Poverty

There are a number of indirect factors, including socioeconomic factors, that contribute to and worsen RTIs in developing countries. Whereas walking and use of public transportation systems provide benefits to health and the environment in industrialized nations, these modes of transport place the poor at risk of RTIs in developing countries owing to the lack of safe pedestrian lanes and inadequately regulated mass transit systems. Using level of education as an indicator of socioeconomic status in Kenya, it was found that 27% of people with no schooling relied on walking and 55% used public transportation, mostly matatus. In contrast, 81% of those educated beyond secondary school rode in private cars, none walked, and only 19% used public transportation. The poor are also less able to pay for medical treatment after being injured because the introduction of user fees at public health facilities has eliminated the free healthcare that was formerly available.

Inadequate Surveillance Systems

Many countries have some sort of system to collect data on road traffic crashes, usually from hospital records or police reports. However, underreporting is a major problem, even in developed countries with good reporting systems. Minor injuries are most likely to be underreported. People may not seek medical treatment for such injuries or may be unable to pay for services and so are not captured by hospital records. This is more likely to be true for rural than urban areas. In rural areas of Ghana, for example, patients that sustained severe injuries were less likely to seek hospital treatment than patients in urban areas due to an inability to pay for care. Police and/or hospitals might not record injuries or fail to share information, resulting in discrepancies between sources. Road traffic crashes that occur in rural areas frequently go unreported due to the lack of police presence. Furthermore, the quality of the data is often questionable and makes international comparisons difficult. Data may be incomplete or interpreted differently, reporting systems differ, and definitions of an RTI or death are not standardized. Even when data are collected, they are rarely used as a basis for developing and evaluating policy or interventions. Reliable and accurate data on the magnitude, characteristics and consequences of road traffic crashes are desperately needed in order to firmly establish RTIs as a public health priority and to create policy guidelines and interventions. Without this data, policy makers will continue to fail to design appropriate policy responses to this public health challenge. Don’t blow your budget on pharmacy items cheap flomax now

Inadequate Trauma Care Systems

Inadequate public health infrastructure means many victims of traffic-related injuries die or are disabled from not receiving prompt trauma care. In many developing countries, formal emergency medical services are nonexistent or are inaccessible to a majority of the population where they exist. Much of sub-Saharan Africa and southern Asia do not have even rudimentary ambulance services in rural and most urban areas. Surviving traffic crash victims are often transported to a hospital by bystanders, relatives, commercial vehicles or the police. In Kenya, only 2.9% of crash victims are transported to a hospital by an ambulance. Likewise, hospitals themselves are largely unprepared to treat trauma victims, who require special equipment and specialized medical care. A study of 11 rural hospitals located along busy roads that received high numbers of RTI victims in Ghana revealed that they were staffed by general practitioners with no training in trauma care. In these same hospitals, none had chest tubes, which are inexpensive and vital for the treatment of life-threatening chest injuries, and only four had the necessary equipment to maintain an open, breathing airway. In Kenya, only 40% of public, private and mission hospitals were well prepared to treat trauma patients, and almost none of the standard treatment items for managing severe injuries were found in government health facilities. While lack of supplies is problematic, so too is poor utilization of such equipment when it is available. A review of >2,000 trauma admissions in an urban hospital in Ghana showed low utilization of blood transfusion and chest tubes. Thus, inadequate trauma care is not unique to rural environments that lack ambulance services, as even well-stocked urban hospitals have much room for improvement in treating trauma victims. Get smart and save money! Buy cialis super active online