Margaret Peden

Imperial College London | Imperial · School of Public Health

Background Burns is a major public health problem in India with high burden of mortality, disability, and catastrophic health expenditure. In response, the union government of India started a national program on prevention and management of burn injuries (NPPMBI). However, after a decade of NPPMBI, health systems and policy response to burns is sti...

Background Road traffic injury is the second leading cause of death for children in China. There has been limited examination of how these policies relate to children. Objective This study aims to systematically characterize national policies for child road injury in mainland China over the past two decades and identify potential gaps based on the...

Background Injuries are a leading cause of death in children in the 0–19-year age group. Despite this they have received comparatively less public and policy attention in previous decades due to a focus on infectious diseases. Health indicators are important tools for advocacy, monitoring, policymaking and public awareness. Indicators related to in...

Background Burn injuries represent a significant public health problem in India, causing around 25000 deaths annually. Delivering specialized care for major burns requires a multidisciplinary health workforce team. Health workforce shortages and training gaps in burn care are well-recognized challenges in India. The performance of health systems is...

There has been limited examination of child road injury policies. This study aims to systematically characterize national policies relevant to child road safety in China over the past two decades and identify potential gaps based on the WHO child road safety framework. As a scoping review, this study searched for national policies for child road sa...

Delivering specialised care for major burns requires a multidisciplinary health workforce. While health systems ‘hardware’ issues, such as shortages of the healthcare workforce and training gaps in burn care are widely acknowledged, there is limited evidence around the systems ‘software’ aspects, such as interest, power dynamics, and relationships...

BACKGROUND The burden of alcohol use among trauma patients and the relative injury risks is not routinely measured in South Africa (SA). Given the prominent burden of alcohol on hospital trauma departments, SA needs practical, cost-effective and accurate alcohol diagnostic tools for testing, surveillance and clinical management of trauma patients....

Background Burn injury is associated with significant mortality and disability. Resilient and responsive health systems are needed for optimal response and care for people who sustain burn injuries. However, the extent of health systems research (HSR) in burn care is unknown. This review aimed to systematically map the global HSR related to burn ca...

Background India has one of the highest burden of burns. The health systems response to burn care is patchy and highly influenced by social determinants. Delay in access to acute care and rehabilitation adversely affects recovery outcomes. There is limited evidence on underlying factors for delays in care. In this study, we aim to explore patients’...

Introduction: Globally, injuries are a leading cause of mortality and morbidity for adolescents, which disproportionately affect the disadvantaged. To build an investment case for adolescent injury prevention, evidence is needed as to effective interventions. Methods: A systematic review of peer-reviewed original research published between 2010-...

Introduction The burden of alcohol use among trauma patients and the relative injury risks is not routinely measured in South Africa (SA). Given the prominent burden of alcohol on hospital trauma departments, SA needs practical, cost-effective and accurate alcohol diagnostic tools for testing, surveillance and clinical management of trauma patients...

Background Globally, thousands of children lose their lives to unintentional injuries every year. Injuries occurring at home to under 5s can be prevented through providing safety equipment but these need to be context-specific. Methods As part of the quantitative component of a larger mixed-methods study, we carried out a survey of households with...

Context Road injury is the second leading cause of death among children in China. Numerous policies has been issued to promote child road safety, however, the extent of coverage of these policies is unknown. Process This scoping review involved examination of policies related to child road safety sourced from the websites of government departments...

Background Globally, thousands of children lose their lives to unintentional injuries every year. Injuries occurring at home to under 5s (burns, falls, poisoning) can be prevented through providing safety equipment e.g. barriers and childproof containers. Although studies have shown significant reductions in child injuries most have been conducted...

Context Access to affordable, reliable, good quality transport is necessary for accessing socio-economic opportunities and resources. Transportation inequities have serious implications for public health, and thus transport policy becomes an important social determinant of health. This research studies how the needs of vulnerable populations are co...

Background: Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10-24 years during the past three decades. Methods: Using the Global Burden of Disease, Injuries, and...

Child injuries are largely preventable yet cause significant mortality and morbidity globally. Injury data from low-income countries is limited for children under the age of 5 and therefore the current understanding of the magnitude of injuries in this age group is low. Hospital-based registries are one mechanism by which injury data can be gathere...

Summary Background Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10–24 years during the past three decades. Methods Using the Global Burden of Disease, Injuries,...

(334/350) Background Road traffic injuries (RTIs) pose a significant health burden with 1.35 million individuals dying on the world's roads annually. Nearly a decade ago, based on agreed road safety indicators, global commitments were encouraged to dramatically reduce this burden as part of the United Nation's Decade of Action for Road Safety 2011...

Background: In South Africa (SA), road traffic injuries, homicides and burns are the leading causes of injury-related deaths among children. Injury-related deaths are well documented for SA, but this is not the case for non-fatal injuries. Objectives: To describe the non-fatal injuries sustained among children aged 0 - 13 years, to identify any...

Background Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10-24 years during the past three decades.

The Covid-19 pandemic has brought to the fore many issues that will impact public health for years to come -one such impact is on the nexus between transportation and health. Promoting safe, active transport is an activity that has many physical and mental health benefits. During lockdowns, many cities in Latin America imposed infrastructural and l...

