Child injury surveillance that guides interventions: the Beijing primary healthcare experience

Abstract

Objectives: To provide feedback to guide injury prevention interventions and to test the feasibility of integrating injury surveillance into the existing primary healthcare service for children under 6 years of age.

Design: This surveillance system was integrated into existing primary healthcare services at the community primary healthcare centre (PHC) and community kindergartens. Parents reported injury incidents during their child's routine health services at scheduled intervals. Kindergarten nurses registered injury incidents at the absentee recording system. A total of 8358 children annually were included into the surveillance in 2006-07. Setting Two urban communities and three rural communities in Beijing, China.

Results: The coverage rates were 93.7% in PHCs and 98% in kindergartens. The injury incidence rates in year 1 and year 2 were 2.7% and 1.9% respectively. The leading causes were falls, being hit by blunt object, and animal injury. Major causes of injury were different between urban and rural children. Over the two-year surveillance period, injury incidence rates declined significantly from 2.7% to 1.7% in urban communities. No significant decrease was seen in rural communities.

Conclusion: Surveillance through the primary healthcare system in Beijing was useful in child injury prevention as data collected allowed managers to design targeted interventions that resulted in decreased injury. In comparison with hospital based surveillance, PHC based surveillance demonstrated an advantage in wide access to children and allowed calculation of injury incidence rates to monitor trends over time. PHC based surveillance can serve as a useful venue to collect child injury data.