1. ICE Injury Statistics International meeting Washington DC, September 7-8, 2006 Pan American Health Organization Injury Statistics Activities

2. PAHO’s Current Projects Morbidity data –Hospital injury surveillance Mortality data –Observatorios Violencia Interpersonal violence – Intimate partner violence, sexual violence, child maltreatment, youth violence, suicides, etc

3. Morbidity data PAHO-CDC-MOH-CISALVA “Injury Surveillance Systems in emergency rooms in Nicaragua, El Salvador and Colombia ” Technical assistance in different LAC countries Existing ISS as found in Jamaica, Peru, Brasil, Honduras, Bolivia, Chile, Argentina, Paraguay, etc MOH in Central America : “Family violence and sexual violence surveillance”

4. Patient arrives at ER Hospital description : Injury Surveillance System Data analysis Statistician & Epidemiologist Data entry and quality control Identification of injured person Fill out Form Dissemination of the results Intervention for Injury Prevention

5. Cali, Colombia: a case study in data cleaning and coding Challenges: –Incomplete codebook –Format –Miscodes beforeafter –Missing data –Excess of variables

6. Cali, Colombia: a case study in data cleaning and coding Missing Data 1.A sses amount of missing data 2.R eview and Reconstruct

7. Cali, Colombia: a case study in data cleaning and coding Predictors of missing data –Hospital –Doctor –Presence of alcohol –Hour of admission –Pre hospital care The future…..?

8. Achievements Injury data collection in ED is possible Health authorities are interested in: –Extension of injury surveillance –Creation of injury prevention programs –Promotion of intersectorial injury mortality surveillance Data is being used to make decisions

9. Challenges “Parallel” systems in the MOH persist Incomplete data in : –alcohol abuse and other drugs, relationship between perpetrators and victims, precipitating factors in self-inflicted, etc Lack of consensus in measures of severity Insufficient dissemination of data to the authorities Insufficient dissemination of data to the authorities

10. Challenges- Opportunities Consolidating existing health information systems, and promoting the integration of ISS in these systems : –Ex SILEX- SIMMOW ( El Salvador ) Expert collaborations ( ICE, IACPV, etc ) –strengthening quality of data, minimum data set, measures of severity, classification, etc New Training Injury Tools Teach- VIP ( WHO ) ; Injury Surveillance Training Manual ( CDC) ; etc

11. Recommendations Regulate injury surveillance in the MOH Increase injury research and training (mentoring) in association with national & international universities Disseminate opportunely data to the authorities Strengthen coordination at the national and local level to achieve best practices for injury prevention Diversify funds to continue technical assistance

12. Mortality data “Observatorios Municipales del Delito“ CISALVA, Colombia –Colombia began in 1992 PAHO – IACPV : “ Pilot the Observatorios in Central America in some municipalities : data to action Linking data from mortality- morbidity ( where the hospital systems exist ) – family violence data ( Pasto, Colombia )

13. Contacts in the countries Colombia CISALVA –Maria Isabel Gutierrez : mgutierr@univalle.edu.co; cisalva@univalle.edu.co mgutierr@univalle.edu.co cisalva@univalle.edu.comgutierr@univalle.edu.co cisalva@univalle.edu.co –Andrés Fandiño : fandino.andres@gmail.com fandino.andres@gmail.com –www.cisalva.univalle.edu.co www.cisalva.univalle.edu.co El Salvador –Silvia Moran de Garcia : smoran@mspas.gob.sv smoran@mspas.gob.sv –Janette Ortiz de Montoya : janetteom@gmail.com janetteom@gmail.com –Rafael Chacon : epidemiologia@hospitalbloom.gob.sv epidemiologia@hospitalbloom.gob.sv –www.mspas.gob.sv www.mspas.gob.sv Nicaragua –Maribel Rivas : viglesiones@minsa.gob.nic viglesiones@minsa.gob.nic –Julio Rocha : injury12003@yahoo.com injury12003@yahoo.com –Francisco Tercero cidsft@yahoo.es cidsft@yahoo.es –www.minsa.gob.ni www.minsa.gob.ni

14. THANKS Alberto Concha- Eastman e-mail : conchaal@paho.org conchaal@paho.org www.paho.org www.paho.orgwww.paho.org Roberto Becker e-mail : beckerro@paho.org beckerro@paho.org Carme Clavel-Arcas e-mail: zgn4@cdc.gov zgn4@cdc.gov www.cdc.gov/ncipc Laura Fraade- Blanar e-mail : lfraade@jhsph.edu Eugenia M. Rodrigues e-mail eugenia@bra.ops-oms.org eugenia@bra.ops-oms.org