# Presentation: 245941

## 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

## 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

## CARIBBEAN COMPLEXITIES

- Barbados
- Belize
- Guyana
- Haiti
- Jamaica
- Suriname
- Trinidad
*Turks & Caicos*
*Cayman Islands*
*Bermuda*

- Martinique
- Guadeloupe
- French Guiana

**CARIBBEAN COMPLEXITIES**

## 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

- 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 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 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

- 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 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

- 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: 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.**

## Leading causes of death for CAREC-member countries, 2000

| 15  - 24 years |  |  | 25 – 44 years |  |  |
| --- | --- | --- | --- | --- | --- |
| Cause | # | Rate | Cause | # | Rate |
| Homicide

HIV/AIDS

MVIs

Suicides | 275

189

125

62 | 21.7

14.9

9.8

4.9 | HIV/AIDS

Homicide

MVIs

Other heart disease

Diabetes

Suicides

Cerebro-vascular Disease | 1628

512

261

202

173

155

151 | 78.7

24.8

12.6

9.8

8.4

7.5

7.3 |

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

| Cause of death | PYLL | % of Total PYLL |
| --- | --- | --- |
| HIV/AIDS

Respiratory disorders in the perinatal period

Homicides

Diabetes mellitus

Ischaemic heart disease

Cerebro-vascular disease

Motor Vehicle Injuries

Congenital malformations

Other heart disease

Intestinal infectious disease | 99081.5

52049

44125

37373.5

32096.5

26026

25351

24794.5

23462.5

19499 | 13.24

6.96

5.90

4.99

4.29

3.48

3.39
3.31

3.14

2.61 |

## 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