Table 39.3Promising and Effective Interventions for Injuries in LMICs

InjuryPromising interventionsInterventions shown to be effective in LMICs (references)
Road Traffic InjuriesReducing motor vehicle traffic: efficient fuel taxes, changes in land-use policy, safety impact assessment of transportation and land-use plans, provision of shorter and safer routes, trip reduction measuresIncreasing the legal age of motorcyclists from 16 to 18 years (Norghani and others 1998)
Making greater use of safer modes of transport
Minimizing exposure to high-risk scenarios: restricting access to different parts of the road network, giving priority to higher occupancy vehicles or to vulnerable road users, restricting the speed and engine performance of motorized two-wheelers, increasing the legal age for operating a motorcycle, using graduated driver's licensing systems
Safer roads
Safety awareness in planning road networks, safety features in road design, and remedial action in high-risk crash sites: making provisions for slow-moving traffic and vulnerable road users; providing passing lanes, median barriers, and street lighting
Traffic calming measures, such as speed bumpsSpeed bumps in reducing pedestrian injuries (Afukaar, Antwi, and Ofosu-Amaah 2003)
Speed cameras
Safer vehicles
Improving the visibility of vehicles, including requiring automatic daytime running lightsDaytime running lights on motorcycles (Radin Umar, Mackay, and Hills 1996; Yuan 2000)
Incorporating crash protective design into vehicles, including installing seat belts
Mandating vehicle licensing and inspection
Safer people
Legislating strategies and increasing enforcement of, for example, speed limits, alcohol-related limits, hours of driving for commercial drivers, seat belt use, bicycle and motorcycle helmet useIncreases in fines and suspension of driver's licenses (Poli de Figueiredo and others 2001)
Legislation and enforcement of motorcycle helmets (Ichikawa, Chadbunchachai, and Marui 2003; Supramaniam, Belle, and Sung 1984).
PoisoningsBetter storage, including positioning and nature of storage vesselsFree distribution of child-resistant containers (Krug and others 1994)
Use of child-resistant containers
Warning labels
First-aid education
Poison control centers
Fall-related injuriesOlder people
Muscle strengthening and balance retraining, individually prescribed
Tai chi group exercise
Home hazard assessment and modification for high-risk individuals
Multidisciplinary, multifactorial screening for health and environmental risk factors
Younger people
Multifaceted community programs of the Children Can't Fly type
Burn-related injuriesFire-related injuries
Introducing programs to install smoke alarms
Separating cooking areas from living areas
Locating cooking surfaces at heights
Reducing the storage of flammable substances in households
Supervising children more effectively
Introducing, monitoring, and enforcing standards and codes for fire-resistant garments
Scald-related injuries
Separating cooking areas from play areas
Improving the design of cooking vessels
Fire- and scald-related injuries
Increasing awareness of burns prevention
Providing first-aid education
DrowningLimiting exposure to bodies of water close to dwellings, such as by fencing
Providing learn-to-swim programs
Providing education about risks for drowning
Increasing supervision and providing lifeguards at recreational facilities
Equipping boats with flotation devices and ensuring their use
Legislating and enforcing rules about the numbers of individuals carried on boats
Having trained and responsive coast guard services

Source: Authors.

From: Chapter 39, Unintentional Injuries

Cover of Disease Control Priorities in Developing Countries
Disease Control Priorities in Developing Countries. 2nd edition.
Jamison DT, Breman JG, Measham AR, et al., editors.
Washington (DC): World Bank; 2006.
Copyright © 2006, The International Bank for Reconstruction and Development/The World Bank Group.

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