WP/200S/DHPIl 011.7 Report Series No.: RS/200S/GE/Ol(PHL)
English only
REPORT
WORKSHOP ON NATIONAL POLICIES AND PLANS ON INJURY AND VIOLENCE PREVENTION
Convened by: WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR THE WESTERN PACIFIC
Manila, Philippines 29-31 July 200S
Notfor sale Printed and distributed by: World Health Organization Regional Office for the Western Pacific Manila, Philippines November 200S
WHOIWPRO LIBRARY '\.t.~.";TL\. PIHLTPPlNES
1 7 APR 2009
NOTE The views expressed in this report are those of the participants in the Workshop on National Policies and Plans on Injury and Violence Prevention and do not necessarily reflect the policies of the World Health Organization.
This report has been printed by the Regional Office of the Western Pacific of the World Health Organization for the participants in the Workshop on National Policies and Plans on Injury and Violence Prevention, which was held in Manila, Philippines from 29 to 31 July 2008.
CONTENTS
Page SUMMARY
1.
INTRODUCTION 1.1 1.2 1.3 1.4 1.5 Background infonnation ............................................................................................................. 1 Objectives ................................................................................................................................... 2 Participants ................................................................................................................................. 2 Organizations .............................................................................................................................. 2 Opening remarks ......................................................................................................................... 3
2.
PROCEEDINGS 2.1 2.2 2.3 2.4 2.5 Country reports ........................................................................................................................... 3 Case reports .............................................................................................................................. 11 Working papers ......................................................................................................................... 12 Group discussion ...................................................................................................................... 14 Regional cooperation ................................................................................................................ 16
3.
CONCLUSIONS 3.1 3.2 3.3 Review of the status of national policies, plans and programmes ............................................ 16 Sharing of country experiences in development and implementation of national policies, plans and programmes .............................................................................................................. 17 Next steps for developing or strengthening national policies, plans and programmes ............. 17
ANNEXES:
ANNEX 1 - LIST OF PARTICIPANTS, OBSERVERS AND SECRETARIAT ANNEX 2 - PROGRAMME OF ACTNITIES ANNEX 3 - LIST OF DOCUMENTS DISTRIBUTED DURING THE WORKSHOP ANNEX 4 - OPENING REMARKS KEYWORDS Health policy I Public policy! Wounds and injuries - prevention and contraIl Violence - prevention and control
SUMMARY
The Workshop on National Policies and Plans on Inju!)' and Violence Prevention was conducted in Manila, Philippines from 29 to 31 July 2008 by the World Health Organization Regional Office for the Western Pacific. The objectives of the workshop were: (1)
to review the status of national policies, plans and programmes for injU!)' and violence prevention;
(2) to share count!)' experiences in the development and implementation of national policies, plans and programmes; and (3) to identify the next steps for developing or strengthening policies, plans and programmes. The workshop was attended by 21 participants, including government officials responsible for policy and/or planning related to injU!)' and violence prevention and national focal points on injU!)' and violence prevention, from Brunei Darussalam, Cambodia, China, Fiji, Japan, the Lao People's Democratic Republic, Malaysia, the Marshall Islands, the Federated States of Micronesia, Mongolia, New Zealand, Palau, Papua New Guinea, the Philippines, the Republic of Korea, Samoa, Tonga, Vanuatu and Viet Nam. There were also observers from the National University of Singapore and Universiti Malaya. Three WHO staff served as the workshop secretariat. The proceedings comprised a global review of the development of national policies and plans on inju!)' and violence prevention, and a presentation of the Regional Framework for Action on InjU!)' and Violence Prevention and Count!)' Profiles in the Western Pacific Region. Participants then presented status reports on the development and implementation of national policies and plans on injU!)' and violence prevention in their countries. The participants from Mongolia and Viet Nam presented their experiences and lessons learnt in this area. The WHO guidelines on developing national policies were then introduced. This was followed by participants undertaking a group discussion on how national policies, plans and programmes could be developed or strengthened. Participants then identified priority next steps to develop or strengthen national policies, plans and programmes in their own countries. The results were shared at a plena!)' session. Participants discussed regional cooperation in the development of national policies, plans and programmes, before the closing of the workshop. The workshop participants arrived at the following conclusions. (l)
Review of the status of national policies, plans and programmes
Nineteen Member States from the Western Pacific Region were represented at this workshop. Each count!)' gave an account of the current situation in terms oflegislation/laws, policies and action plans that addressed violence and injU!)' prevention at the national level: (a) Situation ofnationallegislationllaws - Of the 19 countries that attended this workshop, New Zealand is the only one with nationallegislation/laws for all types injuries. All 19 countries have nationallegislationllaws on road traffic inju!)' prevention.
Nine out of 19 countries - Cambodia, Japan, Malaysia, the Marshall Islands, Mongolia, New Zealand, Palau, the Philippines and Viet Nam - have national legislationlIaws on violence prevention. Only New Zealand has national legislation/laws on drowning. (b) Situation of national policies - Seven out of 19 countries, namely Cambodia, China, New Zealand, Palau, the Philippines, Samoa and Viet Nam have national policies on all injuries. Nine countries have national policies on road traffic injury prevention. Four countries, i.e. New Zealand, Palau, the Philippines and Viet Nam, have national policies on drowning. Nine out of 19 countries have national policies on violence prevention. (c) Situation of national action plans - Six out of 19 countries, including Cambodia, Fiji, Mongolia, New Zealand, the Republic of Korea and Viet Nam, have national action plans on all injuries. Eleven out of 19 countries have national action plans on road traffic injury prevention. Four countries, i.e. Fiji, New Zealand, the Philippines and Viet Nam, have national action plans on drowning. Seven out of 19 countries have national action plans on violence prevention. (2) Sharing of country experiences in development and implementation of national policies, plans and programmes (a) Presentations by participants from Mongolia and Viet Nam highlighted the benefits of having national policies and programmes, which include expression of clear commitment of the Government, mobilization of resources from different sources, and attracting donor support. (b) Difficulties faced in the implementation of policies and programmes include effective coordination among different stakeholders, defining clear roles and responsibilities of each stakeholder, insufficient financial and human resources, overdependency on donor support, and monitoring of effective implementation. (c) Participants agreed that the benefits of comprehensive national policies and programmes on injury and violence prevention would outweigh the difficulties they might face, and that the difficulties could be overcome. (3) Next steps for developing or strengthening national policies, plans and programmes (a) Participants discussed ways to enhance technical exchange as well as the steps they intended to take upon return to their countries. In terms of ongoing communication between participants, the most prevalent view was to establish some kind of electronic platform to permit ongoing exchange. (b) Participants set forward a variety of next steps that they planned on taking upon return to their countries. Nevertheless, there was a fair amount of overlap in terms of the broad thematic direction. Two broad themes emerged as priorities for next steps: (a) data collection, harmonization and sharing; and (b) cross-sectoral meetings to engage stakeholders and clarify roles and responsibilities. (c) Three lesser themes were also cited and identified as steps to be focused on by participants upon their return. These were: (a) capacity-building; (b) raising awareness within government and the population at large; and (c) specific policy development undertakings.
