Hospital-based Injury Surveillance System (HBISS) in Nicaragua Julio Rocha Francisco Tercero
CONTENT • Background • Process • Results • Evidence-based decision making • Next steps and challenges
BACKGROUND • Epidemiology Transition in Nicaragua • Before the Revolution: Infectious diseases • (Before 1979) • During the Revolution: War-related injuries • (1979-1990) • After the Revolution: Noncommunicable and • (1990-Present) Injuries
BACKGROUND • Technical Support on Injury Surveillance: • During 1990-1995 (only in Leon): • Social Medicine, KI (SAREC) • Academic but not institutional support. • During 2000-2005 (National level): • CDC, PAHO, with SAREM support. • Aimed to strengthen the Ministry of Health capacity • buildings.
BACKGROUND Injury surveillance approaches in Leon, Nicaragua
PROCESS • Advocacy for interdisciplinary support • for Injury Prevention and Control • Minister and vice-Minister of Health • Forensic Institute • Mayors • NGOs: Networking with woman and young people. • University • Police
PROCESS • The Training Program included: • A user’s manual on HBISS. • Series of workshops on injury registration and • data analysis (External trainers). • Epi Info training to data entry and Epidemiologist.
PROCESS Monitoring included: Capture of cases. Quality of data. Completeness and timeliness of case reports.
RESULTS • Dissemination of injury data: • National and International publications. • International Conferences. • Training. • Feedback with local autorities.
Results from the Hospital-based Injury Surveillance System, Nicaragua, 2003-2004
Proportion of injuries by intent and sex. Nicaragua, 2003-2004.
Proportion of injuries by intent and age. Nicaragua, 2003-2004.
Proportion of injuries by mechanism and sex. Nicaragua, 2003-2004.
Proportion of injuries by mechanism and age. Nicaragua, 2003-2004.
Proportion of injuries by mechanism and intent. Nicaragua, 2003-2004.
Proportion of injuries by intent and severity. Nicaragua, 2003-2004.
Proportion of injuries by mechanism and severity. Nicaragua, 2003-2004.
Evidence-Based Decision Making • Injuries were included in the National Plan of Health (2004-2015) • The notification of injuries are compulsory (2005). • Injury prevention in the agenda of three municipalities: • Violence • Suicide • Traffic • To calculate injury cost to measure the burden of injuries (2003).
Next steps and challenges • To improve the quality of the HBISS. • To standardize injury severity indicators to monitor • properly the impact of intervention measures. • To guarantee the sustainability of the HBISS. • The needs to institutionalize within the Ministry of • Health a National Injury Prevention Program.
Acknowledgements To all members of the hospitals that are involved in the hospital-based injury surveillance systems.
CONTACT US: • Julio Rocha • Email: email@example.com • Web site http://www.minsa.gob.ni • Francisco Tercero • Email: firstname.lastname@example.org • Web site http:// www.cids.edu.ni