Understanding the burden of injuries in Nepal: A systematic review of published studies

Mytton, Julie; Bhatta, Santosh; Thorne, Matthew Charles; Pant, Puspa Raj

doi:10.1080/2331205x.2019.1673654

Cited by 18 publications

(24 citation statements)

References 45 publications

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“…In relation to home injuries, the percentage of all injuries that were home-related in our study are similar to those reported in a recent systematic review conducted in Nepal. 10 Work-related injuries were much higher in our study (28.7%) than in those studies included in the review (11–19%). 10 Earlier studies considered the place of injury occurrence but our study added context and applied operational definitions to the place of injury occurrence, e.g., home- or work-related.…”

Section: Discussioncontrasting

confidence: 49%

“…10 Work-related injuries were much higher in our study (28.7%) than in those studies included in the review (11–19%). 10 Earlier studies considered the place of injury occurrence but our study added context and applied operational definitions to the place of injury occurrence, e.g., home- or work-related. The high number of work-related injuries could be explained by two reasons.…”

Section: Discussioncontrasting

confidence: 49%

“…A recent systematic review of injury research in Nepal identified an absence of evidence about inequalities in injury occurrence. 10…”

Section: Introductionmentioning

confidence: 99%

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Home and work-related injuries in Makwanpur district, Nepal: a household survey

Pant

Deave

Banstola

et al. 2020

Preprint

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Objective: This paper describes the epidemiology of home- and work-related injuries, their mechanisms, inequalities and costs associated with these injuries. Methods A household survey was undertaken in three palikas (administrative areas) of Makwanpur district between April-June, 2019. Data were collected electronically on non-fatal injuries that occurred in the previous three months and fatal injuries that occurred in the previous five years. Findings 17,593 individuals were surveyed from 3,327 households. The injury rate was 8.0/1000 population for home injuries and 6.4/1000 for work-related injuries; 61.0% of home injuries were among females and 69.9% of work-related injuries among males. Forty-eight percent of all home injuries were due to falls (28 males (50.9%) and 40 females (46.5%)); burn/scalds were higher among females 15 (10.5%). Cuts and piercings accounted for 40% of all work-related injuries and 36.3% were falls. Injury incidence varied by ethnic group: home injuries were highest in Brahmin (12/1000) and work-related injuries highest in Rai groups (21.0 per 1000). The total mean cost of work-related injury was US$143.3 (SD 276.7), higher than for home injuries (US$130.4, SD 347.6). The number of home (n=74, 64.9%) and work-related (n=67, 77.9%) injuries were higher in families below the poverty line (<US$1.9) than families in the next income bracket (US$1.9-3.2)(home: n=22, 19.3%; work: n=11, 12.8%). Conclusions Home and occupational fall injuries are common. The inequalities in injury identified in our study by rurality, age, sex, income level and ethnic group can help target injury prevention interventions for vulnerable groups.

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Section: Discussioncontrasting

confidence: 49%

Section: Discussioncontrasting

confidence: 49%

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Home and work-related injuries in Makwanpur district, Nepal: a household survey

Pant

Deave

Banstola

et al. 2020

Preprint

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“…Population-based estimates of injury incidence are available but use variable definitions and data sources. A systematic review in 2019 of injury research in Nepal identified a large number of publications, though most were small hospital case series [ 5 ] at high risk of bias. The most recent nationally representative community-based survey used data from the 2001 census and reported an annual incidence of fatal injuries of 42/100 000 in men and 19/100 000 in women [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

The prevention of – and first response to – injuries in Nepal: a review of policies and legislation