1. INTRODUCTION
1.1
Background information
Injuries caused an estimated 5.2 million deaths worldwide, equivalent to 9% of total world deaths, and resulted in some 181 million disability-adjusted life years (DALYs) lost, or 12% of the world total, in 2002. Given current trends, the global burden of injuries and violence is expected to increase considerably during the coming decades, particularly in low- and middleincome countries. In the Western Pacific Region, it was estimated that injuries caused more than 1.2 million deaths in 2002, or more than 3300 deaths each day, which constituted 24% of worldwide injury deaths. Recognizing the magnitude of the problem, the World Health Assembly addressed these issues and produced resolutions (WHA 56.24 and WHA 57.10) which called on governments to develop national policies for injury and violence prevention. Comprehensive policies and wellthought action plans are essential if efforts at prevention are to be effective. Development of policies, action plans and programmes for injury and violence prevention requires the establishment oflinks across different ministries and other stakeholders at all levels. In order to support Member States in developing effective policies and action plans, WHO has published guidelines for policy-makers and planners on developing policies to prevent injuries and violence. These guidelines provide the rationale behind the need for such a tool, role of the health sector and the link between policies and legislation. Depending on national circumstances, the health sector could take various roles, namely leadership, catalytic, coordination and support. Efforts to address the problem of injuries and violence are increasingly being taken at the regional level. WHO in the Western Pacific Region has collaborated with several countries since 2002 to develop national policies, reports and action plans. Viet Nam has developed a national policy on injury prevention. Mongolia has developed a national programme on injury and violence prevention with an action plan and national reports on injury prevention and violence prevention. China has produced a national report on injury prevention. Malaysia has produced a national report on violence prevention. The experience of these countries can be shared with other countries. WHO has convened two regional meetings on injury and violence prevention: one in Manila, Philippines in May 2006 for Asian countries, and the other in Nadi, Fiji in April 2007 for Pacific island countries. At these meetings, participants discussed and formulated a Regional Framework for Action on Injury and Violence Prevention, 2008-2013. The Regional Framework for Action contains various recommended actions pertaining to national policies and plans including: (1) improving the reporting of injury and violence; (2) preparing an intersectoral plan of action; (3) setting national goals and targets for injury and violence prevention; (4) introducing and enforcing relevant legislation; and (5) increasing allocation of funds for injury and violence prevention activities. The Regional Framework for Action also contains recommended actions for specific injury prevention areas including road traffic injuries, child and adolescent injuries and violence.
-2-
In February 2008, WHO convened a meeting for Member States to review their experiences pertaining to collection of data on road traffic injuries. WHO also convened a meeting in June 2008 to discuss a regional action plan for implementation of the Regional Strategy to Reduce Alcohol-Related Harm, which addressed issues such as drinking and driving and alcohol-related violence. Countries are starting to implement the Regional Framework for Action on Injury and Violence Prevention and require guidance and lessons learnt from the development of national policies and plans. There is a need to review the status of national policies, share country experiences and identifY the next steps for strengthening national policies. 1.2 Objectives The objectives of the workshop were: (1) to review the status of national policies, plans and programmes for injury and violence prevention; (2) to share country experiences in the development and implementation of national policies, plans and programmes; and (3) to identifY the next steps for developing or strengthening policies, plans and programmes. 1.3 Participants
The workshop was attended by 21 participants including government officials responsible for policy and/or planning related to injury and violence prevention and national focal points on injury and violence prevention. The participants were from Brunei Darussalam, Cambodia, China, Fiji, Japan, the Lao People's Democratic Republic, Malaysia, the Marshall Islands, the Federated States of Micronesia, Mongolia, New Zealand, Palau, Papua New Guinea, the Philippines, the Republic of Korea, Samoa, Tonga, Vanuatu and Viet Nam. There were also observers from the National University of Singapore and Universiti Malaya. Three WHO staff served as the workshop secretariat. A list of participants, observer and secretariat members is given in Annex 1. 1.4 Organization
The workshop programme is given in Annex 2, and a list of documents distributed during the workshop is in Annex 3. The documents include working papers prepared by WHO staff members, country reports and case reports prepared by participants, and other handout materials. Workshop participants elected Ms Jennifer Brown from New Zealand as the chairperson, and Dr Franklin Diza from the Philippines as the vice-chairperson. The technical sessions of the workshop started with a global review of the development of national policies and plans on injury and violence prevention, and a presentation of the Regional Framework for Action on Injury and Violence Prevention and Country Profiles in the Western Pacific Region. Participants then presented the status of development and implementation of national policies and plans on injury and violence prevention. Discussions were conducted on main findings from country report presentations. These presentations and discussions addressed the first objective of the workshop.
-3-
The participants from Mongolia and Viet Nam presented their experiences in the development and implementation of national policies, plans and programmes for injury and violence prevention. All participants discussed main fmdings from these presentations. These activities achieved the second objective of the workshop. The WHO guidelines on developing national policies were then introduced. This was followed by participants undertaking a group discussion on how national policies, plans and programmes could be developed or strengthened. Participants then prepared priority next steps to develop or strengthen national policies, plans and programmes in their own countries. The results were shared at a plenary session. These activities addressed the third objective of the workshop. Participants discussed regional cooperation in the development of national policies, plans and programmes, before conclusions and closing of the workshop. 1.5 Opening remarks
Dr Shigeru Omi, WHO Regional Director for the Western Pacific, welcomed participants to the workshop. He stated that injuries were becoming an important public health issue, along with noncommunicable diseases, as countries developed. In the last 200 years or so, diseases and injuries had been increasingly caused by human activities, and as such could be avoided by developing effective strategies. Dr Omi noted the efforts of the Gove=ent of Viet Nam in developing and implementing a national policy on injury prevention, particularly controlling motorcycle traffic injuries. Dr Omi stressed that WHO considered injuries and violence prevention as an important area of work and that its governing body, the World health Assembly, had produced several resolutions in this field. In the Western Pacific Region, WHO developed the Regional Framework of Action on Injury and Violence Prevention, through two regional consultations in 2006 and 2007. WHO also developed guidelines for Developing Policies to Prevent Injuries and Violence to assist Member States to develop national policies and action plans. He mentioned that with the framework and guidelines in place, it was now time to develop and implement country-specific plans of action for injury and violence prevention. The main purpose of this workshop was to start the process of developing and strengthening national policies and plans for injury and violence prevention. Wishing participants fruitful discussions, Dr Omi declared the workshop officially open.
