WHAT ARE WE DOING FOR INJURIES; THE BURDEN AND LEVEL OF PREPAREDNESS FOR MASS EMERGENCIES IN KHYBER PAKHTUNKHWA PROVINCE OF PAKISTAN: A QUALITATIVE STUDY
Abstract
Background: Injuries are one of the highly prevalent public health problems of Pakistan but still we are unable to develop a mechanism for its quantification and management. To understand the reasons of not doing so we need detailed discussion among the leaders of different stakeholders working in area of injuries. In this study, a focus group discussion (FGD) of provincial health leaders was conducted to explore challenges and gaps and identify opportunities for quantification and management of injuries in the province of Khyber Pakhtunkhwa (KP).
Methods: This was a descriptive qualitative study conducted in Khyber Medical University, Peshawar, Pakistan. Study participants were policy makers, academia, senior level health mangers and representatives from international organizations. Purposive sampling was applied to select respondents for FGD from relevant areas to capture diversity of opinions among participants. The data were transcribed verbatim and analyzed thematically through open-coding process.
Results: One FGD was conducted in this study with a total of 11 participants. The study participants identified a number of challenges and gaps regarding quantification of injuries' burden in KP province of Pakistan and preparedness of existing health system to cope with mass emergencies. The discussion yielded four areas of detailed discussion which are; developing a surveillance system for injuries, capacity of District Health Information System, existing level of preparedness at provincial and district level and suggestions for improvement of existing situation with plans for capacity improvement.
Conclusions: In countries like Pakistan routine health information system is the better option for quantification of injuries' burden, but needs review of existing indicators and sheer commitment from field level to higher authorities with due consideration of technology assimilation. A multipronged approach is required for preparedness including; trainings on emergency medicine and skills, incentives for staff to fill vacant posts, well equipped ambulances and provision of other supplies on regular basis.
Keywords: Injuries, Focus Group Discussion (FGD), health information system, surveillance system, preparedness.
References
Krug EG, Sharma GK, Lozano R. The global burden of injuries. American journal of public health. 2000;90(4):523.
Gosselin RA, Spiegel DA, Coughlin R, Zirkle LG. Injuries: the neglected burden in developing countries. Bull World Health Organ. 2009;87(4):246-a.
Krug EG, Organization WH. Injury: a leading cause of the global burden of disease. 1999.
Kopits E, Cropper M. Traffic fatalities and economic growth. World Bank Policy Research Working Paper. 2003(3035).
Haagsma JA, Graetz N, Bolliger I, Naghavi M, Higashi H, Mullany EC, et al. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Injury prevention. 2015:injuryprev-2015-041616.
Organization WH. An estimated 12.6 million deaths each year are attributable to unhealthy environments (News release) [News release]. 2016. Available from: http://www.who.int/mediacentre/news/releases/2016/deaths-attributable-to-unhealthy-environments/en/.
Fox-Rushby J, Mulligan J, Walker D. Economic evaluations of non-communicable disease interventions. The Health Economics Research Group;. 2006.
Nishtar S, Bile KM, Ahmed A, Amjad S, Iqbal A. Integrated population-based surveillance of noncommunicable diseases: the Pakistan model. American journal of preventive medicine. 2005;29(5):102-6.
Razzak JA, Laflamme L. Limitations of secondary data sets for road traffic injury epidemiology: a study from Karachi, Pakistan. Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors. 2005;9(3):355-60.
Ghaffar A, Hyder AA, Mastoor MI, Shaikh I. Injuries in Pakistan: directions for future health policy. Health policy and planning. 1999;14(1):11-7.
Fayyaz J, Wadhwaniya S, Shahzad H, Feroze A, Zia N, Mir M, et al. Pattern of fall injuries in Pakistan: the Pakistan National Emergency Department Surveillance (Pak-NEDS) study. BMC emergency medicine. 2015;15 Suppl 2:S3.
Khan UR, Bhatti JA, Shamim MS, Zia N, Razzak JA, Jooma R. Clothing-related motorcycle injuries in Pakistan: findings from a surveillance study. International journal of injury control and safety promotion. 2015;22(4):308-13.
He S, Lunnen JC, Zia N, Khan U, Shamim K, Hyder AA. Pattern of presenting complaints recorded as near-drowning events in emergency departments: a national surveillance study from Pakistan. BMC emergency medicine. 2015;15 Suppl 2:S4.
Khan I, Khan N, Naeem R, Kerai S, Allen K, Zia N, et al. Bomb blast injuries: an exploration of patient characteristics and outcome using Pakistan National Emergency Departments Surveillance (Pak-NEDS) data. BMC emergency medicine. 2015;15 Suppl 2:S7.
Shah A. The 18th Constitutional Amendment: Glue or solvent for nation building and citizenship in Pakistan? The Lahore Journal of Economics. 2012;17:387.
Ezenkwele U, Holder Y. Applicability of CDC guidelines toward the development of an injury surveillance system in the Caribbean. Injury Prevention. 2001;7(3):245-8.
Smith GS, Barss P. Unintentional injuries in developing countries: the epidemiology of a neglected problem. Epidemiologic reviews. 1991;13(1):228-66.
Schuurman N, Cinnamon J, Walker BB, Fawcett V, Nicol A, Hameed SM, et al. Intentional injury and violence in Cape Town, South Africa: an epidemiological analysis of trauma admissions data. Global health action. 2015;8:27016.
Mutale W, Chintu N, Amoroso C, Awoonor-Williams K, Phillips J, Baynes C, et al. Improving health information systems for decision making across five sub-Saharan African countries: Implementation strategies from the African Health Initiative. BMC health services research. 2013;13 Suppl 2:S9.
Das A, Gupta S, Joshi S, Agarwal P, Murmu L, Tanson T, et al. White paper on academic emergency medicine in India: INDO-US Joint Working Group (JWG). Japi. 2008;56:789-97.
Razzak JA, Kellermann AL. Emergency medical care in developing countries: is it worthwhile? Bulletin of the World Health Organization. 2002;80(11):900-5.
Ramanujam P, Aschkenasy M. Identifying the need for pre-hospital and emergency care in the developing world: a case study in Chennai, India. JAPI. 2007;55.
Thakore S, Morrison W. A survey of the perceived quality of patient handover by ambulance staff in the resuscitation room. Emergency Medicine Journal. 2001;18(4):293-6.
Bellows JW, Douglass K, Atilla R, Smith J, Kapur GB. Creation and implementation of an emergency medicine education and training program in Turkey: an effective educational intervention to address the practitioner gap. International journal of emergency medicine. 2013;6(1):29.
Martel J, Oteng R, Mould-Millman NK, Bell SA, Zakariah A, Oduro G, et al. The development of sustainable emergency care in ghana: physician, nursing and prehospital care training initiatives. The Journal of emergency medicine. 2014;47(4):462-8.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.