Reducing childhood mortality and morbidity from injuries in Tanzania and Zimbabwe

Research Question

What are effective, sustainable, and cost-effective strategies that target the causes and consequences of child injuries in Tanzania and Zimbabwe? Background

Child injuries are a leading cause of death and disability globally. They cause a loss of economic productivity at individual, family, societal, and national levels, lead to catastrophic health expenditures, and impose a significant burden on healthcare systems. With simple, cost-effective interventions, many child injuries are preventable.

However, a lack of reliable data on injury prevalence, care processes, and outcomes has hindered evidence-based policymaking in Tanzania and Zimbabwe. Our research programme aims to bridge this gap and contribute to national efforts to reduce child mortality and morbidity from injury. Tanzania and Zimbabwe have been chosen as research locations due to their high incidence of child injuries, modelled at 80.9 and 68.0 per 1000 persons respectively, and their government’s commitment to reducing child mortality and morbidity from injury by 2030.

Our research programme will address the WHO’s World Report on Child Injury Prevention recommendations: 1) enhance the quality and quantity of data for child injury prevention, 2) research on the causes, consequences, costs, and prevention of child injuries, 3) implement specific actions to prevent and control child injuries, and 4) strengthen health systems to address child injuries.

Aims and Objectives

1) Assess the burden and determinants of child injuries across age groups, socio-demographic categories, and geographic regions; 2) Develop, implement, and evaluate cost-effective strategies for child injury prevention with scale-up across communities; 3) Determine the cost of service delivery across referral and district networks to guide evidence-based resource allocation; and 4) Develop, implement, and evaluate a sustainable community-led capacity building programme to improve child injury care.

Methods

We will employ a mixed-methods approach, using qualitative and quantitative methodologies for patient-level and health economic analyses. Our research will be guided by Complex Systems Theory and the Systems-Within-Systems Framework, acknowledging the interconnected nature of childhood trauma and the bidirectional influence between children and the broader systems they are embedded in.

Timelines for delivery

Our research programme will take place from July 2024 to June 2028, with a total duration of 48 months. It includes a 6-month setup phase, a 30-month data collection and intervention phase, and a 12-month data analysis and dissemination phase. Anticipated impact and dissemination

Aligned with in-country child health improvement priorities, our research anticipates reducing child injury incidence and enhancing trauma care skills among clinicians, ultimately improving children's health. Findings will be disseminated through publications in public health, policy, and clinical journals and presentations at academic meetings. Policymakers will be equipped with comprehensive reports and policy briefs for informed decision-making.

Healthcare practitioners will gain toolkits and health economic data for effective service delivery. The public will be engaged via various media outlets and advocacy groups, promoting awareness and safety practices. We foresee our programme influencing broader health systems and economic productivity, creating a ripple effect of benefits.