2. PROCEEDINGS
2.1 2.1.1
Country reports Brunei Darussalam
In Brunei Darussalam, road traffic accidents are the leading cause of injury-related mortality and second leading cause of morbidity after falls. As a result, road safety has become a priority in the Gove=ent's strategy to prevent violence and injury. In 2004, the National Road Traffic Safety Council of Brunei, in which the Ministry of Health plays a coordinating role, developed a five-year action plan aimed to reduce injuries, to save more lives, and to increase compliance on helmet and seatbelt wearing by 2008. Four national laws were implemented to address the following: failure to use safety belts, cell phone usage while driving, failure to stop at a red traffic light and unlawful U turns. The implementation of the laws is enforced with the
- 4-
help of the Royal Police Force, Land Transport and media. Several national and subnational programmes on road safety have also been organized regularly to increase the public's awareness. In addition, the University of Brunei is researching the cost of road traffic accidents with an aim to further enforce the laws and increase the public's awareness. Data obtained from the four hospitals in Brunei Darussalam and the Royal Police Force are categorized according to the WHO International Classification of Diseases (ICD-l 0) under Injury and Poisoning and External Causes. Apart from the action plan on road safety, there is no other policy or action plan for the prevention of other forms of injuries. A lack of human resources, inadequate allocation of funds and insufficient data collection are among the issues and challenges faced. However, the Ministry of Health plans to improve data collection through its current e-health project. 2.1.2 Cambodia
Injury caused by road traffic accidents is more common than other causes. It ranks as the third leading cause of mortality in Cambodia. Its impact on public health and the economy led the Government of Cambodia to recognize it as one of the priorities of its injury and violence action plan and to promulgate the Road Safety Law. The national policy and strategic plan on road safety are being implemented by relevant ministries and other organization agencies. The Ministry of Health has developed a national policy on injury and violence prevention management and has been implementing it since the beginning of2008. In line with the injury and violence action plan, the Ministry of Health has developed a national policy and strategic plan of emergency medical services and pre-hospital and hospital trauma care to strengthen and improve the capacity of emergency medical services in reducing injury fatality rate and disability. It has also promUlgated a Domestic Violence and Child Labour Law to reduce further the high mortality rate of injury. 2.1.3 China
China is the most populous developing country in the world. The total population of China is 1.32 billion, according to the Chinese Statistical Yearbook of 2007. About 45% of the total population lives in the urban areas, and 55% in the rural. Around 20% of the population is below 15 years old, while 12% is over 60 years old. China's gross domestic product (GDP) reached 3 trillion in 2007. Injury is the fifth leading cause of death. The incidence of death caused by injury and poisoning in rural areas declined from 1990 to 2005, but it is still higher than in urban areas. Traffic accidents, suicide, drowning, poisoning and falling are major reasons for injury-related deaths. In China, injury prevention and control involves a lot of sectors, including: health, public security, transportation and women unions. The health sector is responsible for leading, catalyzing, coordinating and supporting intersectoral efforts to prevent and control injury. In 2003, the State Council set up the National Road Safety Work Coordination Committee involving 15 ministries. In 2002, the State Council established the National Safe Production Committee. As the main authority in charge of injury prevention in China, the Ministry of Health,
through its Mental Health Division, has adopted injury control as a public health issue. A few laws for injury prevention and control have been passed, but they remain effective because of a lack of enforcement and an unwillingness of people to change their behaviours to prevent injury in daily life. China has several data collection and reporting systems, including death statistics
-5-
systems, integrated data collection systems, and an injury surveillance system. There is no special country-level household survey for injury; however, the Ministry of Health plans to collect relevant injury occurrence data through an existing national survey. Injury prevention and control is still in the primary stage in China. Issues and challenges include: (1) lack of national coordination mechanism or intersectoral cooperation organization to control all types of injury, especially in the Ministry of Health; and (2) lack of evidence-based experiences to develop a national plan for injury prevention and control. 2.1.4 Fiji
Fiji is currently developing a national policy and plan on injury and violence prevention. Several stakeholders are contributing to the effort. Participating government ministries include Health, Transport, Labour, Education and Youth and Sports. Furthermore, there are nongovernmental organizations (NGOs) like the National Road Safety Council (road traffic injury), the Women's Crisis Centre (domestic violence), the National Council on the Prevention of Suicide (suicide) and the Fiji Red Cross Society (drowning). International agencies like WHO and the International Labour Organization provide funding for various awareness programmes. Academic institutions like the Fiji School of Medicine are involved in providing research support, e.g. the Traffic Related Injury Prevalence Survey (TRIPS). The three leading causes of injury-related deaths are road traffic injuries, drowning and suicide. The health sector's role towards policy development is mainly leadership (suicide prevention) and catalytic (road safety). Fiji does not have a comprehensive injury policy. However, there are policies that address specific injury mechanisms. For example, certain policies enacted as legislation under the Land Transport Act address the prevention of road traffic injuries. The Land Transport Legislation is effectively enforced. Furthermore, there is a strategic plan in place to address the prevention of suicide. The data collection system for injuries in Fiji is hospital-based and all hospital admissions are ICD-l 0 coded. The police department maintains road death statistics. Finally, the main challenge for Fiji is to increase multi sectoral collaboration so that all specific policies can be brought under one umbrella organization (e.g. National Injury and Violence Prevention Council), which then will have an all encompassing policy. 2.1.5 Japan
In Japan, various government sectors are involved in injury prevention activities and policy formulation. These include: Ministry of Health, Labour and Welfare; National Police Agency; Ministry of Land, Infrastructure and Transportation (MLIT); Ministry of Economy, Trade and Industry (METI), Fire and Disaster Management Agency, and Ministry of Education. Policy councils consisting of related ministers and coordinating bodies are usually set up in the Cabinet Office. The role of the Ministry of Health, Labour and Welfare in policy formulation is limited. It plays a leadership role only in prevention of child abuse and occupational injuries. It plays a major role in prevention of intimate partner violence (IPV), food safety, and prevention of youth violence. It plays a supporting role in prevention of suicide, traffic injuries, and criminal violence, focusing on victim care. Although there is no comprehensive policy that covers all kinds of injuries, various focused policies exist, such as: traffic injury prevention; suicide prevention; violence prevention (IPV, child abuse, youth violence, and criminal violence); product safety; food safety; occupational health; and building-related safety. Of these various policies, the most successful examples are reduction of traffic injury deaths, occupational injuries, and deaths due to criminal
-6-
violence. Each implementing agency collects data to monitor and evaluate the effectiveness of their policies. Since the collected data are not open to researchers, scientifically sound evaluations are rarely done. Several injury-related data collection systems exist. The Ministry of Health, Labour and Welfare collects data on vital statistics and occupational injuries. The National Police Agency collects data on traffic injuries, suicide, and criminal violence. The Fire and Disaster Management Agency collects data on fire-related injuries. The National Agency for the Advancement of Sports under the Ministry of Education collects data on school injuries. The National Institute of Technology and Evaluation under MET! and National Consumer Affairs Center under the Cabinet Office collect data on product-related injuries. MLIT collects data on building-related and elevator-related injuries. There is a hospital-based trauma registry system run by the Japanese Association for Trauma Surgeons, which focuses on improvement of trauma care qUality. Issues and challenges in Japan's injury prevention policies include: (1) Japan does not have a comprehensive policy that covers all kinds of intentional and unintentional injuries, though it has various focused policies; (2) coordination among related agencies is not satisfactory; (3) the Ministry of Health, Labour and Welfare is not involved in formulation of the core elements in many prevention policies; and (4) scientific research and evaluation should be more encouraged. 2.1.6 Lao People's Democratic Republic
The Lao People's Democratic Republic has a land area of 236 800 square kilometres. It is a landlocked country in South-East Asia, bordered by Myanmar and China to the northwest, Viet Nam to the east, Cambodia to the south, and Thailand to the west. It has a total population of 5.6 million with a population growth rate of 2.8%. The total length of the country's road network is 32 624 km. The fatality rate is 13 per 10 000 vehicles and 7.6 per 100 000 persons. Fatalities in road traffic accidents have increased from 357 in 1997 to 556 in 2007. The most frequent causes of road accidents are drunk-driving, poor knowledge of traffic rules, disrespect of traffic rules, human error and increase in the number vehicles on the roads. The key stakeholders and their respective roles are as follows: (1) The Department of Transport is responsible for vehicle control, traffic management, issuance of drivers' licenses, supervision of driving schools, formulation of traffic regulations and road safety campaigns. (2) The Department of Traffic Police is in charge of enforcement, investigation and crash reporting. (3) The Department of Education ensures the incorporation of road safety education in schools. (4) The Department of Health Care under the Ministry of Public Health handles hospital injury surveillance and pre-hospital care. The National Road Safety Strategy and Action Plan, approved by the Government in January 2005, aims to improve driving skills, enforce helmet wearing for motorcycle riders and passengers, check on night-time visibility of motorcyclists and bicyclists, and check on drunkdriving and speeding. The plan also aims to strengthen traffic management and to improve
-7-
signing and delineation of public roads. Presently, the National Road Safety Campaign (NRSC) and its secretariat are being established. In order to implement the Action Plan, a database system will be set up, road safety campaigns will be organized, and school programmes will be checked. 2.1. 7 Malaysia
Malaysia's population was 25.2 million in 2007. Of those, 63% were 15 to 64 years old. The state of the nation's health and economy are modest, as evidenced by a GDP of US$ 12700, crude birth rate of 17.6, crude death rate of 4.4, infant mortality rate of 6.7, life expectancy at birth of71.9 for men and 76.4 for women, unemployment rate of 3.4%, and poverty rate of5.7%. The Government generates all policy statements regarding violence and injury. Policy on unintentional injury comes from the Ministry of Transport. Policy on intentional injury falls under the Ministry of Health. Various committees, councils, laws and plan of actions exist to support the violence and injury prevention strategies in the country. The Ministry of Health headed the Prevention ofChild Abuse, a panel under National Social Issues (NSI)I. Last year, the Government created the Malaysia Institute of Road Safety (MIROS) to look into issues related to road traffic injuries. MIROS is responsible for monitoring the Road Safety Plan for 2006-2010. Targets set for road traffic injuries for 2010 are: two deaths per 10000 registered vehicles (currently 3.98),10 deaths per 10000 population (current 23.5) and 10 deaths per one billion vehicle kilometres travelled. Data collection systems are based in multiple agencies. A National Injury Surveillance System was proposed two years ago but has not yet materialized. Among the issues and problems noted are: (1) the health sector has inadequate human and financial resources, (2) injury and violence is not considered a priority area in the health sector, (3) multiple agencies involved in coordination; (4) lack of expertise and interest in the public health arena; and (5) lack of current or extensive research to support policies. 2.1.8 Marshall Islands
The Marshall Islands is a very small country with a total population of about 52 338. The major cause of injury and related death is car accidents. The annual number of accidents is relatively high in terms of population size. The Office of the Attorney General is responsible for initiating laws. While there are laws regarding violence (criminal code), these laws need to be enforced in order to reduce the number of road traffic injuries. The Ministry of Health is not the lead agency in preventing injury and violence. Instead, it works in collaboration with the Ministries of Justice, Education, Public Works, Resources and Development, Internal and Foreign Affairs. The Ministry of Health is the only health institution that provides health care services to the people of the Marshall Islands; all health outreach programmes are conducted by Ministry of Health staff. The Ministry of Health has encouraged other ministries to help prevent injury and violence. However, without a written document or policy on injury and violence, and without qualified personnel to work specifically on injury surveillance data, the Marshall Islands is facing serious challenges.
