Prof. Abdelbari Bener - Arab Children Health Congress

4 TH ARAB CHILDREN HEALTH CONGRESS 

THE NEED FOR GOOD DATA AND A 

SCIENTIFIC APPROACH 

FOR 

ACCIDENTS AND INJURIES: PREVENTION OF 

INJURIES AMONG CHILDREN 

Presented by 

Prof. Dr. Abdulbari Bener 

Professor for Public Health 

University of Manchester & 

Weill Cornell Medical College 

Hamad Medical Corporation

INTRODUCTION

INTRODUCTION 

• Injuries resulting from traffic collisions are a 

major cause of childhood death, 

hospitalization and disability throughout the 

world. 

• World Health Organization reported that 

around 10 million children annually are 

estimated to be injured or disabled as a 

result of road traffic injuries. 

• The exact proportion of children disabled by 

Road traffic injuries varies by age group and 

across countries.

INTRODUCTION 

• The exact proportion of children disabled 

by road traffic injuries varies by age 

group and across countries. 

• Globally, the road traffic death rate 

among children is 10.7/100,000 

population. 

• Road safety is of prime concern to many 

countries, all of whom require data and 

evidence.

CHILD RESTRAINT LEGISLATION BY 

COUNTRY/AREA

ROAD TRAFFIC INJURY MORTALITY RATES PER 100,000 

CHILDREN BY WHO REGION

DISTRIBUTION OF GLOBAL CHILD INJURY DEATHS 

BY CAUSE

PROPORTION OF FATAL ROAD TRAFFIC DEATHS AMONG CHILDREN 

BY TYPE OF ROAD USER IN SELECTED OECD COUNTRIES

THE CHILD INJURY DEATH LEAGUE

INTRODUCTION 

• Reliable data and evidence are essential 

for describing the burden of road traffic 

injuries, assessing risk factors, 

developing and evaluating interventions, 

providing information for policy makers 

and decision makers and racing 

awareness. 

• Without reliable data on accidents and 

injuries, the priorities for road traffic 

injury prevention cannot be rationally or 

satisfactorily determined.

INTRODUCTION 

• Data on the incidence and types of crashes 

as well as a detailed understanding of the 

circumstances that lead to crashes is 

required to guide safety policy. 

• However, in many countries, systematic 

efforts to collect road traffic data are not well 

developed and underreporting of deaths and 

serious injuries is common. 

• The health sector has an important role to 

play in establishing data systems on injuries, 

Road traffic accidents, effectiveness of 

interventions and communications of these 

data to a wide audience.

ROAD TRAFFIC INJURY AS A 

PUBLIC HEALTH PROBLEM

THE NEED FOR GOOD DATA 

FOR ACCIDENTS & INJURIES


FOR ACCIDENTS AND INJURIES 

• An important element in dealing with child 

injuries is ascertaining the magnitude and 

characteristics of the problem.. 

• A thorough understanding is needed, not only 

of the volume of child injury deaths, but also 

of : 

• the children who are most affected 

• the types of injury that are most prevalent 

• the geographic areas where the greatest 

problems are found



• the particular risk factors 

• the child health policies, programs and 

specific injury interventions that are in 

place 

• standardized definitions are needed that 

are used across countries, not only for 

injuries but for disability as well.



The following are the key reasons for 

collecting the data on accidents and 

injuries:- 

• overview the problem 

• monitor trends 

• identify high risk/problem groups 

• identify high risk, hazardous locations



• enable objective planning and 

resource management 

• evaluate effectiveness and monitor 

achievement of targets 

• make international comparisons

POTENTIAL SOURCES OF DATA 

• The most two important potential sources 

for accidents and injury data are Police 

department data and hospital data. 

• However, in many countries a significant 

number of road crashes are not reported 

to the police. 

• The level of so called underreporting 

varies considerably from countries to 

countries.

POTENTIAL SOURCES OF DATA 

• Hospital data are an important source of 

information, especially about injury and 

treatment, but information relating to the 

scene of the crash is often missing in 

medical data. 

• For trend analyses and overviews of the 

accidents and injuries, it is recommended 

that both health and police records be 

examined. Direct matching of these two 

departments is always difficult in every 

country.

Country Specific Information System 

Key Source of Road Traffic Injury Data 

Source Type of data Comments 

POLICE 

• No. of road traffic 

incidents- fatalities 

and injuries 

• Type of road users 

involved 

• Age & Sex of 

causalities 

• Type of vehicles 

involved 

• Police assessment 

of causes of 

crashes 

• Varies from one 

country to another 

• Police records can 

be inaccessible 

• Underreporting is a 

common problem


Source 

Health settings 

• Hospital inpatient 

records 

• Emergency room 

records 

• Trauma registries 

• EMS records 

• Primary Health Clinic 

Type of data 

• Location of 

Crashes 

• Fatal and non 

fatal 

injuries 

• Age & Sex of 

causalities 

• Costs of 

treatment 

Comments 

• Level of detail varies 

from one health care 

facility to another 

• Injury data may be 

recorded under other 

causes, making it 

difficult to extract for 

analysis 

Insurance firms 

• Fatal and nonfatal 

injuries 

• Damage to 

Vehicles 

• Costs of claims 

• Access to these data 

may be difficult


Source 

Govt. departments 

and specialized 

agencies collecting 

data for national 

planning & 

development 

Type of data 

• Population 

denominators 

• Income & 

expenditure data 

• Health indicators 

• Exposure data 

• Pollution data 

• Literacy levels 

Comments 

• These data are 

complimentary & 

important for 

analysis 

of Road traffic 

injuries. 

