Publications
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Keshri VR, Jagnoor J, Peden M, et al., 2024, Why does a public health issue (not) get priority? Agenda-setting for the national burns program in India., Health Policy Plan
There is growing scholarly interest in what leads to global or national prioritisation of specific health issues. By retrospectively analysing agenda-setting for India's national burn program, this study aimed to better understand how the agenda-setting process influenced its design, implementation, and performance. We conducted document review and key informant interview with stakeholders and used a combination of analytical frameworks on policy prioritisation and issue framing for analysis. The READ (Readying material, Extracting data, Analysing data and Distilling findings) approach was used for document reviews, and qualitative thematic analysis was used for coding and analysis of documents and interviews. The findings suggest three critical features of burns care policy prioritisation in India: challenges of issue characteristics, divergent portrayal of ideas and its framing as a social and/or health issue, and over-centralisation of agenda setting. First, lack of credible indicators on the magnitude of the problem and evidence on interventions limited issue framing, advocacy, and agenda-setting. Second, the policy response to burns has two dimensions in India: response to gender-based intentional injuries and the healthcare response. While intentional burns have received policy attention, the healthcare response was limited until the national program was initiated in 2010 and scaled up in 2014. Third, over-centralisation of agenda setting (dominated by a few homogenous actors, located in the national capital, with attention focussed on the national ministry of health) contributed to limitations in program design and implementation. We note following elements to consider when analysing issues of significant burden but limited priority: the need to analyse how actors influence issue framing, the particularities of issues, the inadequacy of any one dominant frame, and the limited intersection of frames. Based on this analysis in India, we recommend a decentralise
Petersen Williams P, Prinsloo M, Peden MM, et al., 2024, Identifying and Validating Alcohol Diagnostics for Injury-Related Trauma in South Africa: Protocol for a Mixed Methods Study., JMIR Res Protoc, Vol: 13, ISSN: 1929-0748
BACKGROUND: The burden of alcohol use among patients with trauma and the relative injury risks is not routinely measured in South Africa. Given the prominent burden of alcohol on hospital trauma departments, South Africa needs practical, cost-effective, and accurate alcohol diagnostic tools for testing, surveillance, and clinical management of patients with trauma. OBJECTIVE: This study aims to validate alcohol diagnostics for injury-related trauma and assess its use for improving national health practice and policy. METHODS: The Alcohol Diagnostic Validation for Injury-Related Trauma study will use mixed methods across 3 work packages. Five web-based focus group discussions will be conducted with 6 to 8 key stakeholders, each across 4 areas of expertise (clinical, academic, policy, and operational) to determine the type of alcohol information that will be useful for different stakeholders in the injury prevention and health care sectors. We will then conduct a small pilot study followed by a validation study of alcohol diagnostic tools (clinical assessment, breath analysis, and fingerprick blood) against enzyme immunoassay blood concentration analysis in a tertiary hospital trauma setting with 1000 patients. Finally, selected alcohol diagnostic tools will be tested in a district hospital setting with a further 1000 patients alongside community-based participatory research on the use of the selected tools. RESULTS: Pilot data are being collected, and the protocol will be modified based on the results. CONCLUSIONS: Through this project, we hope to identify and validate the most appropriate methods of diagnosing alcohol-related injury and violence in a clinical setting. The findings from this study are likely to be highly relevant and could influence our primary beneficiaries-policy makers and senior health clinicians-to adopt new practices and policies around alcohol testing in injured patients. The findings will be disseminated to relevant national and provincial go
Keller ME, Ledesma RD, Poó FM, et al., 2024, Newspaper framing of motor vehicle crashes and road safety in Argentina., Int J Inj Contr Saf Promot, Vol: 31, Pages: 86-95
The media plays a key role in shaping the public's perception of road safety. This study analyzes the newspaper coverage and framing of motor vehicle crashes (MVCs) and road safety in Argentina, South America. The content of 304 articles published by 15 newspapers in November 2020 was reviewed. The results show that episodically framed news stories (focused on a single event or incident) prevail over thematically framed articles. MVCs are presented primarily as 'police' events and tend to receive more coverage when fatalities are involved. There is limited information provided on contextual and risk factors, and road safety advice is rarely included. Speeding, infrastructure, alcohol and other human-related variables are the most cited risk factors. Very few articles mention the use of protective devices (seat-belt, helmet and child restraint system). Although motorcyclists represent 40% of RTC deaths in Argentina, only 20% of the news coverage was about them. News coverage was quite similar in national and regional newspapers. There is an opportunity for the media to help build a better road safety culture, but significant changes in news framing are required. Practical recommendations for editors, journalists and road safety practitioners are provided.
