Tampere declaration presents unique opportunity to solve injuries

By Samuel Hinneh Courtesy: ICFJ-WHO Safety 2016 Reporting Fellowship Program

In an effort to tackle the global health burden of injuries, the Tampere Declaration presents a golden opportunity for government agencies, ministries, governments, injury prevention practitioners, among others to firmly provide solutions to causes of injuries.

The participants of the 12th World Conference on Injury Prevention and Safety Promotion, held 18–21 September 2016 in Tampere, Finland, called for strong, coordinated whole-of-government and whole-of-society action to reduce the impact of injuries and violence.

Recent injury and violence-related policy discussions in the United Nations General Assembly and the World Health Assembly, which resulted in adoption of several resolutions, including on the Decade of Action for Road Safety 2011 to 2020 and the 2030 Agenda for Sustainable Development and its seventeen interdependent Sustainable Development Goals (SDGs), attest to the serious nature of the problem.

The inclusion of injury and violence-related targets in the agenda reflects the recognition by world leaders that injuries and violence are a threat to sustainable development, and shows a growing global commitment to tackling these issues, yet the problem continues to persist, claiming many lives.

Despite increasing attention and commitments, more than 5 million people still die each year attributed to injuries and violence. Injuries are a leading cause of death among young people globally. Tens of millions of people suffer injuries that require medical treatment and often hospitalization, and injuries may lead to lifelong disability.

These injuries result from road traffic crashes and other transport, work, burns, drowning, falls, and poisonings, as well as acts of interpersonal violence, suicide and self-harm, including those involving firearms.

Injuries and violence have a substantial physical and psychosocial health impact on individuals. They cost nations a significant proportion of gross domestic product (GDP) and have a negative economic impact on the injured, their families, and their communities.

The burden of injuries and violence, along with their underlying causes and risk factors, are not randomly distributed throughout the world. Nearly 90% of injury and violence-related deaths occur in low- and middle-income countries.

Within many countries, people of poorer economic status have higher risk of injuries and injury-related deaths than wealthier individuals. Injury prevention and safety promotion are important tools for reducing avoidable inequalities in outcomes and achieving health equity.

Evidence and experience show that the vast majority of injuries and violence are predictable and preventable. Multisectoral approaches to preventing injuries and violence and limiting their consequences have resulted in dramatic and sustained reductions in morbidity and mortality in some settings.

These approaches include changes to policy and legislation in the health sector and beyond and behaviour change programmes, and incorporate both individual- and population-level interventions. Such evidence-based interventions are likely to save costs.

Therefore participants at the conference calls on leaders to develop multisectoral national action plans to implement policy, programmes and legislation for injury and violence prevention and control, with clear targets and monitoring mechanisms.

"Designate focal points and create units for injury and violence prevention within the Ministry of Health, and other ministries as relevant to the national context, for example the Ministry of Transport, Ministry of Interior, Ministry of Labour; strengthen the capacity of relevant ministries to work across sectors in a collaborative and coordinated manner,” the declaration states.

The declaration also underscored the need to invest in injury prevention and safety promotion and develop innovative funding mechanisms as well as ensure universal access to essential pre-hospital and facility-based emergency care services.

Dr Etienne Krug, the Director of the WHO Department for the Management of Non-communicable Diseases, Disability, Violence and Injury Prevention says nobody can solve the problem alone, emphasising the need for multi sectoral approach.

"It is not the police alone who can fix it, it is not transport ministry alone, it is not health alone, the really needs to be a collaboration between the different sectors to make sure that we tackle the issue,” he says.

The declaration calls adaptation, implementation and monitoring of proven strategies at national and local level to reduce risk factors and prevent injuries and violence, including but not limited to legislation, regulation, enforcement, environmental modification, and safety equipment and standards.

It calls also for raising awareness and improving health literacy through communication and dissemination of information on the impact of injuries and violence, and effective prevention and control strategies. Integrate injury and violence prevention into other health and safety advocacy platforms, the declaration adds.

Dr Sally-Ann Ohene, Disease Prevention and Control Office at WHO Country Office for Ghana states that collective efforts is required to tap into various agencies or sectors strengthens to implement actions to promote safety.

"The issue had been who the convener is and the health ministry should serve as the convener even though health ministry does not address the risk factors such as poor roads, legislation, to bring the stakeholders together so that the conversation can start. WHO has been instrumental in trying to organise these stakeholders together, and it can be done,” she notes.

Again, the declaration emphasises the need to build community capacity to identify local injury and violence priorities and to take effective action to prevent injuries and violence and improve outcomes. Develop local platforms to engage multiple stakeholders in dialogue and advocacy, such as those created through the Safe Communities movement, it notes.

Moreover, the declaration equally mentions the importance of strengthening standardised national and community- and facility-based data collection on fatal and non-fatal injuries and violence, in order to reveal the true magnitude and allow more effective development and monitoring of prevention and control initiatives. "Collect and disaggregate data sufficiently, and use it to analyse gender, socioeconomic and other inequities that underlie patterns of injury and violence.

"Encourage improved external cause of injury (in addition to diagnosis) coding, utilisation of standard core data sets for injury. Fund research that expands the scientific evidence base for both prevention and improved outcomes for the injured, including research on risk factors and underlying causes,” the declaration states.

Ms Ayikai Poswayo, Programme Director at AMEND, a nongovernmental organization in sub-Saharan Africa says NGOs have a very important role to play because they can help bring more of the voices of the people to the fore.

"We also need government because they set the policies, agenda and determine where the money goes so if civil society, governments and private sector, if we are all able to work together, then for instance the private sector can also bring in funds to work together for a greater good,” she adds.

The declaration also calls for strengthening capacity building for injury prevention and safety promotion, including education, training and professional development to facilitate effective research, policy development, provision of care, system organisation and coordination, advocacy and data collection.

It also encourage the participation of civil society and the private sector in injury and violence prevention. Review actions of industry to ensure they promote injury and violence prevention consistent with current evidence.