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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: Dec 3, 2019

On November 11-14, 2019, faculty and students from the Johns Hopkins International Injury Research Unit (JH-IIRU) were on the ground in Vietnam for a series of workshops and presentations designed towards sustainable capacity development for injury prevention in the region, share research findings, and convene with collaborators and other experts.

“This trip was a fitting representation of the multidisciplinary work we conduct at the Johns Hopkins International Injury Research Unit,” said Director Dr. Abdul Bachani, who was joined by Associate Director Dr. Qingfeng Li, as well as post-doctoral fellow Dr. Eric Thuo, and PhD student Niloufer Taber. “In just four days, our team traveled across Vietnam to work closely with students, researchers, and government officials and cover a variety of injury subjects, including road safety, trauma, drowning prevention, and more.”

Kicking off the trip, the team joined collaborators from the Hanoi University of Public Health (HUPH) at a Fogarty International Center-National Institutes of Health-sponsored training on literature review and analysis for injury prevention research. Dr. Cuong Pham, a JH-IIRU collaborator and director of HUPH’s Centre for Injury Prevention and Policy Research (CIPPR), co-led a lecture on road injury and drowning prevention research with Drs. Bachani and Li before Taber facilitated a workshop on scientific literature findings and reviews.

“It's always a pleasure working together with the Johns Hopkins International Injury Research Unit,” said Dr. Pham. “The strength of our collaboration allows us to expand our collective reach in the region and beyond. Looking ahead, we’re eager to build on our collaborations with future partnership opportunities.”

The following day in Hanoi, Dr. Bachani and the team joined global experts from the World Health Organization, Ministry of Health, Global Health Advocacy Incubator, and HUPH, for the 3rd National Injury Conference in Vietnam, which sought to find long-term solutions to reduce the national burden of injury. In the grand meeting, Dr. Bachani presented on evidence-based policy advocacy and the team supported poster presentations from fellows in the JHU-Hanoi Trauma and Injury Research Program.

On November 13, as part of a post-conference event, local government officials and healthcare providers heard from Dr. Bachani who presented on recommendations for the health sector on injury and drowning prevention and control.

On the final day of the trip, Drs. Li and Pham co-led a dissemination workshop for the Bloomberg Initiative for Global Road Safety (BIGRS) on measurement and evaluation. Dr. Li presented on the Unit’s work in Ho Chi Minh City over eight rounds of road safety evaluations and provided evidence-based recommendations before leading a discussion on the results and further opportunities for support.

Each year – according to the Global Status Report on Road Safety 2018 – 1.3 million people die on the world’s roads. Another 20-50 million sustain non-fatal injuries, and among 15-29 year-olds road traffic injuries (RTIs) are the leading cause of death globally.

Statistics such as these fuel our work here at the Johns Hopkins International Injury Research Unit to work tirelessly within the road safety field and strive to reduce the burden of RTIs around the world.

As we conclude another phase working with Bloomberg Philanthropies and international partners, we can reflect on our time working across 10 cities and 10 countries to reduce non-fatal and fatal RTIs and impact key risk factors.

  1. Understand your data sources
    When our team was in Vietnam, studying mortality due to RTIs, we had a number of secondary data sources at our disposal and each provided us with different information. From police and hospital data, to national surveys and commune level vital registration information, we were able to draw diverse insights on everything from injury and fatality rates to crash frequencies and details.

    Such is the case for road safety data around the world: to ensure the full story, it’s important to gather from multiple sources and understand the value that each has.
     
  2. Repeated measurements are useful in monitoring trends and identifying focus areas
    As we learned when we studied helmet use, speeding, restraint use, and drink driving in these cities and countries, repeated rounds of measurement are important to identify patterns and trends; they can help with identification of emerging issues as well as highlight areas of programmatic success.

    If we hadn’t looked at multiple rounds in Bangkok, for example, we wouldn’t have as clearly been able to conclude that females had a significantly lower rate of helmet use, or to focus on passengers, weekends, and evening/night-time enforcement.
     
  3. Mixed methods approach necessary to understand underlying factors
    To truly paint accurate road safety pictures, we utilized a combination of both quantitative and qualitative studies. And in doing so, this mixed-methods approach provided a clearer understanding of factors underlying the observed trends or outcomes than if we implemented a more one-dimensional focus.

    While conducting KAP roadside interviews in two Kenyan towns, we analyzed nearly 5,000 respondents’ answers to questions on the top factors related to the decision to speed, as well as the proportion that knew the speed limit at the part of the road. These analyses were helpful in assessing each towns’ road safety climate. Complementing them, however, were the insightful interviews that provided a more detailed commentary on the situation.
     
  4. Coordinated efforts necessary for sustained improvement
    It takes a village to oversee continued progress, which we learned throughout our work, including during drink-driving observations in Addis Ababa.

    Assessing the drink-driving rate in the Ethiopian city over more than three years, for example, we could cross-reference critical points of partner efforts such as mass media campaigns and enforcement. In doing so, we learned the significant impact of each strategy and, in tandem with each other, the overall value provided to the community.
     
  5. External activities do have an impact
    Sometimes, independent and uncontrollable events and activities can become mechanisms for change, too.

    During our time in Cambodia, for example, we tracked helmet wearing rates among drivers and pinpointed several newsworthy dates that triggered an impact. From the floods in Kandal and Kampong Speu, to the national elections, and even the funeral of a former king, the scope and visibility of enforcement in the region became catalysts for behavior change, both positive and negative.
     
  6. You can’t do it alone!
    Through the collaboration with multidisciplinary partners, messages can be amplified and the reach can be widened.

    Studying information sharing across stakeholders in Colombia, we were able to glean the true potential of campaigns when working in larger networks and increasing capacity development. As we mapped, our network of report sharing between local stakeholders, such as Universidad de Los Andes and Universidad de Antioquia, as well as other organizations including iRAP, World Bank, Vital Strategies, and World Resource Institute, we saw a greater impact and effect on our stakeholders, ranging from the media and general public, to the Bogota Traffic Police and other city government agencies.

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