Cullen P, Peden AE, Francis KL, et al., 2024, Interpersonal Violence and Gender Inequality in Adolescents: A Systematic Analysis of Global Burden of Disease Data From 1990 to 2019., J Adolesc Health, Vol: 74, Pages: 232-245
PURPOSE: Interpersonal violence is a leading cause of adolescent deaths and disability. This study investigates sex differences in burden of interpersonal violence for adolescents and explores associations with gender inequality. METHOD: Using data from the 2019 Global Burden of Disease study, we report numbers, proportions, rates of interpersonal violence deaths and disability adjusted life years (DALYs) for all ages, and rate of change (from 1990 to 2019) in adolescents aged 10-24 years disaggregated by sex and geography. We explored associations with gender inequality using gender inequality index. RESULTS: One in four (24.8%) all-age interpersonal violence deaths are in adolescents. In 2019, the rate of deaths in adolescent males was almost six times higher than females (9.3 vs. 1.6 per 100,000); and since 1990, the rate of decline in DALYs for females was double than that for males (-28.9% vs. -12.7%). By contrast, the burden of sexual violence is disproportionately borne by adolescent females, with over double the rate than males (DALYs: 42.8 vs. 17.5 per 100,000). In countries with greater gender inequality, the male-to-female ratio (deaths and DALYs) was increased among older adolescents, pointing to benefits for males in more gender equal settings. DISCUSSION: Social identities, relationships, and attitudes to violence are established in adolescence, which is an inflection point marking the emergence of disproportionate burdens of interpersonal violence. Our findings affirm that global agendas must be expanded to address interrelated factors driving multiple forms of interpersonal violence experienced by adolescents and reverberating to the next generation.
Puvanachandra P, Mugeere A, Ssemugabo C, et al., 2024, Voices from the ground: community perspectives on preventing unintentional child injuries in low-income settings, International Journal of Environmental Research and Public Health, Vol: 21, Pages: 1-15, ISSN: 1660-4601
Unintentional injuries significantly contribute to mortality and morbidity among children under five, with higher prevalence in low- and middle-income countries (LMICs). Deprived communities in these regions face increased injury risks, yet there is limited research on child safety tailored to their unique challenges. To address this gap, we conducted focus group discussions in rural Uganda, involving parents, village health workers, community leaders, teachers, and maids. The objective was to understand community perceptions around child safety and determine what culturally and age-appropriate solutions may work to prevent child injuries. Analysis of discussions from ten focus groups revealed five main themes: injury causes, child development and behavior, adult behavior, environmental factors, and potential safety kit components. Common injuries included falls, burns, drowning, and poisoning, often linked to environmental hazards such as unsafe bunk beds and wet floors. Financial constraints and limited space emerged as cross-cutting issues. Participants suggested educational resources, first aid knowledge, and practical devices like solar lamps as potential solutions. The study presents invaluable insights into child safety in rural Ugandan homes, emphasizing the role of community awareness and engagement in designing effective, accessible interventions. It underscores the importance of context-specific strategies to prevent childhood injuries in similar resource-constrained environments.
