WHO issues guidance on monitoring injuries

BMJ 2002; 324 doi: (Published 02 February 2002) Cite this as: BMJ 2002;324:260
  1. Wendy Moore
  1. London

    Experts from more than 50 countries have combined forces to produce guidelines that will help healthcare staff in developing countries to set up systems to monitor the toll of death and disability from injuries.

    The manual, which is published by the World Health Organization and the Centers for Disease Control and Prevention in the United States, is designed to help planners and front line clinical staff produce systematic data on injuries, whether they are working in a computerised city hospital or a remote first aid clinic. The information that the systems generate will help target action to cut injury rates.

    Injuries, whether intentional or unintentional, have been seen as the “Cinderella” of the public health movement. Prevention has been neglected until recently largely because, the WHO has argued, injuries were viewed as accidents or random events.

    Now that the role of prevention—from seat belts to fire safety—is better understood, public health efforts are still hampered by lack of information on numbers, types, and circumstances of injuries. Monitoring systems are least developed in poorer countries, where the toll of deaths and disability is often highest.

    Although the guidelines are designed as a practical aid to setting up data collection systems in all settings, they are meant to be particularly useful in countries with severe restraints on resources. They explain how to set up simple, cheap but effective systems for collecting, coding, and processing data in places where there may be little or no electronic equipment, inadequate electricity supplies, few staff, and no research expertise. The manual reproduces model forms used in hospitals in South Africa, Jamaica, and Nicaragua.

    More than five million people die worldwide from injuries each year, and many more have permanent or short term disabilities, according to WHO figures. Road traffic collisions are the leading cause of injury related deaths in men, and self inflicted harm is the main cause in women. But causes vary by region. In Africa, wars are the main cause of death from injuries, whereas in China self inflicted injuries are the main factor.

    The WHO's injury surveillance guidelines are available at

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