I
NSI : Chaired by Deputy Prime Minister
- 8-
2.1.9
Federated States of Micronesia
The Federated States of Micronesia does not have a comprehensive policy on injury and violence per se. The Federated States of Micronesia, however, has road safety laws that allow the police to stop motorcyclists not wearing helmets, monitor speed limits, check drivers' licenses, etc. The punishments vary and are very harsh sometimes. The presentation mainly focused on violence-causing injuries and death. It highlighted some prevention measures taken and included in the National Strategic Development Plan (2004-2023) and in the implementation programmes under the Convention on the Rights of Children, Convention on the Elimination of All Forms of Discrimination against Women, Youth Policy and Disability Policy. The Federated States of Micronesia is reviewing a draft policy on violence and trafficking, which will include all types of violence. In fact, there is a draft plan for gender equality that covers all forms of violence and discrimination. 2.1.10 New Zealand Injury remains a leading cause of death and disability in New Zealand. Injury prevention efforts are coordinated through the New Zealand Injury Prevention Strategy and its six priority areas: road traffic injury, fall prevention, drowning prevention, assault prevention, suicide prevention and workplace safety. Overall, injury statistics have experienced a downward trend over the last few decades. In some areas, a plateau has occurred and continued efforts are required to ensure injury rates do not increase. Regular monitoring of progress against the Injury Prevention Strategy occurs every six months. New Zealand plans to focus on strengthening community injury prevention, workforce development, coordination of efforts and outcome evaluation. 2.1.11 Palau
In Palau, coordination and collaboration efforts are strong among government agencies and NGOs including community-based organizations. The injury and violence prevention committee is capitalizing on these strong working relationships to address some challenges in moving towards national policies and action plans. The immediate challenge for Palau is to place injury data collection and surveillance as a priority task for the stakeholders and establish baseline data on injury. In addition to the immediate priority, comprehensive assessment should be done in the next couple of months to determine gaps in policies and effectiveness on social marketing tools to really evaluate public health interventions. 2.1.12 Papua New Guinea
Several departments within the Government are working in the area of injury prevention and control; however, their efforts are not coordinated. The country plans to take the following steps: (1)
carry out a situational analysis: (a) (b) (c) to identify potential stakeholders; to identify the types of data held in each department; and to classify the types ofinjury and violence.
-9-
(2)
call a stakeholders' meeting with the following agenda: (a) (b) (c) (d) to present the results of the situational analysis; to appoint a department to lead and coordinate prevention activities; to monitor and evaluate the impact of injury and violence; and to review reports of each department.
2.1.13
Philippines
Accidents and injuries consistently remain one of the leading causes of mortality in the Philippines. The Philippines health statistics from 1975 to 2002 revealed that there has been an increasing trend of mortality due to accidents per 100 000 population. The mortality rate increased from 19.11100 000 population in 1975 to 41.9/100 000 in 2003. The top five leading causes of death due to injury are assault, transport accidents, accidental drowning and submersion, intentional self-harm and accidental falls. Accidents ranked eighth in 1975, seventh in 1985, sixth in 1995, fifth in 2002 and fourth in 2003 as among the 10 leading causes of death. Road traffic accidents constitute the majority of transport accidents. The commitment of the Philippine Government to injury and violence prevention is embodied in its constitution, which mandates the protection and promotion of the right to health of the people. Administrative Order No. 2005-0023 of the Department of Health identified FOURmula ONE for Health as the implementing mechanism for health sector reform, thereby ensuring better health outcomes, a more responsive public health system, and more equitable health financing through critical reform initiatives in areas of health financing, regulation, service delivery and governance. The Department of Health similarly issued Administrative Order No. 2006-0016 on 16 June 2006 establishing the National Policy and Strategic Framework on Child Injury, and Administrative Order No. 2007-0010 on 19 March 2007 establishing the more comprehensive National Policy on Violence and Injury Prevention. The Philippines recognizes the importance of stakeholders' involvement in injury prevention, programme formulation, strategic planning and programme implementation. Initially, government agencies were the ones who spearheaded the formulation of policies and programmes. Later on, NGOs, academia and research institutions became involved. In the process, an interagency mechanism was established to harmonize collaboration among the different stakeholders. Injury is a public health concern. As such, the health sector is the focal agency and assumes the leadership and coordination role. Since it also introduces innovative strategies for programmes, it assumes a catalytic role as well. It also plays a supportive role in policy research, capability building, formulation of financing schemes like social insurance, protection of vulnerable groups and budget allocation. The National Electronic Injury Surveillance System (NEISS) has been piloted in seven hospitals. It is due for expansion and training of human resources has been done. The population-based mortality data are derived from the Philippine health statistics which use ICD codes for diagnosis and external causes. There is, however, a lack of morbidity data. Injuryfocused reports come from transport police and NGOs. There is a paucity of national surveillance data from non-fatal injury.
- 10 -
2.1.14 Republic of Korea The Ministry of Health and Welfare and the Korean Center for Disease Control are considered to be coordinators in injury prevention area and they plan and implement a long-term injury prevention programme. Also, they support related activity or other ministries/agencies/nongovernmental organizations. They organize an "injury forum" which include many stakeholders in injury prevention. An effective intervention programme is required for injury prevention especially in suicide. For effective programme implementation and assessment of results, the current injury surveillance system needs to be reinforced. Additionally funds are required for new injury prevention programme.
2.1.15 Samoa Over the years, Samoa has done various programmes and initiatives in terms of intentional and unintentional injuries. Various government and nongovernmental organizations deal with injuries in the context of related mandates, e.g. the police lead efforts in the area of road safety with the Ministry of Transport; the Ministry of Women, Community and Social Development deals with initiatives under the Convention on the Rights of Children and Convention on the Elimination of All Forms of Discrimination against Women; and the Accident Compensation Corporation deals with payment issues of various injuries. The Ministry of Health, under the Fanau and Aiga Manuia Project funded by New Zealand's International Aid & Development Agency (NZAID), conducted a needs analysis in 1999 with the focus on children. The needs analysis found that injury and poisoning was the leading cause of death for 1- to 4-year-olds and the second leading cause of hospitalization for 5- to 14-year-olds. In 2007, a Traffic-related Injury Prevention Initiative was launched in Samoa. This project recently completed a situational analysis of injuries in Samoa as a result of various stakeholders' consultations. At this stage, Samoa needs to assess the feasibility of a comprehensive policy for injuries, whether intentional or unintentional. Information systems need to be improved and strengthened so that they can capture valuable and meaningful information, which, in tum, could inform decision-making at all levels. 2.1.16 Tonga Tonga has a population of 106000 people (2005) and a per capita income of a low-middle income country. An estimated 145 Tongan dollars (US$ 80) per person is spent on health each year. Life expectancy is 70 years for men and 72 years for women. The Government spends 10% of its gross national product (GNP) on health. About 470 to 500 people die each year in Tonga. Of these fatalities, 40% are caused by diseases of the cardiovascular system; 20% by cancer, 10% by endocrine and other metabolic diseases, and 8% by respiratory diseases. Less than 4% (20) are due to injuries. Of the total number of injuries, about 50% are caused by road crashes, 15% by assault and the rest are due to drowning, falls, bums, electrocution and suicide (in approximately equal proportions). For nonfatal injuries, it is the third most common cause of hospital admissions.
