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Johns Hopkins International Injury Research Unit

A World Health Organization Collaborating Center for Injuries, Violence and Accident Prevention

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Date: Jan 7, 2014

Prehospital care is an important part of emergency medicine, but in some countries that have a de-centralized ambulance system, patients must first understand how the services work before they can be utilized to their full potential.

Recently, members of the JH-IIRU team, including associated faculty members Aruna Chandran, and Junaid Razzak from the Department of Emergency Medicine at Aga Khan University, as well as JH-IIRU director, Adnan Hyder, published a paper that examined patient perceptions of ambulance usage in Karachi, Pakistan. The purpose of the study was to analyze patient perspectives of the ambulance system in order to understand how to improve ambulance use.

In “Insights on the Effects of Patient Perceptions and Awareness on Ambulance Usage in Karachi, Pakistan,” published in the September issue of Emergency Medicine Journal, the team found patient perceptions fell under three major headings: mistrust of the ambulance services; belief in the inadequacy of ambulance services and a lack of knowledge about both ambulance service and prehosptial care. The researchers determined that in order to improve overall prehospital care, changing perceptions of ambulance services is as important as improving the ambulance services themselves.

To access the full article, click here.

This month, JH-IIRU published its second special issue, “Global Road Safety: Updates from Ten Low- and Middle-Income Countries,” in Injury. This supplemental issue, which features 12 scientific papers jointly authored by nearly 50 JH-IIRU colleagues and collaborators from 30 institutions and organizations within the participating countries, presents findings from the ongoing monitoring and evaluation activities in the ten participating countries, and includes an evaluation of the trauma component of the program. It highlights the mixed methods approach of data collection and showcases both the successes as well as the challenges of collecting such data in real-world settings.  

Road traffic injuries (RTIs) account for nearly 1.24 million deaths each year, with 92% occurring in low- and middle-income countries.  Today, RTIs are the 8th leading cause of death globally, and if no action is taken, the World Health Organization (WHO) estimates that they will jump to the 5th leading cause by 2030. Moreover, the economic losses associated with road traffic deaths are just as devastating, costing low- and middle-income countries an estimated $100 billion every year. While these statistics are shocking, the impact of road traffic crashes is often overlooked as a serious disease burden.

In an effort to reduce these unacceptable rates of road traffic injuries, in 2010, JH-IIRU joined a consortium of six partners, including the World Health Organization, the Global Road Safety Partnership, the Association for Safe International Road Travel, EMBARQ and the World Bank to evaluate and implement road safety solutions in 10 countries that account for nearly half (48%) of all traffic deaths globally. The Bloomberg Philanthropies Global Road Safety Program (formerly the Road Safety in 10 Countries Project, or RS10) is a five-year initiative that draws on support from Bloomberg Philanthropies and the World Health Organization to evaluate and implement road safety solutions where they are needed most.

In 2012, JH-IIRU published its first special issue, “Public Health Burden of Road Traffic Injuries: An Assessment from Ten Low and Middle Income Countries,” in Traffic Injury Prevention, which highlighted new and aggregate data collected and analyzed in the 10 participating countries during the first two years of the Global Road Safety Program. These 11 scientific papers served as a foundation for the monitoring and evaluation work of the entire project.

The goal of the Global Road Safety Program is to save lives by providing evidence for stronger road safety interventions around the world.  By generating new knowledge and providing important data on proven interventions such as seatbelt- and helmet-wearing, reducing speeding and eliminating drunk driving, JH-IIRU hopes to encourage key decision makers to develop policies and solutions that will save lives.

JH-IIRU is thankful to all who contributed, especially Bloomberg Philanthropies for their generous support. Hyder said.

The newest special issue can be found here:

The previous special issue can be found here:

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