Objective: Globally, injury is the fourth major cause of death and the third leading contributor to
Disability Adjusted Life Years lost due to health conditions, with the greatest burden borne by lowmiddle
income countries (LMICs) where injury data is scarce. In the absence of effective vital registration
systems, mortuaries have been shown to provide an alternative source of cause of death information for
practitioners and policy makers to establish strategic injury prevention policies and programs.
This evaluation sought to assess the feasibility of implementing a standardised fatal injury data
collection process to systematically collect relevant fatal injury data from mortuaries. The process
evaluation is described.
Methods: A manual including a one page data collection form, coding guide, data dictionary, data entry
and analysis program was developed through World Health Organization and Monash University
Australia collaboration, with technical advice from an International Advisory Group. The data collection
component was piloted in multiple mortuaries, in five LMICs (Egypt, India, Sri-Lanka, Tanzania and
Zambia). Process evaluation was based on a questionnaire completed by each country’s Principal
Investigator.
Results: Questionnaires were completed for data collections in urban and rural mortuaries between
September 2010 and February 2011. Of the 1795 reported fatal injury cases registered in the
participating mortuaries, road traffic injury accounted for the highest proportion of cases, ranging from
22% to 87%. Other causes included burns, poisoning, drowning and falls. Positive system attributes were
feasibility, acceptability, usefulness, timeliness, and simplicity and data field completeness. Some
limitations included short duration of the pilot studies, limited injury data collector training and
apparent underreporting of cases to the medico-legal system or mortuaries.
Conclusion: The mortuary has been shown to be a potential data source for identifying injury deaths and
their circumstances and monitoring injury trends and risk factors in LMICs. However, further piloting is
needed, including in rural areas and training of forensic pathologists and data-recorders to overcome
some of the difficulties experienced in the pilot countries. The key to attracting ongoing funding and
support from governments and donors in LMICs for fatal injury surveillance lies in further demonstrating
the usefulness of collected data.
Objective: Globally, injury is the fourth major cause of death and the third leading contributor toDisability Adjusted Life Years lost due to health conditions, with the greatest burden borne by lowmiddleincome countries (LMICs) where injury data is scarce. In the absence of effective vital registrationsystems, mortuaries have been shown to provide an alternative source of cause of death information forpractitioners and policy makers to establish strategic injury prevention policies and programs.This evaluation sought to assess the feasibility of implementing a standardised fatal injury datacollection process to systematically collect relevant fatal injury data from mortuaries. The processevaluation is described.Methods: A manual including a one page data collection form, coding guide, data dictionary, data entryand analysis program was developed through World Health Organization and Monash UniversityAustralia collaboration, with technical advice from an International Advisory Group. The data collectioncomponent was piloted in multiple mortuaries, in five LMICs (Egypt, India, Sri-Lanka, Tanzania andZambia). Process evaluation was based on a questionnaire completed by each country’s PrincipalInvestigator.Results: Questionnaires were completed for data collections in urban and rural mortuaries betweenSeptember 2010 and February 2011. Of the 1795 reported fatal injury cases registered in theparticipating mortuaries, road traffic injury accounted for the highest proportion of cases, ranging from22% to 87%. Other causes included burns, poisoning, drowning and falls. Positive system attributes werefeasibility, acceptability, usefulness, timeliness, and simplicity and data field completeness. Somelimitations included short duration of the pilot studies, limited injury data collector training andapparent underreporting of cases to the medico-legal system or mortuaries.Conclusion: The mortuary has been shown to be a potential data source for identifying injury deaths andtheir circumstances and monitoring injury trends and risk factors in LMICs. However, further piloting isneeded, including in rural areas and training of forensic pathologists and data-recorders to overcomesome of the difficulties experienced in the pilot countries. The key to attracting ongoing funding andsupport from governments and donors in LMICs for fatal injury surveillance lies in further demonstratingthe usefulness of collected data.
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