- 11 -
The presenters believe that data on injuries are incomplete. Nevertheless, due to the health priorities as noted above, the Ministry of Health, together with its partners, have spent most of their efforts on the development of policies aimed at reducing risk factors to diseases of the cardiovascular system and cancer. The emphasis has been on tobacco control, promotion of healthy eating and exercise. Road traffic injury, however, was identified in the 1990s as a very significant cause of morbidity. In 1995, a national committee was mandated by Cabinet to develop policies to address this issue. Unfortunately, due to many competing priority health needs and lack of resources, no significant progress has been made in this area. As a consequence, there is no current policy to guide actions to reduce road traffic injuries, adverse effects of alcohol or violence-related injuries. This workshop has presented a great opportunity to Critically look at policies that need to be developed, in order to address these important health problems in Tonga. 2.1.17 Vanuatu Injury and violence are major causes of hospital admissions for childbirth and complications of childbirth. Vanuatu does not have a blanket policy that addresses all types of violence and injury. However, it does have policies regarding the following: Public Health Act No. 24 of 1994 mentions seat belt use; Road Traffic Act No. 29 of 1962; and Section 107 of the Penal Code deals with domestic violence (physical, emotional, sexual) as intentional assault. Vanuatu's small pieces of policies need to be reviewed and combined so that it can develop one strong violence and injury prevention policy in the future. 2.2 2.2.1 Case reports Mongolia
Mongolia is one of the few landlocked countries in the world. It is located in north-east Asia and sandwiched between two superpowers (China and the Russian Federation). The territory ranks 17th in the world for size. Concerning popUlation density, however, Mongolia is among the most sparsely populated. The population is 2.635 million, almost half of which (61 %) live in Ulaanbaatar City. Total health expenditure increases every year, for example, US$ 68 million in 2003, US$ 78 million in 2004, US$ 90 million in 2005. Injury and poisoning was the fifth leading cause of population morbidity in 2007. Since 1995, the number of deaths due to injury has increased every year. It ranked as the fifth leading cause of population mortality in 1990, moved up to fourth place in 1994 and has been ranked third since 2000. In 2007, injury, poisoning and certain other consequences of external causes were the main causes of mortality, with 2800-3000 people or one in five dying annually because of them. Of these fatal cases, traffic accidents comprised 20.4% in 2004, 19.0% in 2005, 16.9% in 2006 and 18.2% in 2007.
- 12 -
In July 2002, the Government of Mongolia approved the National Programme on Injury and Accident Prevention 2002-2008. This programme was proposed to implement the state policy on public health, and to resolve the issues of injury prevention in conformity with WHO policies and recommendations. The goal of the programme is to decrease mortality and the number of disabled and handicapped people due to injury. The Ministry of Health, as the main organization to implement programme activities, has reported to the Government every year about progress and results. During these years, the Ministry of Health established a Research Training Center in National Traumatology and an Orthopaedic Research Center, and organized more than 10 training courses, workshops and seminars at national and other levels. 2.2.2 Viet Nam
During the period 1990-2000, before the National Policy on Accident and Injury Prevention was formulated, accidents and injuries were on the rise and were becoming two of the leading causes of mortality in Viet Nam. On 27 December 2001, the Prime Minister promulgated Decision number I 9712001lQD-TTg, thereby formulating the National Policy on Accident and Injury Prevention for the period 2002-201 O. The National Policy focuses on traffic injuries, occupational injuries, and injuries at school and in the community. Until now, certain results have been achieved when implementing the national policy on accident and injury prevention. Long-term and annual action plans on injury prevention at various ministries and provinces have been developed. Related legal documents have been reviewed and revised (traffic law, labour law, etc.). Many information, education and communication (lEC) activities have been done to raise the awareness of the community and policy-makers on injury prevention. Injury surveillance has been reinforced, providing timely data for intervention and evaluation of the ongoing programme. Pre-hospital care and trauma care have been invested in and improved according to WHO guidelines. Many interventions at national and community levels have been implemented, such as helmet-wearing programme, prevention of drinking and driving, safe homes, safe schools, safe communities, and safe working places. Capacity of staff working on injury prevention has been strengthened and donor support for injury prevention work in Viet Nam has been augmented. Many challenges and issues came up during the implementation of the national policy. Lessons learnt during the implementation included: (I) coordination and collaboration between ministries and sectors; (2) adequate and efficient advocacy; (3) enough investment for capacity-building; (4) evidencebased interventions; (5) evaluation and following up mechanism; and (6) resourcses mobilization. 2.3 2.3.1 Working papers Global review in 2007
Dr Meddings presented key points with respect to policy development based on discussions held with WHO's six regional advisers during 2007. The following themes emerged from these discussions: (1) A substantial amount of policy work is going on, some of which is directly supported by WHO.
(2) Policy work tends to focus on unintentional injury prevention, in particular, road safety.
- 13 -
(3) Overall, policy development work is increasing, with a growing number of requests coming to WHO regional offices for support. (4) Policy development processes are driven by a range of actors, including bilateral donors, regional development banks, regional resolutions, and mUltiple implementers. (5) Some policy processes become very donor-driven, with implementation following funding rather than the policy document. A number of issues were presented for discussion, including: (I) WHO wishes to place a greater priority on this work, although there is a need to be more strategic, i.e. taking account World Health Assembly and regional resolutions, the diverse drivers of policy-making processes, and the potential ambiguity of roles and responsibilities of the health sector. (2) The multisectoral nature of injury and violence prevention requires thinking about more integrated approaches to injury and violence prevention policy-making, and avoiding vertical policy-making for every type of injury. (3) While the health sector may not be the lead agency, the case should be made within govermnent for the added value of health sector input, both from a curative and a public health (i.e. injury prevention) perspective. (4) There is a need to be opportunistic and creative about entry points for policymaking in regard to injury and violence prevention, including making the case for injury and violence prevention being relevant to poverty reduction, development assistance frameworks, attainment of the Millennium Development Goals, and working with the media to help build awareness within the general public about the impact of injury and violence, and its preventability. 2.3.2 Regional Framework for Action on Injury and Violence Prevention and Country Profiles
Dr Hisashi Ogawa, Regional Adviser in Healthy Settings and Environment, WHO Regional Office for the Western Pacific, presented the Regional Framework for Action on Injury and Violence Prevention 2008-2013, which had been developed through two regional consultations with Member States in 2006 and 2007. He described the goals, regional targets, and recommended actions of the Regional Framework in detail. The recommended actions were divided into two areas: (J) cross-cutting action area, and (2) specific injury-prevention action area. The cross-cutting area includes infrastructure development, data, capacity-building, research, and pre-hospital and hospital care. The specific injury prevention action area includes road traffic injury prevention, child and adolescent injury prevention and violence prevention. He described further the recommended actions for infrastructure development as they were related to the subject of the workshop. They include: development of a national report with priority in the country identified; development and implementation of a national action plan with goals and targets, legislation and regulations; increased allocation of funds; establishment of a high-level intersectoral committee; and development and implementation of policies for the safe design of environments and products. He then presented the outline of a country profile on injury and violence prevention, using the example of Palau. The country profiles would be posted on the WHO Regional Office website.
