Barriers and facilitators of implementing child injury surveillance system

Purpose: Child injuries are a global public health problem and injury surveillance systems (ISS) can be beneficial by providing timely data. However, ISS implementation has challenges. Opinions of stakeholders of ISS implementation barriers and facilitators are a good source to understand this phenomenon. The aim of this study is to investigate barriers and facilitators of implementing ISS in Iran. Methods: This is a qualitative study. Data were gathered through interviews with 14 experts in the field of child injury and prevention from Iranian Ministry of Health and Medical Education (MOHME), medical univers让ies, pediatrics hospitals, general hospitals and health houses during January 2017 to September 2017. Data collection and analysis con tinued until data saturation. Data were analyzed using con tent analysis through identifying meaning units. Results: Barriers were classified in three main categories and nine subcategories including management barriers (including performance, coordination and cooperation, supervision and attitude), weakness in data capture and usage (including data collection, data recording and data dissemination) and resource limitation (including human and financial resources). Facilitators identified in three areas of policy making (including empowerment and attitude), management (including organization, function and cooperation and coordination) and data recording and usage (including data collection/distTibution and data recording). Conclusion: The most important barrier is lack of national policy in child injury prevention. The most important facil让ator is improving MOHME function through passing supportive regulations. Effective data usage and dissemination of information to those requiring data for policy making can help reduce child injuries. Coalition of stakeholders helps overcome existing barriers.

Using modified Delphi method to propose and validate the components of a child injury surveillance system for Iran

Purpose:Child injuries are a public health concern globally.Injury surveillance systems(ISSs)have beneficial impact on child injury prevention.There is a need for evidence-based consensus on frameworks to establish child ISSs.This research aims to investigate the key components of a child ISS for Iran and to propose a framework for implementation.Methods:Data were gathered through interview with experts using unstructured questions from January 2017 to December 2018 to identify child ISS functional components.Qualitative data were analyzed using content analysis method.Then,modified Delphi method was used to validate the functional components.Based on the outcomes of the content analysis,a questionnaire with closed questions was developed and presented to a group of experts.Consensus was achieved in two rounds.Results:In round I,117 items reached consensus.In round II,5 items reached consensus and were incorporated into final framework.Consensus was reached for 122 items comprising the final framework and representing 7 key components:goals of the system,data sources,data set,coalition of stakeholders,data collection,data analysis and data distribution.Each component consisted of several subcomponents and respective elements.Conclusion:This agreed framework will assist in standardizing data collection,analysis and distribution,which help to detect child injury problems and provide evidence for preventive measures.