Yes / Around 1.35 million deaths are caused by Road Traffic Injuries (RTIs) each year. This study aimed to explore the perceptions of Vanuatu's Health Care Workers (HCWs) regarding the existing preventative strategies for RTI. Materials and methods: In 2020, this study used qualitative approaches to collect data from HCWs using Focus Group Discussions (FGDs). Study participants were self-identified Ni-Vanuatu HCWs who had been serving for more than 6 months in three main hospitals where the study was conducted and purposive sampling was used to gather the study participants. To guide the FGDs, a semi-structured open-ended questionnaire was created. Thematic analysis was used to processed the data obtained, based on predetermined themes that were based on theory while also enabling the data to determine new themes. Result: From 5 FGDs with 22 HCWs who were emergency nurses, doctors and public health officers, data saturation was reached. The study yielded five main themes and sixteen subthemes. The relevance and trends of RTI, barriers to effective care, pre-hospital management capacity, barriers to pre-hospital care and addressing RTI were among the key subjects. The findings suggest that addressing health institutional leadership and resources will improve prevention of RTIs. Conclusion: Prevention of RTIs is hindered by the lack of health institutional capacities in terms of leadership and resources that include emergency equipment, financial and trained human resources. The health sector should consider developing stronger leadership in road safety to be an essential part of its core business. / We acknowledge with gratitude the Vanuatu Government through the Training and scholarship units under the Ministry of Education, for the financial support towards this study.

To determine accurately the number of serious injuries at EU level and to compare serious injury rates between different countries it is essential to use a common definition. In January 2013, the High Level Group on Road Safety established the definition of serious injuries as patients with an injury level of MAIS3+(Maximum Abbreviated Injury Scale). Whatever the method used for estimating the number or serious injuries, at some point it is always necessary to use hospital records. The aim of this paper is to understand the implications for (1) in/exclusion criteria applied to case selection and (2) a methodological approach for converting ICD (International Classification of Diseases/Injuries) to MAIS codes, when estimating the number of road traffic serious injuries from hospital data. A descriptive analysis with hospital data from Spain and the Netherlands was carried out to examine the effect of certain choices concerning in- and exclusion criteria based on codes of the ICD9-CM and ICD10. The main parameters explored were: deaths before and after 30 days, readmissions, and external injury causes. Additionally, an analysis was done to explore the impact of using different conversion tools to derive MAIS3 + using data from Austria, Belgium, France, Germany, Netherlands, and Spain. Recommendations are given regarding the in/exclusion criteria and when there is incomplete data to ascertain a road injury, weighting factors could be used to correct data deviations and make more real estimations.

<p>Globally, injury is a major public health problem. The extent of the problem varies considerably by demographic subgroups, regions and national income. The overall objective of this thesis is to examine the relationship between injury mortality and economic development, and to discuss its role in the changing patterns of mortality as described in health transition theory.</p><p>By cross-sectional analysis between cause-specific injury-related mortality and income per capita, studies included in this thesis indicated that while unintentional injury mortality (UIM) and homicide rates correlated negatively with GNP per capita for total populations with varying patterns for age-specific mortality, suicide rates increased slightly by nations’ income per capita, especially among women. In age- and cause-specific injury mortality differentials between low-income, middle-income and high-income countries, ageing and injury interplay mutually with regard to health transition; declining rates in child UIM by income level contributes to the ageing process, while increasing UIM among the elderly, in combination with ageing populations boosts the absolute number of injury deaths in this segment.</p><p>Between the income-based country groups, both cross-sectional and longitudinal analyses show that injury mortality for all three major causes (i.e. unintentional injury, suicide and homicide) first increase and then decrease with rising income per capita, following an inverted U-shaped curve.</p><p>These results illustrate that injury is not a homogeneous public health phenomenon from a health transition perspective. While child unintentional mortality clearly agrees with ‘diseases of poverty’, unintentional injury in the elderly agrees with ‘diseases of affluence’. Patterns for homicide and suicide are more complex and uncertain. Generally, the strength and direction of injury mortality by economic development vary considerably by age, sex and type of injury.</p><p>Further research on causations, mechanisms, broader indicators and data quality, as well as theoretical developments on health transition taking new findings and parallel frameworks into account, is needed to fully understand the complex relationship between economic development and injury mortality.</p>