- 14 -
2.3.3
WHO guidelines on developing national policies
Dr Meddings presented the guidelines published by WHO in 2006 on injury and violence prevention policy development. Rather than providing a detailed breakdown of the document, the presentation focused on a number of key issues covered in the document. Among these were: (1) the definitional issues around the term "policy", stressing that WHO considers it to be a written document; (2) the various roles that the health sector can play in terms of policy development, including leadership, catalytic, coordinating and supportive roles; (3) the emphasis on the importance of ensuring involvement of the health sector in policy development, with this contribution stemming from the health sector's privileged access to data collection, its curative clinical responsibilities, and its public health input in terms of prevention; and (4) the three-stage process of policy development described in the policy guidelines, consisting of the following: (a) Initiation - covering the various steps that need to be undertaken to ensure that sufficient awareness is raised, potential stakeholders identified, and the injury situation sufficiently well characterized that injury prevention policy-making can be initiated. (b) Formulation - covering the main priorities that need to be incorporated within the policy document so as to ensure an effective policy document with appropriate goals, objectives and interventions, clarification of roles, responsibilities and coordination mechanisms, and an evaluation plan. (c) Endorsement - covering the processes and targets for stakeholder and governmental approval and high-level endorsement. The presentation then provided an introduction to the group work segment. The first of two groups consisted of participants wishing to discuss and identifY steps to improve the implementation and effectiveness of existing policies. The second group consisted of participants whose wish was to discuss and identify steps to initiate a policy development process. 2.4 Group discussion
Discussions of Group 1 (i.e. countries interested in improving the implementation and effectiveness of existing policies, plans or programmes on injury and violence prevention) focused on main obstacles to effective implementation of policy; data collection and monitoring systems to evaluate the effectiveness of policy; and fmancing of policy. The main outcomes of the discussion were: (I)
coordination among stakeholders in implementing policy is often difficult;
(2) roles and responsibilities of each stakeholder in implementing policy are not well defined and understood;
- 15 -
(3) monitoring activities are often not linked to the evaluation of effectiveness of intervention; (4) priority is not given to injury and violence prevention;
(5) injury surveillance systems are in place in some countries, but they are not used for evaluating policy interventions; (6) surveys designed specifically to evaluate the effectiveness of policy are often needed; and (7) financing the implementation of injury prevention policy may require innovated approaches (e.g. use of sin tax; fines from violating laws, etc.). Group 2 consisted of II participants as well as Dr David Meddings. The countries represented were Brunei Darussalam, the Federated States of Micronesia, Japan (two participants), the Lao People's Democratic Republic, Malaysia, the Marshall Islands, Papua New Guinea, Samoa, Tonga and Vanuatu. The objective of the group discussion was to enable each participant to identify three to five priority steps to take upon return to his or her country in order to initiate a policy development process. The discussion began with a brief review of the main messages given in the previous session describing the WHO policy development guidelines that pertained to policy initiation. From the ensuing discussion, it quickly became apparent that participants wished to identify the scope of a violence and injury prevention policy initiative. The following were put forward: Country Scope of policy Domestic violence or comprehensive (all violence and injury) Comprehensive (all violence and injury) Comprehensive (all violence and injury) Drowning prevention and suicide prevention Comprehensive (all violence and injury) Gender-based violence Comprehensive (all violence and iniurv) Comprehensive (all violence and injury) Comprehensive (all violence and iniury) Comprehensive (all violence and injury) or potentially domestic violence
Brunei Darussalam Japan (2 participants) Lao People's Democratic Republic Malaysia Marshall Islands Micronesia, Federated States of Papua New Guinea Samoa Tonga Vanuatu
Obviously, from the above table, ambitions were high and most of the remainder ofthe discussions focused around comprehensive policies, although reference was periodically made to more focused injury topics. One of the issues discussed was awareness-raising, which was considered in terms of raising awareness for the need for policies to reduce injury and violence among the general public and also among non health-sector government and academic counterparts. A number of methods for creating this awareness were discussed, including the utility of surveillance and/or survey data (which would also be an important component of creating the epidemiological profile within the setting), victim groups and high-profile injury events, community-based NGOs, and the media. Within government counterparts, a mechanism discussed was taking
- 16 -
advantage of scheduled intersectoral meetings (or calling one if they were not regular events), to ensure that injury and violence-related issues were addressed and the importance of prevention understood. 2.5 Regional cooperation
At the regional level, WHO encourages Member States to do the following: (1) adopt and/or develop national plans and/or strategies on injury and violence prevention in line with implementing the Regional Framework on Injury and Violence Prevention; (2) coordinate the completion of the Global Status Report on Road Safety to provide concrete and comparative baseline data; (3) support the regional conference on injury and violence prevention held in Viet Nam in November 2008; (4) strengthen regional websites on injury and violence prevention, like the websites of the Regional Office for the Western Pacific, Office of the WHO Representative in South Pacific and Association of South East Asian Nations (ASEAN), for information-sharing. At the subregional level, WHO encourages Pacific island countries and areas to do the following: (1) develop their national plans and/or strategies on injury and violence prevention, with reference to the Regional Framework on Injury and Violence Prevention; (2) incorporate injury and violence prevention, especially injury prevention, into national plans and/or strategies on noncommunicable disease (NCD) control and prevention (since NCD has the highest disease burden, and NCD prevention and control has been given high priority and confirmed budgets in Pacific island countries); and (3) put road traffic injury as the entry point and a priority in the field of injury prevention in Pacific island countries.
3. CONCLUSIONS
3.1
Review of the status of national policies. plans and programmes
Nineteen Member States from the Western Pacific Region were represented at this workshop. Each country gave an account of the current situation in terms oflegislationllaws, policies and action plans that addressed violence and injury prevention at the national level: (1) Situation of nationallegislationllaws - Of the 19 countries that attended this workshop, New Zealand is the only one that has nationallegislationllaws on all types of injuries, including drowning. All 19 countries have nationallegislationllaws on road traffic injury prevention. Nine out of 19 countries - Cambodia, Japan, Malaysia, . the Marshall Islands, Mongolia, New Zealand, Palau, the Philippines and Viet Nam - have nationallegislationllaws on violence prevention.
(2) Situation of national policies - Seven out of 19 countries, namely Cambodia, China, New Zealand, Palau, the Philippines, Samoa and Viet Nam, have national policies on all injuries. Nine out of 19 countries have national policies on Road Traffic Injury Prevention. Four countries, i.e. New Zealand, Palau, the Philippines and Viet Nam, have national policies on drowning. Nine out of 19 countries have national policies on violence prevention. (3) Situation of national action plans - Six out of 19 countries, including Cambodia, Fiji, Mongolia, New Zealand, the Republic of Korea and Viet Nam, have national action plans on all injuries. Eleven out of 19 countries have national action plans on road traffic
- 17 -
injury prevention. Four countries, i.e. Fiji, New Zealand, the Philippines and Viet Nam, have national action plans on drowning. Seven out of 19 countries have national action plans on violence prevention. 3.2 Sharing of country experiences in development and implementation of national policies, plans and programmes (1) Presentations by participants from Mongolia and Viet Nam highlighted the benefits of having national policies and programmes, which include expression of clear commitment of the Government, mobilization of resources from different sources, and attracting donor support. (2) Difficulties faced in the implementation of the policies and programmes include effective coordination among different stakeholders, defining clear roles and responsibilities of each stakeholder, insufficient financial and human resources, overdependency on donor support, and monitoring of effective implementation. (3) Participants agreed that the benefits of comprehensive national policies and programmes on injury and violence prevention would outweigh the difficulties they might face, and that the difficulties could be overcome. 3.3 Next steps for developing or strengthening national policies, plans and programmes (1) Participants discussed ways to enhance technical exchange as well as the steps they intended on taking upon return to their countries. In terms of the ongoing communication between participants, the most prevalent view was to establish some kind of electronic platfonn to permit ongoing exchange. (2) Participants set forward a variety of next steps that they planned on taking upon return to their countries. Nevertheless, there was a fair amount of overlap in terms of the broad thematic direction. Two broad themes emerged as priorities for next steps: (a) data collection, harmonization, and sharing; and (b) cross-sectoral meetings to engage stakeholders and clarify roles and responsibilities. (3) Three lesser themes were also cited and identified as steps that participants focus on upon their return. These were: (a) capacity-building; (b) awareness-raising within government and the population at large; and (c) specific policy development undertakings.
