As in other middle-income countries, an understanding of the epidemiology of road traffic deaths, injuries and disabilities in Palestine is critical to inform sustainable research and policy initiatives aimed at reducing this burden. However, road traffic casualties and their attendant risks are still poorly quantified in the West Bank. Palestine has begun to address road safety by establishing links between several stand-alone road traffic surveillance systems conducted by different West Bank stakeholders. The Palestinian National Institute of Public Health (PNIPH) - a World Health Organization project - supports the establishment of a national integrated Road Traffic Casualties Information System (RTC-IS) to produce accurate data on road casualties nationally, namely fatalities, injuries and disabilities, and enable the implementation of preventive measures and the monitoring of results.
Aims and objectives
The overall aim of the assessment is to assist in reducing the burden of car crashes and transport-related deaths, injuries and disabilities by improving the RTC-IS in the West Bank, Palestine. The specific objectives are to provide a detailed assessment of existing road traffic surveillance systems and generate recommendations for improvements.
The Guidelines for Conducting a Stakeholder Analysis were used to design and conduct formal stakeholder analysis of the feasibility of the RTC-IS project in Palestine.
The assessment of the data systems follows the general methodology for formal assessments of surveillance systems and registries as described by WHO and the Centers for Disease Control and Prevention in the USA. It was carried out during February to April 2014 in the West Bank in close collaboration with the MoH and Palestinian Civil Police. In addition to collecting background information from stakeholders, the assessment team used qualitative methods of a semi-structured questionnaire and in-depth interviews.
Some of the main findings are as follows: Information on deaths, injuries and disabilities related to road traffic accidents is collected by at least five stand-alone road traffic surveillance systems operated by different agencies in the West Bank.
There are no formal descriptions, case definitions, or standard operating procedures for the RTC surveillance systems in Palestine. There are no formal guidelines to data collectors on completing the data collection forms; there is minimal training of stakeholders involved on data collection for RTC-IS. There are only limited data quality checks and a near total lack of quality assurance systems at every level of RTC-IS data flows. There is often little understanding of RTC-IS and no feedback of the results from upper to lower levels. Dissemination is limited to a few fixed tables (graphs) in annual reports.
The focused assessment concludes 11 recommendations:
- Establish a multisectoral working group on RTC-IS;
- Establish a RTC-IS data warehouse;
- Adopt standard case definitions for crash-related death, injury and disability;
- Revise the Data Collection Forms (DCFs);
- Develop guidelines for completing DCFs;
- Establish a feedback system;
- Establish capacity building (training and education) activities for stakeholders;
- Establish quality assurance mechanisms;
- Improve RTC-IS data utilization;
- Examine the possibility of participation by the Gaza Strip in the RTC-IS initiative;
- Improve other relevant registries.
Assessment of the RTC-IS by stakeholders in the Gaza Strip is further advised. Detailed assessment of other partners, including insurance companies and PRCS, should be also performed.