Globally, injury is a major public health problem. The extent of the problem varies considerably by demographic subgroups, regions and national income. The overall objective of this thesis is to examine the relationship between injury mortality and economic development, and to discuss its role in the changing patterns of mortality as described in health transition theory. By cross-sectional analysis between cause-specific injury-related mortality and income per capita, studies included in this thesis indicated that while unintentional injury mortality (UIM) and homicide rates correlated negatively with GNP per capita for total populations with varying patterns for age-specific mortality, suicide rates increased slightly by nations’ income per capita, especially among women. In age- and cause-specific injury mortality differentials between low-income, middle-income and high-income countries, ageing and injury interplay mutually with regard to health transition; declining rates in child UIM by income level contributes to the ageing process, while increasing UIM among the elderly, in combination with ageing populations boosts the absolute number of injury deaths in this segment. Between the income-based country groups, both cross-sectional and longitudinal analyses show that injury mortality for all three major causes (i.e. unintentional injury, suicide and homicide) first increase and then decrease with rising income per capita, following an inverted U-shaped curve. These results illustrate that injury is not a homogeneous public health phenomenon from a health transition perspective. While child unintentional mortality clearly agrees with ‘diseases of poverty’, unintentional injury in the elderly agrees with ‘diseases of affluence’. Patterns for homicide and suicide are more complex and uncertain. Generally, the strength and direction of injury mortality by economic development vary considerably by age, sex and type of injury. Further research on causations, mechanisms, broader indicators and data quality, as well as theoretical developments on health transition taking new findings and parallel frameworks into account, is needed to fully understand the complex relationship between economic development and injury mortality.

Introduction: The burden of road traffic injuries (RTI) is worsening globally, particularly in low- and middle-income countries (LMIC) and among the young and economically productive populations. A major barrier to improving road safety in India and other LMIC is that existing RTI data sources are severely limited by poor population coverage and data quality. This dissertation explores the reliability and feasibility of using a novel data source with verbal autopsy (VA) methods for the purposes of RTI surveillance in India. Methods: The reliability of the VA methods was assessed using physician agreement on the specific categories of injury death as the metric. Next, a nationally representative household mortality survey with VA methods was used to directly estimate the age- and gender-specific RTI death rates and to identify context-specific RTI risk factors in India. Finally, a national spatial database was constructed to quantify potential access to trauma care in relation to the spatial distribution of RTI deaths in India. Results: Across a broad array of application settings in India, the level of physician agreement was high indicating that the VA methods were reliable in distinguishing RTI deaths among other specific categories of injury deaths. The estimated 183,600 RTI deaths in 2005 from the mortality survey were over 50% more than the national police statistics. Of these RTI deaths, 65% were males between ages 15-59 years, 68% were pedestrians and other vulnerable road users, and over 55% occurred at the scene of collision, within minutes of collision, and/or involved a head injury. The existing community health centres and district hospitals in the Indian public health system had inadequate trauma care capacity but were suitably located to allow broad spatial access to timely trauma care for the majority of RTI deaths in India, which were most problematic in the northern states of Punjab, Haryana, Himachal Pradesh and in Tamil Nadu. Conclusions: Properly designed VA studies can provide accurate and reliable RTI surveillance data and assist in identifying context-specific road safety interventions.

Introduction: The burden of road traffic injuries (RTI) is worsening globally, particularly in low- and middle-income countries (LMIC) and among the young and economically productive populations. A major barrier to improving road safety in India and other LMIC is that existing RTI data sources are severely limited by poor population coverage and data quality. This dissertation explores the reliability and feasibility of using a novel data source with verbal autopsy (VA) methods for the purposes of RTI surveillance in India. Methods: The reliability of the VA methods was assessed using physician agreement on the specific categories of injury death as the metric. Next, a nationally representative household mortality survey with VA methods was used to directly estimate the age- and gender-specific RTI death rates and to identify context-specific RTI risk factors in India. Finally, a national spatial database was constructed to quantify potential access to trauma care in relation to the spatial distribution of RTI deaths in India. Results: Across a broad array of application settings in India, the level of physician agreement was high indicating that the VA methods were reliable in distinguishing RTI deaths among other specific categories of injury deaths. The estimated 183,600 RTI deaths in 2005 from the mortality survey were over 50% more than the national police statistics. Of these RTI deaths, 65% were males between ages 15-59 years, 68% were pedestrians and other vulnerable road users, and over 55% occurred at the scene of collision, within minutes of collision, and/or involved a head injury. The existing community health centres and district hospitals in the Indian public health system had inadequate trauma care capacity but were suitably located to allow broad spatial access to timely trauma care for the majority of RTI deaths in India, which were most problematic in the northern states of Punjab, Haryana, Himachal Pradesh and in Tamil Nadu. Conclusions: Properly designed VA studies can provide accurate and reliable RTI surveillance data and assist in identifying context-specific road safety interventions.

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