Pant

Mytton

Dharel³

et al. 2021

Health Res Policy Sys

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Background Injuries, the cause of an estimated 4.5 million deaths annually and many more disabilities worldwide each year, are the predictable outcome of particular circumstances. One of the most effective ways to prevent injuries is through policy and legislation. The aim of this research study was to identify and critically review all policy and legislation in Nepal that had the potential to prevent injuries. Methods We identified legislation and policy that met inclusion criteria through a stakeholder meeting, networks and contacts, and websites and electronic resources. Each included document was critically reviewed to identify areas of strength and opportunities for improvement. We compared the included documents against WHO’s recommendations of known effective interventions. Results Sixty-two documents met the inclusion criteria for this review. Of these, 24 (38.7%) were exclusively related to road injuries, 11 (17.7%) to occupational injuries, 6 (9.7%) to injuries in the home and 5 (8.1%) to injuries at school; 30 (48.4%) documents included text related to the first response to injuries. Of 127 strategic recommendations by WHO that provided an area for policy or legislative focus, 21 (16.5%) were considered adequately met by Nepali policy and legislation, 43 (33.9%) were considered partially met and 63 (49.6%) were not met. Conclusion We drew five conclusions from this critical policy review, which we have related to recommendations as follows: widening the scope of legislation and policy for injury prevention to emphasize injuries occurring at home or school; addressing the causes of injuries and promoting proven preventive measures; greater clarity on both individual and institutional roles and responsibilities; trustworthy data and quality evidence to inform decision-making; and financial investment and capacity-strengthening for injury prevention and first response. The current system of federal governance in Nepal has potential for strengthening injury prevention and first response at the central, provincial and local levels.

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“…In our study, we sought to develop, design and evaluate the feasibility of a bespoke rst-responder trauma training programme for the NTP. There is limited research on injuries occurring to residents of Nepal, including road tra c injuries 10 . There is a paucity of research on the tra c-police o cers' experience of, and training in, providing emergency care at the crash scene.…”

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confidence: 99%

Post-Crash Trauma Care: First-Responder Training for the Traffic Police in Makwanpur, Nepal; A Pre and Post-Intervention Cross-Sectional Survey

Smart¹,

Banstola²,

Raut³

et al. 2020

Preprint

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BackgroundThe World Health Organisation has estimated Nepal's road traffic fatality rate as one of the highest in South-East Asia. Road-crashes are the 7th leading cause of mortality in Nepal, but there is currently a lack of nationwide emergency medical services. We developed, designed and evaluated the feasibility of a first responder training programme for the traffic police in Nepal.Methods39 traffic police officers in Makwanpur District participated in the study and 29 attended the 3-day first response course. A training needs assessment survey was conducted with participants prior to course design. A knowledge and confidence pre-test was followed-up by post-testing. Participants were supplied with a trauma-pack and asked to complete a report form when first-responder skills were used. Post-testing and follow-up survey were conducted at 6-months which explored experiences of applying first response skills.ResultsPre-course needs assessment showed that 97% of the participants believed that giving first-aid was their responsibility;95% had experience of transporting road-crash victims to hospital with a range of injuries. Low levels of first-aid training and a lack of standardisation were reported. Knowledge and confidence levels were low in pre-test. Post-test knowledge scores improved by 40% to 75%. Confidence levels improved post-course but were reduced at 6-months. In the 6-month study period, participants attended 303 road-crashes. 44% of the participants had used at least one first-response skill from the course; applying skills on 92 occasions, though incident report-forms were frequently not completed. ConclusionsDelivering a first-response programme for the traffic-police is feasible. Knowledge could be retained and used, and skills were in frequent demand. Barriers to providing treatment included; patient already en-route to hospital; resistance from relatives or bystanders and competing police duties. Further studies will need to reinforce the need to capture the use of incident report forms when first responder skills are applied. It is feasible practically and financially to extend the training to cover other districts/all of Nepal as a low-cost measure to combat road traffic injury in the absence of formal emergency medical services.

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Understanding the burden of injuries in Nepal: A systematic review of published studies

Cited by 18 publications

References 45 publications

Home and work-related injuries in Makwanpur district, Nepal: a household survey

Home and work-related injuries in Makwanpur district, Nepal: a household survey

The prevention of – and first response to – injuries in Nepal: a review of policies and legislation

Post-Crash Trauma Care: First-Responder Training for the Traffic Police in Makwanpur, Nepal; A Pre and Post-Intervention Cross-Sectional Survey

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