ANNEXl
3LIST OF PARTICIPANTS,
OBSERVERS AND SECRETARIAT 1. PARTICIPANTS
BRUNEI DARUSSALAM
Dr Abdul Rashid Haji Mohammad Senior Medical Officer and Deputy Administrative Head RIPAS Hospital Orthopedic Department Bandar Seri Begawan Tel. No.: +673877 0161 E-mail: rashI17@yahoo.com
CAMBODIA
Dr Prak Piseth Raingsey Director Preventive Medicine Department Ministry of Health No. 151-153, Avenue Kampuchea Krom Phnom Penh Tel. No.: (855-23)722 933 Fax No.: (855-23)426034 and 426841 E-mail: pisethsey@yahoo.com
CHINA
DrQinRu Deputy Section Chief Ministry of Health No.1 Xizhimenwai Nanlu Beijing 100044 Tel. No.: 86 10 68792655 Fax No.: 861068790514
FIJI
Dr Tharid Akhtar Ali General Manager Community Health Ministry of Health PO Box 2223 Government Buldings Suva Tel. No.: +679 6660913 Fax No.: +679 6652476 E-mail: tali@health.gov.fij
JAPAN
Dr Masao Ichikawa Associate Professor of PubJic Health and Epidemiology Graduate School of Comprehensive Human Sciences Medical Branch, University of Tsukuba 1-1-1 Tennodai, Tsukuba-shi Ibaraki-ken 305-8575 Tel.lFax No.: +81-3-5685-2750 E-mail: masao@md.tsukuba.ac.jp Dr Shinji Nakahara Assistant Professor Department of Preventive Medicine St. Marianna University School of Medicine 2-16-1 Sugao, Miyamaeku Kawasaki City Kanagawa 2168511 Tel. No.: 81-44-977-8111 ext. 3416 Fax No.: 81-44-977-8356 E-mail: snakahara@marianna-u.ac.jp
LAO PEOPLE'S DEMOCRATIC REPUBLIC
Dr Phisith Phoutsavath Chief of Hospital Management Division Department of Curative Medicine Ministry of Health, Vientiane Capital Vientiane Tel. No.: 85620 5402432 Fax No.: 85621 21 7848 E-mail: Psavath@gmail.com
MALAYSIA
Dr Ahamad bin Jusoh Senior Assistant Director Disease Control Division Ministry of Health Malaysia Level 6, Block E10, Complex E Federal Government Administrative Centre 62590 Putrajaya Tel. No.: 603-8883 4380 Fax No.: 603-8834150 E-mail: ahamad@dph.gov.my
MARSHALL ISLANDS, REPUBLIC OF THE
Mr Adri Joseph Hicking Mental Health Counselor Ministry of Health PO Box 16 Majuro MH 96960 Tel. No.: 6922477728 Fax No.: 6926253432 E-mail: hicking41@hotmail.com
MICRONESIA, FEDERATED STATES OF
Ms Jane Elymore National Gender Development Officer Department of Health and Social Affairs PS Box 70, Federated States of Micronesia Palikir,Pohnpei96941 Tel. No.: 6913202619 Fax No.: 691 3205263 E-mail: elymorej@mail.fm
MONGOLIA
Ms Natsagnyam Narangerel Head of Health and Financial Management Department Ministry of Health Government Building VIII Olympic Street 2 Ulaanbaatar 210648 Tel. No.: 976 11 701110891 Fax No.: 976-11-320633 E-mail: gereI69@yahoo.comlnarangerel@nchd.mn
NEW ZEALAND
Ms Jennifer Brown Manager, Public Safety ACC Head Office, Shamrock House 81-83 Molesworth St Wellington Tel./Fax No.: +64 04 9184137 E-mail: Jennifer.Brown@acc.co.nz
PALAU
Ms Pearl Lynn Marumoto Emergency Health Adminsitrator Ministry of Health One Hospital Road, Mayuns Causeway Koror 96940 Tel. No.: 680 488 6750 Fax No.: 6804881212 E-mail: p_marumoto@palau-health.net
PAPUA NEW GUINEA
Ms Susan Rose Haroe Technical Advisor
Clinical Practice and Standards National Department of Health P.O. Box 807 Waigani Tel.lFax Nos: (675) 323 1640/3013989/311 3836
PHILIPPINES
Dr Franklin Diza Medical Specialist IV and Focal Person Violence and Injury Prevention Program Department of Health Rizal Avenue, San Lazaro Compound Sta Cruz, Manila Tel. No.: 9302279 Fax No.: 7438301 Loc 1751 E-mail: anklinmd@yahoo.com
REPUBLIC OF KOREA
Dr Seong-Woo Kim Deputy Director Ministry of Health and Welfare Division of Chronic Disease Surveillance Korea Center for Disease Control and Prevention 5th Floor Dae-il Building 12-3 Nokbun-dong Eunpyung-gu Seoul 122-701 Tel. No.: 82-2-380-2931 Fax: 82-2-355-2539 E-mail: kksw5555@hanmail.net Dr Kyoung-Iun Song Assistant Professor SMG-SNU Boramae Medical Center 39 Boramae Road, Dongjak-gu Seoul Tel No.: 82-3-840-2775 E-mail: doctorsong@paran.com
SAMOA
Ms Sosefina Tepora Tualaule1ei Principal Policy Analyst Ministry of Health P. O. Box 2268 Apia Fax No.: (685)25057
TONGA
Dr Siale Akau'ola Medical Superintendent, Clinical Services Ministry of Health PO Box 49 Nuku'alofa Tel. No.: 676 23-200 Fax No.: 67624291 E-mail: drmalkaiake@hotmail.com
VANUATU
MrBen Taura Violence and Injury Focal Point Shefa Provincial Health Office PMB 9009 Ministry of Health Port Vila Tel. No.: 25356 E-mail: btaura@Vanuatu.gov.vu
VIETNAM
Dr Luong Mai Anh Deputy Director of Occupational Health and Injury Prevention Division General Department of Preventive Medicine and Environmental Health, Ministry of Health Alley No. 135, Nui Truc Street Hanoi Tel. No.: 8447366349 Fax No.: 844 7260237 E-mail: _lmanh2004@yahoo.com
2. OBSERVER
National University of Singapore
Professor David Koh Head, Department of Community, Occupational and Family Medicine Yong Loo Lin School of Medicine National University of Singapore 16 Medical Drive Singapore 117597 Tel. No.: 6565164989 (DID) Fax No.: 65-677791489 E-mail: cofkohd@mus.edu.sg
Universiti Malaya
Dr Krishnan Rajam Fakulti Perubatan Universiti Malaya 50803 Kuala Lumpur Malayaysia Tel. No.: (603) 7957 7941 Fax No.: (60379577941 E-mail: sowmyak@yahoo.com
SECRETARIAT
WHO Western Pacific Regional Office
Dr Hisashi Ogawa (Responsible Officer) Regional Adviser in Healthy Settings and Environment WHO Regional Office for the Western Pacific United Nations Avenue corner Taft Avenue Manila Philippines Tel. No.: 528 9884 Fax No.: 521 1036 E-mail: ogawah@wpro.who.int
WHO Office of the Representative in South Pacific
DrLi Dan Medical Officer, Non-Communicable Diseases Office of the WHO Representative in the South Pacific Level 4 Provident Plaza One Downtown Boulevard 33 Ellery Street Suva Fiji Tel. No.: 6793304600 Fax No.: 6793300727 E-mail: lid@sp.wpro.who.int
WHO Headquarters
Dr Richard David Meddings Scientist, Injuries and Violence Prevention World Health Organization (Headquarters) Avenue Appia 20 CH-1211 Geneva 27 Switzerland Tel. No.: +4122 791 3798 Fax No.: +4122791 3111 E-mail: meddingsd(iV,who.int
ANNEX 2
PROGRAMME OF ACTIVITIES
29 July 2008 0800-0830 0830-0900 Registration Opening ceremony Opening Address by the WHO Regional Director for the Western Pacific Self-introduction of participants and representatives/observers Election of meeting officers (e.g. chairperson and vice-chairperson) Administrative announcements Group photograph and coffee/tea break Introduction to the meeting (e.g. objectives, programme of activities) DrH. Ogawa
0900-0930 0930-0950
Reviewing the status of national policies, plans and programmes for injury and violence prevention (Objective 1)
0950-1010
Global review in 2007 Dr D. Meddings, Department of Injury and Violence Prevention and Disability, WHO, Geneva Regional Framework for Action on Injury and Violence Prevention and Country Profiles with focus on development of national policies and plans DrH. Ogawa Country reports on development and implementation of national policies, plans and programmes - 15 minutes/country - Brunei Darussalam - Cambodia - China - Fiji - Japan
