Understanding the causes and consequences of injuries to adolescents growing up in poverty in Ethiopia, Andhra Pradesh (India), Vietnam and Peru: a mixed method study

Abstract

The World Health Organization estimates that almost half of all premature deaths among 15- to 19-year olds can be attributed to injuries with most (95%) fatal injuries occurring in low- and middle-income countries. Yet the evidence base for adolescent injuries in low-income countries is poor. This article uses a mixed method approach to gain an understanding of patterns, causes and consequences of unintentional injuries among adolescents aged between 14 and 16 years in four low-income country settings. Survey data collected in 2009 in Ethiopia, India (Andhra Pradesh), Peru and Vietnam (from ~900 adolescents in each country) were integrated with qualitative research (conducted between 2007 and 2011) with a nested sample of older cohort children in Ethiopia (n = 25) and India (n = 25) using an iterative process. Logistic regression models were fitted to examine potential risk factors for injuries. Injuries were a concern for adolescents in all countries and occurred during work, recreation and sports or transportation. Being male was associated with an increased risk for all types of injuries, whereas being poor was only significantly associated with work injuries. Area of residence (urban vs rural) made a difference in some countries and for some kinds of injuries as did perceived health status. Qualitative findings highlight the consequences of injuries not only for the adolescents but also for the social and economic status of the entire household. Injury prevention programmes need to be specific to cultural and environmental settings, expectations of adolescent's responsibilities and responsive to the context of poverty.

Nonfatal Injuries and Psychosocial Correlates among Middle School Students in Cambodia and Vietnam

“…In concurrence with previous studies [6,7,11,19], male gender was, in this study, in Vietnam but not in Cambodia, associated with injury. Further, experiencing hunger as an indicator of low socioeconomic status was, in this survey, associated with annual injury prevalence, as also found in previous studies [6,7,11].…”

“…Further, experiencing hunger as an indicator of low socioeconomic status was, in this survey, associated with annual injury prevalence, as also found in previous studies [6,7,11]. It is possible that adolescents coming from a lower socioeconomic status may be more exposed to work-related injuries [11], and experience greater material deprivation and societal obstacles to protect them from injury [20]. …”

“…Motor vehicle or transport-related injuries may be related to poor traffic infrastructure, including road conditions, poor public transport, pedestrian injuries, lack of helmet use, non-use of seatbelts, and alcohol [11]. In the previous large child injury survey in Vietnam, the most prevalent non-fatal injury type was also falls [10].…”

“…Falls were the main cause of nonfatal injuries among children and adolescents (1 to 18 years), followed by animal bites, road traffic injuries, injuries from sharp objects and burns in Vietnam [10]. In another local study in Vietnam, unintentional injuries among adolescents (14–16 years) had a prevalence of 8.2% in the past three years [11], while recreation and sports injuries were at 3.1%, followed by transportation injuries (2.9%) and work injuries (2.2%) [11]. In the Survey Assessment of Vietnamese Youth (14–25 years) in 2009, 10.6% had experienced a road traffic injury in the past year [12].…”

Community perceptions of unintentional child injuries in Makwanpur district of Nepal: a qualitative study

“…In India, Jagnoor [14] studied elderly people’s perceptions about falls. Qualitative studies explore broader information on injuries, their consequences and prevention [15,16]. Qualitative findings help conceptualise the risk and provide with the hands-on possibilities of injury prevention [17].…”