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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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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


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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


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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


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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


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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.


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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


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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


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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


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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


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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


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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)


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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.


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Leading causes of death for CAREC-member countries, 2000


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


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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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