Keshri VR, Abimbola S, Parveen S, et al., 2023, Navigating health systems for burn care: Patient journeys and delays in Uttar Pradesh, India., Burns, Vol: 49, Pages: 1745-1755
BACKGROUND: India has one of the highest burden of burns. The health systems response to burn care is sometimes patchy and highly influenced by social determinants. Delay in access to acute care and rehabilitation adversely affects recovery outcomes. Evidence on underlying factors for delays in care are limited. In this study, we aim to explore patients' journeys to analyse their experiences in accessing burn care in Uttar Pradesh, India. METHODS: We conducted qualitative inquiry using the patient journey mapping approach and in-depth interviews (IDI). We purposively selected a referral burn centre in Uttar Pradesh, India and included a diverse group of patients. A chronological plot of the patient's journey was drawn and confirmed with respondents at the end of the interview. A detailed patient journey map was drawn for each patient based on interview transcripts and notes. Further analysis was done in NVivo 12 using a combination of inductive and deductive coding. Similar codes were categorised into sub-themes, which were distributed to one of the major themes of the 'three delays' framework. RESULTS: Six major burns patients (4 female and 2 males) aged between 2 and 43 years were included in the study. Two patients had flame burns, and one had chemical, electric, hot liquid, and blast injury, respectively. Delay in seeking care (delay 1) was less common for acute care but was a concern for rehabilitation. Accessibility and availability of services, costs of care and lack of financial support influenced delay (1) for rehabilitation. Delay in reaching an appropriate facility (delay 2) was common due to multiple referrals before reaching an appropriate burn facility. Lack of clarity on referral systems and proper triaging influenced this delay. Delay in getting adequate care (delay 3) was mainly due to inadequate infrastructure at various levels of health facilities, shortage of skilled health providers, and high costs of care. COVID-19-related protocols and restric
Keshri VR, Peden M, Singh P, et al., 2023, Health systems research in burn care: an evidence gap map, INJURY PREVENTION, ISSN: 1353-8047
Peden AE, Cullen P, Bhandari B, et al., 2023, A systematic review of the evidence for effectiveness of interventions to address transport and other unintentional injuries among adolescents, JOURNAL OF SAFETY RESEARCH, Vol: 85, Pages: 321-338, ISSN: 0022-4375
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Jagnoor J, Singh I, Peden M, 2023, Equity in mobility: an intersectional policy analysis from India, Pages: 535-535
Background: Sustainable Development Goal Target 11.2 states that by 2030 countries should provide access to safe, affordable, accessible and sustainable transport systems for all. Transportation inequities have serious implications for public health, and thus transport policy becomes an important social determinant of health. The social circumstances affecting under-served populations are influenced by societal constructs and complex hierarchies, including policy and implementation of transportation systems. Objective: To explore how social equity considerations can be more effectively incorporated and operationalised in transportation planning. Methods: Guided by intersectional lens and domains of PROGRESS- Plus, policy at the national and subnational level (Delhi) were analysed. Further in-depth interviews were conducted for 30 participants and were anchored for non-binary gender participants, differently-abled people, and adolescents in an urban setting. Findings: Policy documents were found to stigmatise groups based on disability and gender. The policymaking process was found to be exclusionary and ’expert-driven. Voices of vulnerable groups and civil society were left out of the policymaking process. Policies did not detail what evidence was relied upon. The challenges faced by “vulnerable groups” ranged from accessibility, affordability, availability and quality/safety. Softer infrastructure- such as attitudes of service providers were identified as a major limitation to an equitable access of transportation. Conclusion: Adopting an intersectional lens for understanding transport experiences and analysing policies allows for a deeper understanding of the impact of multi-level interacting social locations and structures of domination that shape human experience.
Prinsloo M, Petersen Williams P, Neethling I, et al., 2023, Alcohol diagnostic validation for injury-related trauma: findings from a pilot study, Digital Health, Vol: 9, ISSN: 2055-2076
INTRODUCTION: Alcohol consumption is a key driver of the burden of violence and injury in South Africa (SA). Hence, we aim to validate various alcohol assessment tools against a blood test to assess their utility for improving national health practice and policy. METHODS: We conducted a cross-sectional pilot study from 3 to 19 August 2022 at Groote Schuur Hospital in Cape Town, SA. This was to test logistics for the time of venous blood centrifugation and validation of alcohol assessment tools used in injured patients ahead of the main validation study. Adults aged 18 years and older, who were injured <8 h before arrival were included. Consent was obtained for venous blood alcohol testing to validate, as the gold standard, against the following: active- and passive breath alcohol testing, clinical screening and a finger prick test. Descriptive statistics were reported for the pilot study. RESULTS: The active breath alcohol test's digital reading and the passive test's 'yes/no' results corresponded well against the venous blood alcohol results. The average time to centrifugation was within the laboratory's 2-h cut-off requirement to preserve the alcohol in the serum. DISCUSSION AND CONCLUSION: The pilot study was helpful in identifying challenges with one of the alcohol assessment tools and prevented further costs ahead of the main validation study. We also determined that the selected tertiary hospital site caused a delay in recruiting eligible patients due to other hospital referrals. Hence, the main validation study is in progress at a district-level hospital for a larger sample of eligible patients for testing.