• The data are 

collected 

by different 

ministries 

& departments


Source 

Special Interest 

groups 

• Research 

• Non Governmental 

• Transport authority 

Type of data 

• No. of road traffic 

incidents – fatal & 

non fatal 

• Type of road 

users 

• Age & sex of 

causalities 

• Type of vehicles 

involved 

• Causes 

•Location of crashes 

Comments 

• The various 

organization 

have different 

interests

APPROACHES TO DATA COLLECTION 

• Data on injury and its determinants are essential for 

identifying priority issues and high risk groups, and 

also for understanding the underlying causes of 

injury. 

• Agreement on the definitions of specific injuries is 

essential for accurate measurement and 

comparability. 

• The availability of good quality of data and of trained 

people to analyze such data are therefore important in 

the search for effective prevention interventions. 

• A lack of data can hold back action for want of 

evidence, prevent priorities from being correctly set, 

and hamper research and the evaluation of 

interventions


• In developed countries, detailed analysis of sound 

data has undoubtedly been instrumental in achieving 

high rate of success in child injury prevention. 

• Data on child death and injury are generally either of a 

poor quality or missing 

• Discrepancies in data collected are sometimes used 

as excuses not to do anything, where they could 

instead serve as a foundation to strengthen 

information systems. 

• A major difficulty in child injury prevention is 

obtaining reliable estimates of the scale and pattern 

of child injury and death.


• To this end, the volume, quality and availability of 

national and regional data needs to be increased 

through a combination of : 

• Better data collection systems 

• Improved surveillance 

• Use of hospital discharge systems including ICD 

external cause codes 

• More community based surveys on child injury 

using standard protocols

A SCIENTIFIC APPROACH 

FOR ACCIDENTS & INJURIES

A SCIENTIFIC APPROACH FOR PREVENTION 

OF ACCIDENTS AND INJURIES 

• Because of the complexity of road accident 

causation factors, the various organizations 

involved, and the emotional nature of road 

accidents, there is temptation to embark on 

policies and countermeasures that are visible 

but superficial and with little ultimate effect on 

the level of road safety. 

• It is essential that every developing country 

should have some local research activity on 

road safety issues to aid decision making.



There are a number of scientific approaches to 

collecting and keeping data and evidence on road 

traffic injuries. 

1) INJURY SURVEILLANCE SYSTEM 

Country Specific Information system 

• Most countries have some form of national system for 

aggregating data on accidents and injuries using police 

records and or hospital records or both. 

• However, the quality and reliability of data vary between 

surveillance systems in different countries and also 

between systems within same country. 

• For road traffic injuries, certain key variables need to be 

collected 

• Countries should collaborate and help support regional 

and global systems so that the monitoring and 

evaluation of road safety can be improved and 

sustained.



2) COMMUNITY BASED SURVEYS 

• A second approach to gathering data on road 

traffic injuries is to conduct community based 

surveys. 

• Some injured patients fail to reach hospital for 

variety of reasons and the hospital based injury 

surveillance system will not capture this type of 

cases. 

• But, community based surveys not only pick up 

these unreported cases, but also provide useful 

information on injuries and may be of particular 

relevance in countries where basic population and 

mortality data are not available.



3) SURVEYS ON SELECTED THEME 

• A third approach is to conduct surveys on 

particular themes related to accidents and 

injuries. 

• These surveys may arise from the need for 

specific data that are not available from 

hospital based surveillance system or 

community surveys.



4) HEALTH INDICATORS FOR ACCIDENTS AND INJURIES 

• Indicators are important tools not just for 

measuring the magnitude of a problem, but 

also for setting targets and assessing 

performance. 

• The preparation of health indicators face 

obstacles in data collected like errors in the 

population statistics and vehicle 

registration …etc .



5) DEFINITIONS AND STANDARDISATION OF DATA 

• Road traffic injuries and death cases can 

be missed by the data collection system 

because of differences in the definition 

used in different countries. 

• There are a number of potential problems 

with the definitions of a road traffic death or 

injury arising from the following :- 

• Variations in the interpretation of the 

specified time period between the 

injury event and death.



5) DEFINITIONS AND STANDARDISATION OF DATA 

• The actual interpretation of the 

definition in different countries and by 

different people recording the 

information. 

• Differing levels of enforcement of 

definitions 

• Differing techniques for assessing the 

severity of injuries



6) DISSEMINATION AND APPLICATION 

• Road safety research is not an end in itself 

and findings need to be shared, discussed 

and applied in order for the full benefits to 

be realized. 

• Research institutes should publicize all 

results 

• Research findings can be also disseminated 

through seminars and training courses and 

international conferences.

CONCLUSION 

• Accident and injury data are a crucial 

element of a safety diagnosis. 

• An efficient road safety program must be 

based on these data, since realistic targets 

can only be established by using accident 

related information. 

• A standard data collection instrument 

should be developed by WHO so that all the 

countries will have uniformity in data 

collection.

THE KEY ORGANIZATIONS INFLUENCING 

POLICY DEVELOPMENT

THANK YOU

Prof. Abdelbari Bener - Arab Children Health Congress

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