Prevention and Control of Major Non Communicable Disease

Prevention of Injuries and Disabilities

 

Introduction

Injuries are now being recognized as a major public health problem that occurs from a complex interaction of sociological, psychological, physical and technological phenomena. Injury is the fifth leading cause of death and disability worldwide among those aged 15-59 years. The government of Bangladesh recognizes injury prevention as a priority agenda that will help in alleviating poverty and in achieving the MDG Goals. The NCD cluster of WHO Bangladesh gives support to the injury prevention and management programme of the government of Bangladesh, the overall objective of which is to reduce injury related deaths and disabilities through advocacy and sensitization of policy planners and service providers on magnitude and prevention of injuries; development of national strategies and plan of action for injury prevention; Increase awareness and practice of specific skills and behaviors by injury prevention and safety promotion; increase capacity of health service providers on injury prevention and management.

 

Major injuries to be addressed through this programme are drowning, transport injuries, burn, fall, poisoning, animal bites, electrocution, machine injuries, suicides and violence. The disability component encompasses blindness, deafness and hearing impairment and injury related disabilities.

Country situation

The majority of disabilities in Bangladesh are caused by injuries resulting from different types of accidents (traffic accidents, burns, electrocution, animal attacks, acts of violence and conflict). The nation-wide community based Bangladesh Health and Injury Survey (BHIS) reported an estimated 70,000 annual deaths due to injury (unpublished observation, BHIS) that includes 30,000 children of under 18 years (DGHS 2005). Road traffic injuries alone cause a loss of about 2% of GDP in Bangladesh. Road traffic accidents injure 400,000 people a year and kill approximately 18,500. Deaths due to drowning also claim over 20,000 lives every year. Household and occupational injuries are also very common. To design effective treatment interventions and to identify appropriate health promotion activities aiming at reducing injuries a population-based survey to determine the prevalence of injuries and injury-related disabilities was conducted by the Centre for Injury Prevention and Rehabilitation of Bangladesh with technical support from WHO. This survey found a disability prevalence of 4.1%, and injuries were the cause of 17% of all disabilities. The emergency services of three district hospitals and three upazila health complexes, Dhaka Medical College Hospital and the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) received technical support from WHO for improving the management of injuries and other emergencies.

Absence of an, effective, efficient and dynamic injury surveillance network system, cost-effective strategic plans, documented strategy and guidelines, non-availability or poor availability of support at various levels particularly at secondary and primary care levels, grossly inadequate trained human resource are many of the gaps and challenges which need to be addressed for effective control and prevention of injuries.Developing cost-effective strategic plans, resource allocation, and prompt detection of high-risk groups are dire needs for the country. There is also need for monitoring and evaluation of intervention measures and promotion of research for evidence generation.

WHO Contribution

*         Development of the Strategic Plan of Action for Surveillance and Prevention of Non Communicable Diseases in Bangladesh: The goal of this Action Plan is to reduce the burden of NCDs including injury, mental disorders and blindness in Bangladesh..

*         BanNet (Bangladesh Network for NCD surveillance and Prevention):a forum for active collaboration of organizations/ institutes for compilation and dissemination of information on NCDs. WHO has been actively supporting the Directorate General of Health Services to keep this network functional

*         Prevention and management of avoidable blindness strengthened

*         Awareness on road, home and school safety in association with a collaborative network of stakeholders on injury prevention improved

*         Gender sensitive surveillance of injury initiated

*         Research: for evidence generation on injury related disabilities to identify the risks, hazards and preventive measures.

*         Model Eye Care Project: A special initiative was undertaken by WHO to support the development of a model eye care project as part of PHC services. Training (including a fellowship abroad) of doctors, nurses and paramedics was an important component of the project. Vision testing equipment was also procured.

*         Supported the National Institute of Ophthalmology for conducting a survey on eye disease and for launching a school-based eye sight initiative.

*         Developing human resource: Building national capacity through training and, provision of standard guidelines and tools for disability prevention and control.

 

WHO current collaboration

*         Developing strategies and guidelines for prevention of injury and deafness

*         Development of model upazila ( sub district) on injury prevention and primary eye care

*         Strengthening of the emergency medical services at primary, secondary and tertiary levels of the healthcare delivery system

*         Evidence generation for policy directions by conducting surveys on disability induced disease burden

*         Capacity building of the health workforce through trainings

 

For more information:

Link of the SEARO website: Disability, Injury Prevention and Rehabilitation