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Cobos Muñoz D, Sant Fruchtman C, Miki J, Vargas-Herrera J, Woode S, Dake FAA, Clapham B, De Savigny D, Botchway E. The Need to Address Fragmentation and Silos in Mortality Information Systems: The Case of Ghana and Peru. Int J Public Health 2022; 67:1604721. [PMID: 36589476 PMCID: PMC9794598 DOI: 10.3389/ijph.2022.1604721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 10/24/2022] [Indexed: 12/15/2022] Open
Abstract
Objectives: We aimed to understand the information architecture and degree of integration of mortality surveillance systems in Ghana and Peru. Methods: We conducted a cross-sectional study using a combination of document review and unstructured interviews to describe and analyse the sub-systems collecting mortality data. Results: We identified 18 and 16 information subsystems with independent databases capturing death events in Peru and Ghana respectively. The mortality information architecture was highly fragmented with a multiplicity of unconnected data silos and with formal and informal data collection systems. Conclusion: Reliable and timely information about who dies where and from what underlying cause is essential to reporting progress on Sustainable Development Goals, ensuring policies are responding to population health dynamics, and understanding the impact of threats and events like the COVID-19 pandemic. Integrating systems hosted in different parts of government remains a challenge for countries and limits the ability of statistics systems to produce accurate and timely information. Our study exposes multiple opportunities to improve the design of mortality surveillance systems by integrating existing subsystems currently operating in silos.
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Affiliation(s)
- Daniel Cobos Muñoz
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland,Epidemiology and Public Health Department, University of Basel, Basel, Switzerland,*Correspondence: Daniel Cobos Muñoz, ; Janet Miki,
| | - Carmen Sant Fruchtman
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland,Epidemiology and Public Health Department, University of Basel, Basel, Switzerland
| | - Janet Miki
- Vital Strategies, New York, NY, United States,*Correspondence: Daniel Cobos Muñoz, ; Janet Miki,
| | - Javier Vargas-Herrera
- Vital Strategies, New York, NY, United States,Departamento de Medicina Preventiva, National University of San Marcos, Lima, Peru
| | | | - Fidelia A. A. Dake
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| | | | - Don De Savigny
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland,Epidemiology and Public Health Department, University of Basel, Basel, Switzerland,Vital Strategies, New York, NY, United States
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Osuret J, Namatovu S, Biribawa C, Enock Balugaba B, Bayiga Zziwa E, Muni K, Ningwa A, Oporia F, Mutto M, Kyamanywa P, Guwatudde D, Kobusingye O. State of pedestrian road safety in Uganda: a qualitative study of existing interventions. Afr Health Sci 2021; 21:1498-1506. [PMID: 35222616 PMCID: PMC8843294 DOI: 10.4314/ahs.v21i3.62] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Pedestrians in Uganda account for 40% of road traffic fatalities and 25% of serious injuries annually. We explored the current pedestrian road traffic injury interventions in Uganda to understand why pedestrian injuries and deaths continue despite the presence of interventions. Methods We conducted a qualitative study that involved a desk review of road safety policy, regulatory documents, and reports. We supplemented the document review with 14 key informant interviews and 4 focus group discussions with participants involved in road safety. Qualitative thematic content analysis was done using ATLAS. ti 7 software. Results Five thematic topics emerged. Specifically, Uganda had a Non-Motorized Transport Policy whose implementation revealed several gaps. The needs of pedestrians and contextual evidence were ignored in road systems. The key programmatic challenges in pedestrian road safety management included inadequate funding, lack of political support, and lack of stakeholder collaboration. There was no evidence of plans for monitoring and evaluation of the various pedestrian road safety interventions. Conclusion The research revealed low prioritization of pedestrian needs in the design, implementation, and evaluation of pedestrian road safety interventions. Addressing Uganda's pedestrian needs requires concerted efforts to coordinate all road safety activities, political commitment, and budgetary support at all levels.
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Muni KM, Ningwa A, Osuret J, Zziwa EB, Namatovu S, Biribawa C, Nakafeero M, Mutto M, Guwatudde D, Kyamanywa P, Kobusingye O. Estimating the burden of road traffic crashes in Uganda using police and health sector data sources. Inj Prev 2020; 27:injuryprev-2020-043654. [PMID: 32229535 DOI: 10.1136/injuryprev-2020-043654] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/09/2020] [Accepted: 03/14/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND In many low-income countries, estimates of road injury burden are derived from police reports, and may not represent the complete picture of the burden in these countries. As a result, WHO and the Global Burden of Diseases, Injuries and Risk Factors Project often use complex models to generate country-specific estimates. Although such estimates inform prevention targets, they may be limited by the incompleteness of the data and the assumptions used in the models. In this cross-sectional study, we provide an alternative approach to estimating road traffic injury burden for Uganda for the year 2016 using data from multiple data sources (the police, health facilities and mortuaries). METHODS A digitised data collection tool was used to extract crash and injury information from files in 32 police stations, 31 health facilities and 4 mortuaries in Uganda. We estimated crash and injury burden using weights generated as inverse of the product of the probabilities of selection of police regions and stations. RESULTS We estimated that 25 729 crashes occurred on Ugandan roads in 2016, involving 59 077 individuals with 7558 fatalities. This is more than twice the number of fatalities reported by the police for 2016 (3502) but lower than the estimate from the 2018 Global Status Report (12 036). Pedestrians accounted for the greatest proportion of the fatalities 2455 (32.5%), followed by motorcyclists 1357 (18%). CONCLUSIONS Using both police and health sector data gives more robust estimates for the road traffic burden in Uganda than using either source alone.
