics.
Train PHC physicians, nurses, and paramedics.
Training of the public and first respondents (i.e., Policemen, teachers, drivers).