Surveillance of road crash injuries in Cambodia: an evaluation of the Cambodia Road Crash and Victim Information System (RCVIS)

Abstract

Objective: Worldwide, 1.24 million deaths and 20-50 million road crash injuries occur annually, with a disproportionate burden on low- and middle-income countries. Facing continued growth in motorized vehicles, Cambodia has begun to address road safety, including the creation of a nationwide road crash surveillance system, the Road Crash and Victim Information System (RCVIS). This study evaluates the RCVIS to understand whether road crash injuries are being monitored efficiently and effectively and to identify areas for improvement.

Methods: We used the Centers for Disease Control and Prevention's "Guidelines for Evaluating Public Health Surveillance Systems" (CDC 2001) as an evaluation framework. To assess system attributes, we conducted in-person interviews with Cambodian road safety stakeholders, including representatives from the Ministries of Health and Interior, and reviewed RCVIS annual reports and system operation documents. Characteristics assessed include usefulness, flexibility, acceptability, sensitivity, representativeness, data quality, and timeliness.

Results: The Cambodian government uses RCVIS data extensively for road safety planning purposes. RCVIS participation varies by type of data source, with 100 percent of police districts and 65 percent of hospitals reporting in 2010. Representativeness over time is a limitation-between 2007 and 2008, the number of reporting hospitals decreased from 65 to 42. From 2007 to 2010, the number of nonfatal injuries reported to RCVIS decreased by 35 percent, despite rapid growth in vehicle registrations. The system is timely, with annual reports disseminated within 10 months to more than 250 stakeholders.

Conclusion: The RCVIS provides a strong foundation for the surveillance of road crash injuries and fatalities in Cambodia. Differences in participation by data source and reduced hospital participation over time affect data representativeness and may indicate issues with acceptability. Recommendations include working with hospitals to standardize reporting procedures and to increase awareness about the usefulness of the data they collect.

Fig. 1

Cambodia Road Crash and Victim Information System data collection process.

Fig. 2

Casualties by severity of injury, Cambodia Road Crash and Victim Information System, 2006–2010. ^*Slight injuries include superficial (e.g., bruises, minor cuts) and moderate (e.g., fracture, suture) injuries. †Severe injuries include those that require surgery or intensive care unit (ICU) and hospitalization for at least 8 days. §Fatal injuries include persons killed immediately or dying within 30 days as the result of a traffic crash (HI and NRSC 2010, p. 7).