Implementing a hospital based injury surveillance system in Africa: lessons learned

Abstract

A multinational injury surveillance pilot project was carried out in five African countries in the first half of 2007 (Democratic Republic of the Congo, Kenya, Nigeria, Uganda and Zambia). Hospitals were selected in each country and a uniform methodology was applied in all sites, including an injury surveillance questionnaire designed by a joint programme of the Pan American Health Organization and the United States Centres for Disease Control and Prevention. A total of 4207 injury cases were registered in all hospitals. More than half of all injury cases were due to road traffic accidents (58.3%) and 40% were due to interpersonal violence. Self-inflicted injuries were minimal (1.2% of all cases). This report provides an assessment of the implementation of the project and a preliminary comparison between the five African countries on the context in which inter-personal injury cases occurred. Strengths and weaknesses of the project as well as opportunities and threats identified by medical personnel are summarized and discussed. A call is made to transform this pilot project into a sustainable public health strategy.

Keywords:

• firearms
• injury surveillance
• interpersonal violence
• violence and injury prevention

Acknowledgements

We thank Maria Valenti, Project Co-ordinator, ‘Aiming for Prevention’ International Campaign, International Physicians for the Prevention of Nuclear War (IPPNW), all the physicians, medical students and other professionals who participated in each hospital in Africa, and Dr. Juan Carlos Orengo Valverde, Director of the Public Health Program at the Ponce School of Medicine in Puerto Rico for his support and encouragement in this project. Dr. Alberto Concha-Eastman, PAHO's Regional Advisor on Injury Prevention, Regional Advisor on Injury Prevention. Pan American Health Organization/WHO. Dr. Carmé Clavel-Arcas, formerly at the National Center for Injury Prevention and Control, Centers of Disease Prevention and Control, and Dr. Maria Isabel Gutierrez, Institute for Peace Promotion and Injury/Violence Prevention – CISALVA. University del Valle, Cali, Colombia.