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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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In Pakistan, injuries and trauma are among the top ten contributors to the burden of disease and disabilities. Other related factors, such as poverty, political instability, and natural disasters as well as the lack of legislation or enforcement of preventative measures contribute to the population’s susceptibility to injuries.

While police and hospital records provide some data on injuries, a recent commentary published in Public Health suggests that it is essential that the public health sector invest in injury prevention by creating a strong, evidence-based strategy, improving national polices, and collaborating with the private sector to promote injury prevention.

In “The challenges of injuries and trauma in Pakistan: An opportunity for concerted action,” JH-IIRU director, Adnan Hyder and Aga Khan University professor, Junaid Razzak, examine the current status of injury prevention and control in Pakistan  as well as the burden and the policy context for interventions in the country.

The commentary goes on to suggest that, because injury prevention and emergency care have been proven to be some of the most cost-effective interventions in the health sector, investing in such measures as traffic enforcement, speed control, helmets, child resistant containers and trained emergency personnel makes sense from both an economic and public health viewpoint.

Drs. Hyder and Razzak are directors of the JHU-Pakistan Fogarty International Collaborative Trauma and Injury Research Training Program (JHU-Pakistan ICIRT). The goal of JHU-Pakistan ICIRT is to build a strong network of professionals and help develop sustainable research capacity on acute care of trauma and injuries and emergency medicine in Pakistan.  For additional information on the program, click here:

http://www.jhsph.edu/faculty/research/map/PK/1227

To access the paper, click here: http://www.sciencedirect.com/science/article/pii/S0033350612004696#

While nearly 90% of all worldwide trauma and injury-related deaths and disabilities occur in low- and middle-income countries (LMICs), information about the process and quality of trauma care is lacking, even though a significant number of these deaths could be averted through improvement in trauma care in these countries.

Trauma registries—databases used to monitor and enhance the quality of trauma care—are well-established in many high income countries (HICs), yet in many LMICs they are underdeveloped and incomplete.

Recently, JH-IIRU and colleagues from Aga Khan University published a paper on the development and pilot implementation of a trauma registry in Karachi, Pakistan. The paper examined the structure, process of development and pilot implementation of a locally-developed, electronic registry, The Karachi Trauma Registry (KITR). The paper also described lessons learnt during the implementation.

KITR is the first electronic trauma registry in Pakistan developed with local resources. This registry was able to generate surveillance data such as mechanism of injuries, burden of severe injuries and quality indicators such as length of stay in ED, injury to arrival delay, injury severity and survival probability. This registry is important because TRs have historically been used to promote injury prevention, change policies and evaluate trauma system effectiveness.

“Development and Pilot Implementation of a Locally Developed Trauma Registry: Lessons Learnt in a Low-Income Country,” appears in BMC Emergency Medicine. To read more, click here: http://www.ncbi.nlm.nih.gov/pubmed/23517344

Nino Paichadze is the newest addition to the JH-IIRU staff. Nino is a medical doctor with management experience in medical products and services sectors, and also holds a MPH in health leadership and management from Hopkins. She is fluent in English, Russian and Georgian. Her previous postdoctoral training focused on leadership, management and governance in low- and middle-income countries. We are delighted to have her work with our Bloomberg Philanthropies Global Road Safety Program (Russia), training component, and support other special projects as well.

More than 1.2 million people die every year in road traffic crashes around the world, with the majority (90%) of fatalities in low- and middle-income countries (LMICs). This is despite accounting for less than 50 percent of the world’s registered vehicles. And even though the burden of RTIs is greater in LMICs than high income countries, the generation of evidence from the developing world has not kept pace with the rate of injuries. 
Recently, members of the Johns Hopkins International Injury Research (JH-IIRU) team, and colleagues from the Department of International Health at the Johns Hopkins Bloomberg School of Public Health published a paper in Global Public Health that explores the disparity in research and develops a scientific approach for evaluating large-scale road safety programs in LMICs. 
 
“Large-Scale Road Safety Programmes in Low- and Middle-Income Countries: An Opportunity to Generate Evidence” suggests that what is often missing from road safety initiatives is evidence on the effectiveness of such programs. The paper uses the Road Safety in 10 Countries Project (now referred to at the Bloomberg Philanthropies Global Road Safety Program) as a real-world application of a large-scale multi-country initiative to scientifically test the road safety evaluation approaches used in the project and to generate new knowledge in the field of road safety. The paper also draws on “13 lessons” on large-scale program evaluation, including defining the evaluation scope, selecting study sites, using multiple analytic techniques, continuous monitoring and providing feedback to implementers and policy-makers, among others. 
 
The paper concludes that new knowledge generated from such real-world, large-scale road safety evaluations is more likely to influence local and national policy makers than externally transported knowledge. 
 
To find out more, access the paper click here.
 
 

 

Please join the Johns Hopkins International Injury Research Unit as we recognize three of our students for receiving International Health Endowed Awards.

Casey Branchini, MHS, PhD candidate, Health Systems, is the recipient of the Humanitarian Assistance Award. This award provides support to masters and doctoral students who are committed to improving humanitarian response and health for refugees, displaced persons and populations affected by conflict and natural disasters. Later in the year, Casey plans on using her award to travel to Malaysia to conduct research on the scope and health impact of human rights violations committed against migrant laborers. She will look at the health impact of both intentional and unintentional injuries among individuals in and around the Kuala Lumpur area, including refugees and displaced persons from Burma, and migrant workers from many countries, including Indonesia, Cambodia, the Philippines, and Nepal.  Casey is the research assistant for the RS10 in Cambodia. 

Casey Branchini
Casey Branchini

Nasreen Jessani, BSc, MSPH, DrPH candidate, Health Systems, is the recipient of the Nancy Stevens Student Support award.  This fund was established in 1970 as the International Health Fund, and provides grants to masters or doctoral students in the Department of International Health who are completing their degrees. For 37 years Nancy Stephens was an immensely popular student coordinator in the Department of International Health. At her retirement in 2001, Dr. Robert Black, chairman of the Department honored her by renaming this fund the Nancy Stephens Student Support Fund. Nasreen is a research assistant for the RS10 project in Vietnam. She intends to use the award for tuition support at the Bloomberg School.

Nasreen Jessani
Nasreen Jessani

 

Pooja Sripad, MPH, PhD candidate, Health Systems, is the recipient of the Robert D. and Helen S. Wright Fund. The award was established in 1983 by family members of former International Health faculty member, Robert Wright, MD, MPH ’40,  and provides support for a continuing doctoral student who expects to contribute to the improvement of public health in Africa. Pooja will use the award to support her dissertation work in Kenya, which focuses on health systems trust and women's experiences of maternity care in peri-urban contexts. She is a research assistant for the RS10 project in Brazil.

Pooja Sripad
Pooja Sripad

Congratulations to all award recipients!
 

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