2014.ISDS.Abstracts.Final.pdf


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192

ISDS 2014 Conference Abstracts

Establishing Prospective Road Traffic Injury Surveillance 
in India: Challenges and Solutions

Shailaja Tetali*1, Lakshmi Josyula1, Shivam Gupta2, Shirin Wadhwaniya2, G Gururaj3 and 
Kent Stevens2

1Indian Institute of Public Health- Hyderabad, Hyderabad, India; 2IIRU, Baltimore, MD, USA; 3NIMHANS, Bangalore, India

Objective
To describe the challenges and lessons learned in establishing road 

traffic injury surveillance in two large government teaching hospitals 
in two States of South India, with solutions that eventually helped 
streamline the process.

Introduction
Low- and Middle-Income Countries (LMIC) disproportionately 

bear the high burden of injuries, with 90% of all deaths due to 
injury occurring in these countries1. In India, data on pre-hospital 
care of the injured is either absent or incomplete. The Bloomberg 
Philanthropies Global Road Safety Program is a five-year (2010-
2015) project implemented by a consortium of partners to improve 
road safety in 10 LMICs2. The risk factors being addressed in India 
are reduction of drink driving and increasing helmet use3. Up to 16 
months of data from two large hospitals in Hyderabad (population 8 
million) were retrospectively reviewed to examine the burden of road 
traffic injuries. Unfortunately, key information on the following was 
incomplete: alcohol use; location and activity of patient at the time 
of injury; nature of collision; vehicle in which patient was traveling; 
striking vehicle and type of road user. Information on the presence 
of safety equipment like helmet and seatbelt, and occurrence of pre-
hospital care was uniformly absent. To overcome the information gap, 
round-the-clock injury surveillance was established in July 2013 in 
Hyderabad and in June 2014 in Visakhapatnam.

Methods
Hospital surveillance data were collected round-the-clock using 

a validated paper form. However, this abstract only describes the 
challenges encountered while establishing the surveillance system 
in the two states. Problems and concerns were identified through 
personal discussions of data-collection experiences through field 
notes, review of data-collection forms, and field observation of 
data-collection process by the investigators. Corrective action was 
undertaken when indicated.

Results
The challenges encountered and solutions employed are described 

below:

Conclusions
There are many challenges in establishing surveillance systems 

for road injuries in India, predominantly rapid staff turnover, heavy 
workload and the absence of already existing data recording and 
management in hospitals. Pending administrative solutions such as 
improved staffing and posting, the chief measures to address these 
challenges were sustained dialogue and rapport-building with hospital 
administrators, training of data collectors, and enlisting the aid of 
bridge personnel, such as interns. Reiterating the value of surveillance 
data to negotiate for hospital resources commensurate with the high 
burden of road injuries may help convince hospital administrators to 
sustain such surveillance initiatives.

Challenges and solutions

Keywords
Injury surveillance; Establishing systems; India; Challenges, 
solutions; Public health practice

Acknowledgments

This work was conducted as part of the Global Road Safety Program, 
funded by Bloomberg Philanthropies.

References

1.Stevens et al. Establishing hospital-based trauma registry systems:
lessons from Kenya. Injury, Int. J. Care Injured 44 S4 (2013) S70–S74

2. Editorial: Road Safety in 10 Countries: A Global Opportunity A A.
Hyder, D Bishai

3. Qualitative study to explore stakeholder perceptions related to road
safety in Hyderabad, India. Tetali S, Lakshmi JK, Gupta S, Gururaj 
G, Wadhwaniya S, Hyder AA

*Shailaja Tetali

E-mail: shailaja.t@iiphh.org    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e208, 201