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Affiliation(s)
- Kennedy Maring Muni
- Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Albert Ningwa
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Jimmy Osuret
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Esther Bayiga Zziwa
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Stellah Namatovu
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Claire Biribawa
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Mary Nakafeero
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Milton Mutto
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - David Guwatudde
- Department of Epidemiology & Biostatistics, Makerere School of Public Health, Kampala, Uganda
| | - Patrick Kyamanywa
- School of Health Sciences, Kampala International University, Bushenyi, Uganda
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University College of Health Sciences, Kampala, Uganda
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Road Safety in Low-Income Countries: State of Knowledge and Future Directions. SUSTAINABILITY 2019. [DOI: 10.3390/su11226249] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Road safety in low-income countries (LICs) remains a major concern. Given the expected increase in traffic exposure due to the relatively rapid motorisation of transport in LICs, it is imperative to better understand the underlying mechanisms of road safety. This in turn will allow for planning cost-effective road safety improvement programs in a timely manner. With the general aim of improving road safety in LICs, this paper discusses the state of knowledge and proposes a number of future research directions developed from literature reviews and expert elicitation. Our study takes a holistic approach based on the Safe Systems framework and the framework for the UN Decade of Action for Road Safety. We focused mostly on examining the problem from traffic engineering and safety policy standpoints, but also touched upon other sectors, including public health and social sciences. We identified ten focus areas relating to (i) under-reporting; (ii) global best practices; (iii) vulnerable groups; (iv) disabilities; (v) road crash costing; (vi) vehicle safety; (vii) proactive approaches; (viii) data challenges; (ix) social/behavioural aspects; and (x) capacity building. Based on our findings, future research ought to focus on improvement of data systems, understanding the impact of and addressing non-fatal injuries, improving estimates on the economic burden, implementation research to scale up programs and transfer learnings, as well as capacity development. Our recommendations, which relate to both empirical and methodological frontiers, would lead to noteworthy improvements in the way road safety data collection and research is conducted in the context of LICs.
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Khoshakhlagh AH, Yazdanirad S, Laal F, Sarsangi V. The relationship between illnesses and medical drug consumption with the occurrence of traffic accidents among truck and bus drivers in Tehran, Iran. Chin J Traumatol 2019; 22:142-147. [PMID: 31056467 PMCID: PMC6543181 DOI: 10.1016/j.cjtee.2019.01.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 01/12/2019] [Accepted: 02/25/2019] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To determine the relationship of illnesses and medical drug consumption with the occurrence of traffic accidents among truck and bus drivers. METHODS This is a cross-sectional study on truck and bus drivers in Tehran, Iran. The criteria for participating in this study were: married males over 30 years old, driving license in grade one, five years of job experience, mental health and non-addiction license. The criterion for not participating in this study was the lack of cooperation in responding to the questions. Six months was spent to collect the latest five years data of driving accidents from 2011 to 2016. A total of 323 truck and bus drivers in Tehran city and the suburbs, Iran were chosen. Among them, 112 were responsible for accidents (accident group) while 211 were not responsible for any accidents or involved in an accident in the last five years (non-accident group). A specially designed questionnaire was used to investigate the demographic information, medical drug consumption, medical backgrounds and history of accidents. RESULTS The results revealed that compared with healthy subjects, the occurrence of accidents among people with diabetes (OR = 2.3, p = 0.001) and vision weakness (OR = 1.7, p = 0.020) was significantly higher, while that among people with cardiac (OR = 0.5, p = 0.002) and hypertension (OR = 0.9, p = 0.048) problems was remarkably lower. Moreover, consumption of Gemfibrozil (OR = 1.8, p = 0.010) and Glibenclamide (OR = 2.2, p = 0.002) drugs resulted in significantly higher incidence of accidents than those without. CONCLUSION Frequencies of illnesses like cardiovascular and hypertension were not higher in accident drivers than in non-accident drivers; but diabetes, vision weakness and consumption of Gemfibrozil and Glibenclamide lead to more traffic accidents.
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Affiliation(s)
- Amir Hossein Khoshakhlagh
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeid Yazdanirad
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,School of Public Health, Shahrekord University of Medical Sciences, Shahrekord, Iran,Corresponding author. School of Public Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Fereydoon Laal
- Student Research Committee, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vali Sarsangi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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