Tingvall C, Michael JP, Larsson P, et al., 2022, Saving lives beyond 2020: The next steps, The Vision Zero Handbook: Theory, Technology and Management for a Zero Casualty Policy, Pages: 789-839, ISBN: 9783030765040
Road safety analysis can be used to understand what has been successful in the past and what needs to be changed in order to be successful to reduce severe road trauma going forward and ultimately what's needed to achieve zero. This chapter covers some of the tools used to retrospectively evaluate real-life benefits of road safety measures and methods used to predict the combined effects of interventions in a road safety action plan as well as to estimate if they are sufficient to achieve targets near-term and long-term. Included are also a brief overview of methods to develop boundary conditions on what constitutes a Safe System for different road users. Further to that, the chapter lists some arguments for the need of high-quality mass and in-depth data to ensure confidence in the results and conclusions from road safety analysis. Finally, a few key messages are summarized.
Peden M, Ameratunga S, Mytton J, et al., 2022, The Step Safely guidelines: a catalyst to address the burden of falls in children and adolescents, The Lancet Child & Adolescent Health, Vol: 6, Pages: 673-674, ISSN: 2352-4642
Keshri VR, Peden M, Jain T, et al., 2022, Impact of COVID-19 and containment measures on burn care: A qualitative exploratory study, Burns, Vol: 48, Pages: 1497-1508, ISSN: 0305-4179
BACKGROUND: Burn care in India is limited by multiple constraints. The COVID-19 pandemic and the containment measures restricted access to non-COVID emergency conditions, including burns. The aim of this study was to explore the impact of the pandemic on burn care in India. METHODS: Using the qualitative exploratory methods, we conducted in-depth interviews (IDI) with plastic and general surgeons representing burn units from across India. Participants were selected purposively to ensure representation and diversity and the sample size was guided by thematic saturation. Thematic analysis was undertaken adopting an inductive coding using NVivo 12 Pro. RESULTS: 19 participants from diverse geographic locations and provider types were interviewed. Three major emerging themes were, change in patient and burn injury characteristics; health system barriers, adaptation, and challenges; and lessons and emerging recommendations for policy and practice. There was change in patient load, risk factors, and distribution of burns. The emergency services were intermittently disrupted, the routine and surgical services were rationally curtailed, follow-up and rehabilitation services were most affected. Measures like telemedicine and decentralising burn services emerged as the most important lesson. CONCLUSIONS: The ongoing pandemic has compounded the challenges for burns care in India. Urgent action is required to prioritise targeted prevention, emergency transport, decentralise service delivery, and harnessing technology for ensuring resilience in burns services.