1010-1030
1030-1200
1200-1300 1300-1430
Lunch break Country reports (continued) - Lao PDR - Malaysia - Marshall Islands - Micronesia, Federated States of - New Zealand - Palau Coffee/tea break
1430-1500
1500-1630
Country reports (continued) - Papua New Guinea - Philippines - Republic of Korea - Samoa Reception
1630-1700 30 July 2008 0830-0900 0900-0930
Summary of DAY 1 discussions and findings Country reports (continued) - Tonga - Vanuatu Discussion on main findings from country reports Coffee/tea break
0930-1000 1000-1030
Sharing country experiences in development and implementation of national policies, plans and programmes (Objective 2) 1030-1130 Case reports on the development and implementation of national policies, plans and programmes for injury and violence prevention - 30 minutes/presentation - Mongolia - Viet Nam Discussion on main findings from the case reports Lunch break
1130-1200 1200-1300
Identifying next steps for developing or strengthening national policies, plans and programmes (Objective 3) 1300-1330 WHO Guidelines on Developing National Policies and Introduction to a group discussion Dr D. Meddings Group discussion: Developing/strengthening national policies, plans and programmes: 2 groups Group 1 - Countries with existing policies, plans or programmes on injury and violence prevention Group 2 - Countries without existing policies, plans or programmes on injury and violence prevention 1530-1600 1600-1630 Coffee/tea break Individual work (participants draft their 3-5 priority next steps on the basis of the 2 hours of group discussion)
1330-1530
31 July 2008 0830-0900 0900-1000 Summary of DAY 2 findings Round table reporting (each participant spends 2 minutes to read out their 3-5 priority next steps they will take when they return to their country. Coffee/tea break Plenary discussion on regional cooperation in developing national policies, plans and programmes for injury and violence prevention. Conclusions and closing
1000-1030 1030-1130
1130-1200
ANNEX 3
LIST OF DOCUMENTS DISTRIBUTED DURING THE WORKSHOP
WPRl200SIDHP11 0IHSE(3)/200SIIBI1 WPRl200SIDHP11 01HSE(3 )/200S1IB/2 WPRl200SIDHPIl 0IHSE(3)/200S.1 A WPRl200SIDHPIl 0/HSE(3)/200S.1B WPRl200SIDHP11 01HSE(3 )/200S.2 WPRl200SIDHP11 01HSE(3 )/200S.3
WPRl200S/DHP/10IHSE(3)/200S.4 WPRl200SIDHP11 01HSE(3 )/200S/INF.ll WPRl200SIDHP11 0IHSE(3)/200S/INF.l2 WPRl200SIDHPIl 01HSE(3)1200S/INF.l3 WPRl200SIDHP11 0IHSE(3)/200S/INF.l4 WPRl200SIDHP11 0IHSE(3)/200S/INF.l5 WPRl200SIDHP11 01HSE(3 )/200S/INF.l6 WPRl200SIDHP 11 01HSE(3 )/200S/INF.!7 WPRl200SIDHP11 01HSE(3 )/200S/INF.lS WPRl200SIDHPIl 01HSE(3)1200S/INF.l9 WPRl200SIDHP 11 01HSE(3 )l200S/INF.ll 0 WPRl200SIDHPI1 0/HSE(3)/200S/INF.ll1 WPRl200S/DHP 11 0/HSE(3 )/200S/INF .112 WPRl200SIDHP11 01HSE(3 )/200S/INF .113 WPRl200SIDHP/10/HSE(3)/200S/INF.l14 WPRl200SIDHP/10IHSE(3)/200S/INF.l15 WPRl200SIDHP/10IHSE(3)/200S/INF.l16 WPRl200SIDHP/I OIHSE(3)/200S/INF .117 WPRl200SIDHP/10IHSE(3)/200S/INF.lIS WPRl200SIDHP/I 0/HSE(3)/200S/INF .119
Information Bulletin I List of Participants, Observers and Secretariat Tentative Agenda Tentative Program of Activities Global Review (2007) Dr David Meddings, WHOIHQ Regional Framework for Action on Injury and Violence Prevention and Country Profiles Dr Hisashi Ogawa, HSEIWPRO WHO Guidelines on Developing National Policies Dr David Meddings, WHOIHQ Country Report - Brunei Darussalam Country Report - Cambodia Country Report - China Country Report - Fiji Country Report - Japan Country Report - Lao People's Democratic Republic Country Report - Malaysia Country Report - Republic of the Marshall Islands Country Report - Micronesia, Federated States of Country Report - Mongolia Country Report - New Zealand Country Report - Palau Country Report - Papua New Guinea Country Report - Philippines Country Report - Republic of Korea Country Report - Samoa Country Report - Tonga Country Report - Vanuatu Country Report - Viet Nam
ANNEX 4
Opening Speech by Dr Shigeru Omi, Regional Director World Health Organization for the Western Pacific for the Workshop on National Policies and Plans on Injury and Violence Prevention Manila, Philippines, 29-31 July 2008
LADIES AND GENTLEMEN. Accidents and violence, including those on the road and at homes, workplaces and schools, cause an estimated 5.2 million deaths annually worldwide, equivalent to 9% of total world deaths. In the Western Pacific Region, injuries cause more than 1.2 million deaths every year, or more than 3300 deaths each day. There are many more non-fatal injuries. Given current trends, the burden of injuries is expected to increase considerably in the coming decades, particularly in low- and middle-income countries. Recognizing the magnitude of the problem, the World Health Assembly recently addressed and adopted resolutions which called on governments to develop national policies for injury and violence prevention. Comprehensive policies and strong action plans are essential if our efforts in injury and violence prevention are to be effective. In the Western Pacific Region, we have recently convened two regional consultations involving national focal points on injury and violence prevention. Through these regional consultations, a Regional Framework for Action on Injury and Violence Prevention has been developed. The Regional Framework for Action contains recommended actions pertaining to national policies and plans that can be implemented by Member States and WHO in the next several years. Most injuries are preventable and avoidable with proper safety engineering and with education to induce behavioural changes. National policies, legislation and plans, if effectively enforced and implemented, will provide physical and social environments that support and promote safety. Development of policies, action plans and programmes for
injury and violence prevention requires the establishment of links across various ministries and stakeholders at all levels. To support Member States in developing effective policies and action plans, WHO has published guidelines for policy-makers and planners entitled Developing policies to prevent injuries and violence. In the Western Pacific Region, we have collaborated with
several countries since 2002 to develop national reports, policies and action plans. Some of these efforts will be presented during this workshop. In addition, we will review the status of the development and implementation of
national policies, plans and programmes for injury and violence prevention in all participating countries, and discuss further actions needed to develop and strengthen national policies, plans and programmes in the Region. I urge you to actively participate in the discussions and I look forward to learning about your conclusions and recommendations. Enjoy your stay in Manila. Thank you.