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Child injury surveillance that guides interventions: the Beijing primary healthcare experience
Huan Linnan1, Jianhua Duan, Xinxin Chen
1UNICEF East Asia and Pacific Regional Office, Bangkok, Thailand. hlinnan@yahoo.com
Insights
Primary healthcare surveillance effectively guided child injury prevention interventions in Beijing, showing decreased injury rates in urban areas. This system offers wide access to children for monitoring injury trends.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- Childhood injuries pose a significant public health challenge.
- Effective injury prevention requires robust surveillance systems.
- Integrating surveillance into primary healthcare offers a feasible approach.
Purpose of the Study:
- To assess the feasibility of integrating child injury surveillance into primary healthcare.
- To provide data for targeted injury prevention interventions for children under six.
- To monitor child injury incidence rates and trends.
Main Methods:
- A surveillance system was integrated into community primary healthcare centers and kindergartens in Beijing.
- Parental reporting and kindergarten nurse registration captured injury incidents.
- The study included 8358 children annually from 2006-2007 across urban and rural settings.
Main Results:
- High coverage rates were achieved: 93.7% in primary healthcare centers and 98% in kindergartens.
- Injury incidence rates were 2.7% in year 1 and 1.9% in year 2.
- Falls, blunt object impacts, and animal injuries were leading causes; urban injury rates significantly decreased over two years.
Conclusions:
- Primary healthcare-based surveillance is effective for child injury prevention, enabling targeted interventions.
- This approach provides wide access to children and allows for incidence rate calculation and trend monitoring.
- Primary healthcare settings are valuable for collecting child injury data.
Objectives:
To provide feedback to guide injury prevention interventions and to test the feasibility of integrating injury surveillance into the existing primary healthcare service for children under 6 years of age.
Design:
This surveillance system was integrated into existing primary healthcare services at the community primary healthcare centre (PHC) and community kindergartens. Parents reported injury incidents during their child's routine health services at scheduled intervals. Kindergarten nurses registered injury incidents at the absentee recording system. A total of 8358 children annually were included into the surveillance in 2006-07. Setting Two urban communities and three rural communities in Beijing, China.
Results:
The coverage rates were 93.7% in PHCs and 98% in kindergartens. The injury incidence rates in year 1 and year 2 were 2.7% and 1.9% respectively. The leading causes were falls, being hit by blunt object, and animal injury. Major causes of injury were different between urban and rural children. Over the two-year surveillance period, injury incidence rates declined significantly from 2.7% to 1.7% in urban communities. No significant decrease was seen in rural communities.
Conclusion:
Surveillance through the primary healthcare system in Beijing was useful in child injury prevention as data collected allowed managers to design targeted interventions that resulted in decreased injury. In comparison with hospital based surveillance, PHC based surveillance demonstrated an advantage in wide access to children and allowed calculation of injury incidence rates to monitor trends over time. PHC based surveillance can serve as a useful venue to collect child injury data.
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