GBD 2019 Adolescent Transport and Unintentional Injuries Collaborators, 2022, Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019., The Lancet Public Health, Vol: 7, Pages: e657-e669, ISSN: 2468-2667
BACKGROUND: Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10-24 years during the past three decades. METHODS: Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10-14, 15-19, and 20-24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019. FINDINGS: In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10-24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport
Rosen HE, Bari I, Paichadze N, et al., 2022, Global road safety 2010-18: an analysis of global status reports, Injury, ISSN: 0020-1383
BackgroundRoad traffic injuries (RTIs) pose a significant health burden with 1.35 million individuals dying on the world's roads annually. Nearly a decade ago, based on agreed road safety indicators, global commitments were encouraged to dramatically reduce this burden as part of the United Nation's Decade of Action for Road Safety 2011–2020.MethodsThe analysis was based on global level data from three Global Status Reports on Road Safety published by the World Health Organization in 2013, 2015, and 2018. A total of 161 countries that consistently reported statistics for all three reports were included in the analysis. Descriptive analyses, t-test, Wilcoxon rank-sum test, and Spearman's rank correlation were performed to evaluate past and current trends in road traffic deaths and countries’ progress in achieving key road safety indicators.ResultsWe found no significant decline in global road traffic death rates from 2010 to 2016 and in fact, death rates increased in low-income countries (LICs) and the African Region. Death rates were highly dependent on income level of the country, with deaths higher in low- and middle-income countries (LMICs) when compared to high-income countries (HICs). We found that the strength of enforcement of speed laws and child restraint laws increased from 2011 to 2017. However, we did not find a correlation between enforcement of the five key prevention policies (speeding, drink-driving, seatbelts, helmets, and child restraints) and death rate. In terms of advancement in achieving key road safety indicators, there was slow progress in adopting most of the recommended policies and practices based on the five pillars (road safety management, safer roads and mobility, safer vehicles, safer road users, and post-crash response).ConclusionDespite global efforts during the past decade, road traffic deaths remain disproportionally high in LMICs and African countries as shown by global reports, and progress in achieving global road sa
Hyder AA, Hoe C, Hijar M, et al., 2022, The political and social contexts of global road safety: challenges for the next decade, The Lancet, Vol: 400, Pages: 127-136, ISSN: 0140-6736
The goal of this Series paper is to show how road safety has evolved as a global public health issue over the past two decades and to discuss the political and economic dynamics that led to this change. Specifically, the key stakeholders, influences, networks, issue framing, actor power, and synergistic interactions that have contributed to how road safety has evolved as a global public health issue will be discussed. In doing so, we capture the important chronology of events and discuss a set of challenges that highlight the complexity of road safety. We posit that the global road safety community needs to re-evaluate its role and strategy for the next decade and focus more on implementation and country action to achieve reductions in road traffic injuries. We call for an open and inclusive process to ensure that such a reflection occurs before the end of the current decade.
Puvanachandra P, Ssesumugabi C, Balugaba B, et al., 2022, The epidemiology and characteristics of injuries to under 5’s in a secondary city in Uganda: a retrospective review of hospital data, International Journal of Injury Control and Safety Promotion, Vol: 29, Pages: 550-555, ISSN: 1566-0974
Child injuries are largely preventable yet cause significant mortality and morbidity globally. Injury data from low-income countries is limited for children under the age of 5 and therefore the current understanding of the magnitude of injuries in this age group is low. Hospital-based registries are one mechanism by which injury data can be gathered. This paper presents findings from a retrospective hospital record review of 4 hospitals in Jinja, a rural setting in Uganda, involving the extraction of data for children under the age of 5-years who sustained an injury during a 6-month period in 2019.A total of 225 injury cases were retrieved from the hospitals. Over half (57.3%) of the events occurred among males. The majority (92%) suffered one injury per injury event. Most of the injuries occurred among those aged 13 to 24 months (32.9%). Burns (32% ) and cuts (20%) were the most common cause of injury.This study presents a hospital-based analysis of injuries amongst under 5’s in rural Uganda. It provides information on the characteristics of children entering healthcare facilities in Uganda and highlights the burden of paediatric injuries in the hospital setting.
Prinsloo M, Hunter K, Matzopoulos R, et al., 2022, Non-fatal injuries among boys and girls presenting to Red Cross War Memorial Children's Hospital, Cape Town, SAMJ SOUTH AFRICAN MEDICAL JOURNAL, Vol: 112, Pages: 465-471, ISSN: 0256-9574
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Peden M, Puvanachandra P, Keller M-E, et al., 2022, How the Covid-19 pandemic has drawn attention to the issue of active mobility and co-benefits in Latin American cities, Salud Pública de México, Vol: 64, Pages: S14-S21, ISSN: 0036-3634
The Covid-19 pandemic has brought to the fore many issues that will impact public health for years to come –one such impact is on the nexus between transportation and health. Promoting safe, active transport is an activity that has many physical and mental health benefits. During lockdowns, many cities in Latin America imposed infrastructural and legislative changes in order to abide with public health and social measures to reduce virus spread. These ranged from additional bike lanes to reduced speed limits or incentives to purchase bicycles. These cities showed reduced motorized transport, improved air quality and increased active transport, all of which have multiple health and equity benefits. As countries “build back better”, promoting active transport offers the most value for investment and improves health and well-being while continuing to offer social distancing. Quantified case studies are needed to have a more comprehensive understanding of the impact of active transport in various contexts.
