Global Health seminar: Determining investment priorities for injury care in LMICs

Event details

Abstract:

Injuries account for 8% of all worldwide deaths (4·4 million people annually), with low- and middle-income countries (LMICs) disproportionately affected by injuries. It is estimated that over 90% of injury-related deaths occur in LMICs. Non-fatal injuries are also a significant burden, due to loss of quality of life and the economic implications of injury, often incurred by younger adults. Many injuries can have huge implications on productivity, with consequences felt within and across generations.

Reducing the health and economic burden of injuries is a policy priority for many LMICs. This requires careful investment decisions to be made about injury care, ensuring that effective, economically viable and equitable care is made available. Although there have been significant inroads into establishing which interventions in injury prevention and care are effective and cost-effective, much of it is not specific to LMICs, where infrastructure and health care delivery may be quite different from high income countries (HICs). The scale of the evidence challenge in LMICs is therefore huge.

To prioritise which interventions may represent effective and cost-effective investments to reduce the burden of injuries in LMICs, we can first look to establish which parts of the injury pathway contribute most to the outcomes of injury care, including its economic consequences. To achieve this, economic modelling of pathways can help to identify which elements of care contribute the most towards patient care, both in the short term and also over the longer term. Evidence to inform such modelling, is, however, sparse, which can hamper efforts to inform such policy questions using robust quantitative data. Imperfect evidence can still provide useful inputs into policy decisions. Economic modelling, explicitly characterising uncertainties in the evidence base, can help to provide answers based on currently available data, whilst also informing further data collection.

The EQUI-injury project sought to establish how to improve equitable access to quality care for the injured in LMICs. This included the development of an injury pathway model to understand equitable access to quality injury care which can be applied in multiple contexts. The model aims to determine which barriers, including delays to receiving care or not receiving the optimum care, are the largest
contributors to lifetime costs and outcomes for patients experiencing injuries. This will help to prioritise research to close gaps in outcomes. This work will be used to prioritise further research regarding interventions to improve outcomes/reduce inequalities for patients experiencing injuries. 

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Professor Laura Bojke, CHE, and Professor Justine Davies, University of Birmingham

Laura Bojke's web page

Justine Davies's web page