Abstract
Almost 10% of global deaths are secondary to injuries, yet in the absence of routine injury surveillance and with few studies of injury mortality, the number and cause of injury deaths in many countries are not well understood. This study aimed to develop and evaluate the feasibility of a method to identify injury deaths in rural Nepal. Working with local government authorities, health post staff and female community health volunteers (FCHVs), we developed a two-stage community fatal injury surveillance approach. In stage one, all deaths from any cause were identified. In stage two, an interview with a relative or friend gathered information about the deceased and the injury event. The feasibility of the method was evaluated prospectively between February 2019 and January 2020 in two rural communities in Makwanpur district. The data collection tools were developed and evaluated with 108 FCHVs, 23 health post staff and two data collectors. Of 457 deaths notified over one year, 67 (14.7%) fatal injury events were identified, and interviews completed. Our method suggests that it is feasible to collect data on trauma-related deaths from rural areas in Nepal. These data may allow the development of injury prevention interventions and policy.
Highlights
Accepted: 19 August 2021Injuries claim over five million lives annually, accounting for nine percent of the world’s total deaths [1]
The female community health volunteers (FCHVs) and healthcare workers reported that their regular work was not affected by the additional work of collecting death notification data
Some families were cautious when FCHVs asked to see the deceased’s citizenship card to verify their age, fearing this would involve them in legal issues
Summary
Accepted: 19 August 2021Injuries claim over five million lives annually, accounting for nine percent of the world’s total deaths [1]. According to the Global Burden of Disease (GBD) study, in 2017, the death rates due to injury in Nepal (56.3/100,000) were estimated to be almost double that of high-income countries such as the United Kingdom (31.5/100,000) [2]. The burden of injuries is unequally distributed and mostly affects lower socioeconomic groups [5] Those living in rural areas are more likely to be disadvantaged, having lower levels of education, employment and income from work. Additional to their higher risk of being injured [6], they have reduced access to healthcare and a consequent higher risk of suffering worse outcomes when an injury occurs.
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