Tingvall C, Michael J, Larsson P, et al., 2022, Saving Lives Beyond 2020: The Next Steps, The Vision Zero Handbook, Publisher: Springer International Publishing, Pages: 1-52, ISBN: 9783030231767
<jats:title>Abstract</jats:title><jats:p>Road safety has come a long way in our lifetimes, and there are steps in this progress that mark their place in history. Many of these were technical innovations, such as seat belts, electronic stability control, and geofencing for vehicle speed control. Also important, though perhaps fewer in number, were innovations in strategies to achieve change. These include the public health model of Dr. William Haddon, the introduction of Vision Zero, the World Report on Road Traffic Injury Prevention from WHO and the World Bank, and more recently, the Decade of Action 2011–2020. I am sure that the work and recommendations presented in this report will deserve their place in a “Hall of Fame” for strategic innovation in saving lives across the globe.</jats:p>
Gupta M, Bhaumik S, Roy S, et al., 2021, Determining child drowning mortality in the Sundarbans, India: applying the community knowledge approach, Injury Prevention, Vol: 27, Pages: 413-418, ISSN: 1353-8047
Background The Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region.Methods A community-based survey was conducted in the Sundarbans to determine the drowning mortality rate for children aged 1 to 4 years and 5 to 9 years. A community knowledge approach was used. Meetings were held with community residents and key informants to identify drowning deaths in the population. Identified deaths were verified by the child’s household through a structured survey, inquiring on the circumstances around the drowning death.Results The drowning mortality rate for children aged 1 to 4 years was 243.8 per 100 000 children and for 5 to 9 years was 38.8 per 100 000 children. 58.0% of deaths were among children aged 1 to 2 years. No differences in rates between boys and girls were found. Most children drowned in ponds within 50 metres of their homes. Children were usually unaccompanied with their primary caretaker engaged in household work. A minority of children were treated by formal health providers.Conclusions Drowning is a major cause of death among children in the Sundarbans, particularly those aged 1 to 4 years. Interventions keeping children in safe spaces away from water are urgently required. The results illustrate how routine data collection systems grossly underestimate drowning deaths, emphasising the importance of community-based surveys in capturing these deaths in rural low- and middle-income country contexts. The community knowledge approach provides a low-resource, validated methodology for this purpose.
Ismaili S, Odland ML, Malik A, et al., 2021, The relationship between psychosocial circumstances and injuries in adolescents: An analysis of 87,269 individuals from 26 countries using the Global School-based Student Health Survey, PLOS MEDICINE, Vol: 18, ISSN: 1549-1277
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Ma T, Peden AE, Peden M, et al., 2021, Out of the silos: embedding injury prevention into the Sustainable Development Goals, Injury Prevention, Vol: 27, Pages: 166-171, ISSN: 1353-8047
Globally, unintentional injuries contribute significantly to disability and death. Prevention efforts have traditionally focused on individual injury mechanisms and their specific risk factors, which has resulted in slow progress in reducing the burden. The Sustainable Development Goals (SDGs) represent a global agenda for promoting human prosperity while respecting planetary boundaries. While injury prevention is currently only recognised in the SDG agenda via two road safety targets, the relevance of the SDGs for injury prevention is much broader. In this State of the Art Review, we illustrate how unintentional injury prevention efforts can be advanced substantially within a broad range of SDG goals and advocate for the integration of safety considerations across all sectors and stakeholders. This review uncovers injury prevention opportunities within broader global priorities such as urbanisation, population shifts, water safeguarding and corporate social responsibility. We demonstrate the relevance of injury prevention efforts to the SDG agenda beyond the health goal (SDG 3) and the two specific road safety targets (SDG 3.6 and SDG 11.2), highlighting 13 additional SDGs of relevance. We argue that all involved in injury prevention are at a critical juncture where we can continue with the status quo and expect to see more of the same, or mobilise the global community in an 'Injury Prevention in All Policies' approach.
