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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. USA. Bermuda. Bahamas. Turks &. Caicos. Is.

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slide1

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

map of the caribbean

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
defining the caribbean
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
slide4

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

injuries a growing caribbean concern
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.
injury surveillance infrastructural challenges
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
injury surveillance infrastructural challenges7
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
injury surveillance infrastructural challenges8
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
injury surveillance technical challenges
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
injury surveillance technical challenges10
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
injury surveillance opportunities
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)
injury surveillance opportunities12
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.
homicides
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
ad