Richard Matzopoulos

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An overview of fatal injury surveillance in
South Africa Cuernavaca, Mexico, 1-2 June 2005
Richard Matzopoulos CRIME, VIOLENCE AND INJURY
LEAD PROGRAMME Medical Research
Council University of South Africa Institute for
Social and Health Sciences Centre for Peace Action
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• National Injury Mortality Surveillance System
  (NIMSS)
• strengths and weaknesses
• strategic challenges
• future plans for the NIMSS

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history

• 1993 1995 Cape Town
• 1998 2 years of DACST funding
• national pilot Gauteng, Durban, CT
• 1999 1st annual report Kimberley, PE, EL
• 10 mortuaries, 5 provinces
• 2000 2nd report Gauteng, PE
• 15 mortuaries, 5 provinces
• 2001 3rd report Durban, EL, Mpumalanga
• 32 mortuaries, 6 provinces

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Coverage
Non-natural mortality 68 930 (MRC Burden of
Disease, 2000) 12 to 15 of all mortality NIMSS
24 600 / 68930 36 Rural 5-6, Urban 55-64
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Coverage

• Mainly urban
• Metros - Johannesburg, Durban, Cape Town,
  Pretoria, Port Elizabeth, Erkhuruleni
• Cities East London/KWT/Bisho, Kimberley
• Rural towns
• Mpumalanga, Stellenbosch, Potchefstroom,
  Kroonstad, Nelspruit
• 7 out of 9 provinces represented
• Warehoused at MRC
• Report- generating software

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External cause Firearm Sharp force Hanging Drownin
g
Demographics Age Population group Sex
Event Place Blood alcohol
Forensic info
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External cause of death (N 22 248)
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External cause of death among males (N 17 932)
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External cause of death among females (N 4076)
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Overall apparent manner of death (N 22 248)
Source National Injury Mortality Surveillance
System, 2003
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Fatal injury rates / 100 000 population
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Transport User by BAC (n2953)

• Transport User by BAC, NIMSS, 2003

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• National Injury Mortality Surveillance System
  (NIMSS)
• strengths and weaknesses
• strategic challenges
• future plans for the NIMSS

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strengths and weaknesses

• Data quality and coverage
• ? Detailed info on who, what, when, where
• ? Mortuary catchment and population data
  questionable
• ? (minimised by city coverage)
• ? No gold std for apparent manner of death
• ? Resource for specialised studies
• ?Mainly urban - complete datasets for major
  cities
• ?Rural sites difficult to establish and maintain
• ? ? Representivity ? Comparability (correlates
  with ICD coding)
• Sustainability
• ? Standardised (manuals, procedures, storage,
  reporting)
• ? Cost lt 80 000 p.a. (incl staff, reports,
  media, etc)
• ? widely used / generates considerable
  publicity
• protective factors

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• National Injury Mortality Surveillance System
  (NIMSS)
• strengths and weaknesses
• strategic challenges
• future plans for the NIMSS

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strategic challenges

• Competing data and interests
• StatsSA national (90), 16 yrs, no manner /
  external CoD
• police national, underreporting, criminal
  justice, form-based
• transport national, reliant on police, detailed
  info, substantial underreporting
• Sensationalism vs rationalism
• Media focus on high rates and not public health
  utility
• DoH and other govt depts feel threatened
• Sustainability
• Limited funding prevents expansion
• Relocation of mortuaries from police to health
  (turf ?)
• Data to action
• 3 tiers of government
• City focus for 2010 world cup

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• National Injury Mortality Surveillance System
  (NIMSS)
• strengths and weaknesses
• strategic challenges
• future plans for the NIMSS

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Focus on cities

• city infrastructure
• accessible
• responsive
• well established and centralised documentation of
  strategies and challenges
• coordinated information systems
• amenable to personal and consultative interaction
• 2003 annual report initial commitment to city
  focus
• National injury profile
• City specific rates (Jhb, Durb, CT, Pret)
• Separate city-reports (chapters 3-6)
• transfer to DoH?

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Proposed future location of NIMSS
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Thank You
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8th World Conference onInjury Prevention
Safety Promotion

• ICC, Durban, South Africa
• 2 - 5 April 2006

Data to Action - Securing Safety as a right
www.safety2006.info
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Co-hosts
Conference Profile2000 Participants from 131
Countries350 Oral presentations1500
Posters100 Exhibitors
Sponsor
WorldHealthOrganization
Data to Action - Securing Safety as a right
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Conference ObjectivesTranslate injury data
into prevention actions - Critical review of
approachesFoster exchanges in all fields of
injury prevention and safety promotionExamine
critical applications of injury prevention and
safety promotion practices for different regions
of the worldStimulate/strengthen injury
prevention and safety promotion as central to
national, continental international public
health policies and programmesCreate
opportunities for multidisciplinary and
cross-sectoral dialogue Highlight
international injury prevention milestones and
possibilities for innovation
Data to Action - Securing Safety as a right
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• See you at ICC, Durban, South Africa from
• 2 - 5 April 2006

Data to Action - Securing Safety as a right
For more information visit www.safety2006.info