Kakar IS, Peden M, Jagnoor J, 2021, Intersectionality based policy analysis: Equity in mobility in India, Transport Policy, Vol: 101, Pages: 14-22, ISSN: 0967-070X
Access to affordable, reliable, good quality transport is necessary for accessing socio-economic opportunities and resources. Transportation inequities have serious implications for public health, and thus transport policy becomes an important social determinant of health. This research studies how needs of vulnerable populations are constructed and addressed in transportation policies in India at the national and sub-national (Delhi) level. Thirty-four National and Delhi level policies were analysed using an intersectional lens to understand how policies identify and address mobility inequities faced by vulnerable groups.Intersectionality states that an understanding of individual experiences based on a single aspect of identity (such as class, gender, ability, age, etc.) is unrepresentative of individual needs. Adopting an intersectional lens for analysing policies allows for a deeper understanding of the impact of multi-level interacting social locations and structures of domination that shape human experience. Thus, helping in creating more effective policies to make transportation accessible to vulnerable groups.The research found that policies focussed on a unitary understanding of population groups and therefore did not capture the complexities of transportation inequities experienced by vulnerable groups. While equity was a stated concern, policies fell short of addressing structural factors and interlocking systems of power and oppression which give rise to inequities. Policy documents were also found to stigmatise groups based on disability and gender. The policy making process was found to be exclusionary and ‘expert’ driven. Voices of vulnerable groups and civil society were left out of the policy making process. In terms of evidence, policies did not detail what evidence was relied upon. All the above has negative implications for the operationalisation of equity and social justice.In order to advance a social justice agenda, an intersection
Jagnoor J, Peden M, 2021, Injuries as Global Health Risk Factor: Causes, Burden, and Prevention, Handbook of Global Health: With 362 Figures and 152 Tables, Pages: 823-854, ISBN: 9783030450083
Injuries are most commonly categorized as unintentional or intentional, based on the perpetrator’s intent or intentionality of the act. Unintentional injuries comprise both transport and nontransport injuries. This chapter examines in detail the risk factors for the leading causes of unintentional injuries, namely, road injuries, falls, drowning, burns, and poisoning. It places injuries in a global context, briefly presents the burden, and then goes on to discuss, in detail, the known risk factors for unintentional injuries in high-, low-, and middle-income countries (LMICs). A consistent theme for every category of cause-specific, unintentional injury is the dearth of reliable evidence from LMICs on risk factors, and thus the challenges informing development of evidence-based interventions, and costeffective approaches to prevention.
Gupta M, Kakar IS, Peden M, et al., 2021, Media coverage and framing of road traffic safety in India, BMJ GLOBAL HEALTH, Vol: 6, ISSN: 2059-7908
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Bhaumik S, Hunter K, Matzopoulos R, et al., 2020, Facilitators and barriers to child restraint use in motor vehicles: a qualitative evidence synthesis, INJURY PREVENTION, Vol: 26, Pages: 478-493, ISSN: 1353-8047
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Jagnoor J, Prinja S, Ha N, et al., 2020, Mortality and health-related quality of life following injuries and associated factors: a cohort study in Chandigarh, North India, INJURY PREVENTION, Vol: 26, Pages: 315-323, ISSN: 1353-8047
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Hunter K, Bestman A, Dodd M, et al., 2020, Overloaded and Unrestrained: A Qualitative Study with Local Experts Exploring Factors Affecting Child Car Restraint Use in Cape Town, South Africa, INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol: 17
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Peden M, 2020, Saving lives through vehicle safety., The Lancet Global Health, Vol: 8, Pages: e746-e747, ISSN: 2214-109X
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