The goal of this Series paper is to show how road safety has evolved as a global public health issue over the past two decades and to discuss the political and economic dynamics that led to this change. Specifically, the key stakeholders, influences, networks, issue framing, actor power, and synergistic interactions that have contributed to how roa...

Background Burn care in India is limited by multiple constraints. The COVID-19 pandemic and the containment measures restricted access to non-COVID emergency conditions, including burns. The aim of this study was to explore the impact of the pandemic on burn care in India. Methods Using the qualitative exploratory methods, we conducted in-depth in...

Background Over a million adolescents die globally each year from preventable or treatable causes, with injuries (intentional and unintentional) being the leading cause of these deaths. To inform strategies to prevent these injuries, we aimed to assess psychosocial factors associated with serious injury occurrence, type, and mechanism in adolescent...

Statement of purpose Globally, thousands of children lose their lives to unintentional injuries every year. Injuries occurring at home to under 5s (burns, falls, poisoning) can be prevented through providing safety equipment e.g. barriers and childproof containers. Although a number of studies have shown significant reductions in child injuries mos...

Statement of purpose The purpose of this presentation is to evaluate progress towards achieving the Decade of Action for Road Safety by analyzing the results of three Global Status Reports on Road Safety. Methods/Approach The analysis was based on the data from the three Global Status Reports on Road Safety with global level data from 2010, 2013,...

Background Child road traffic injuries are a major global public health problem and the issue is particularly burdensome in middle-income countries such as South Africa (SA) where injury death rates are 41 per 100 000 for under 5’s and 24.5 per 100 000 for 5–14-year-olds. Despite their known effectiveness in reducing injuries amongst children, and...

Background Globally, nearly 650,000 children lose their lives to injuries every year. Injuries occurring in and around the home to children under 5 years (burns, falls, drowning, poisoning) can be prevented through providing safety equipment e.g. barriers, childproof containers. A number of studies have shown significant reductions in child injurie...

Background The goal of the Decade of Action was to reduce by 50% the predicted increase in road traffic deaths over 10 years (2011–2020). A global plan of action with related indicators was developed and disseminated widely. Methods An assessment was undertaken to ascertain whether the Decade was successful. Mixed methods were used: analysis of th...

Context Each day millions of children worldwide face the risk of road traffic injury and dangerously toxic air on their journey to access education. But we have the solutions, the tools to combat road traffic injury and ensure our children can breathe clean air. The solutions are readily available and affordable, bringing results that are measurabl...

In May 2020, the High Volume Transport (HVT) Applied Research Programme which is funded by UKAid through the Foreign, Commonwealth & Development Office (FCDO), published an insight paper by the Road Traffic Injury Research Network’s RTIRN Chair and Deputy Chair (Drs Kobusingye and Peden) on the nexus between transport and health during the COVID-19...

Background Media coverage of road traffic collisions (RTCs) may influence preventative action. India experiences some of the highest RTC mortality and morbidity rates globally, but advocacy and effective action to mitigate this has been limited. We conducted an analysis of Indian media in English to assess whether coverage met the WHO’s Reporting o...

Access to affordable, reliable, good quality transport is necessary for accessing socio-economic opportunities and resources. Transportation inequities have serious implications for public health, and thus transport policy becomes an important social determinant of health. This research studies how needs of vulnerable populations are constructed an...

Background: The Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region. Methods: A community-based survey was conducted in the Sundarbans to determine the drowning mortality rate for children...

Globally, unintentional injuries contribute significantly to disability and death. Prevention efforts have traditionally focused on individual injury mechanisms and their specific risk factors, which has resulted in slow progress in reducing the burden. The Sustainable Development Goals (SDGs) represent a global agenda for promoting human prosperit...

Background The Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region due to its remoteness and poor coverage of health and police systems. Household methodology was found to be resource and tim...

(1) Background: Children in South Africa experience significant impacts from road injury due to the high frequency of road crashes and the low uptake of road safety measures (including the use of appropriate child restraints). The current study aimed to assess the feasibility of a child restraint program and to describe factors influencing child re...

Background Road traffic collisions contribute a significant burden of mortality and morbidity to children globally. The improper or non-use of child restraints can result in children sustaining significant injuries in the event of a collision. Systematic reviews on the effectiveness of various interventions to increase the use of child restraints a...

Background: Child road traffic injuries are a major global public health problem and the issue is particularly burdensome in middle-income countries such as South Africa where injury death rates are 41 per 100,000 for under 5's and 24.5 per 100,000 for 5-14-year-old. Despite their known effectiveness in reducing injuries amongst children, the rate...

Introduction Injuries are among the 10 leading causes of deaths worldwide. In recent years, the quality and reporting of injury mortality has improved but little or no data are available on the morbidity burden and impact of non-fatal injuries in India. This study evaluates health recovery status postinjury, identifying predictors of recovery in No...

Every year more than 1.35 million people lose their lives on the road and tens of millions more are injured, some permanently. Since the early 2000s there has been renewed focus on the issue, with the United Nations, World Health Organization and the World Bank placing the issue higher on their agendas. Guided by the United Nations General Assembly...

Background Pediatric injuries are associated with significant morbidity and mortality, especially in low- and middle-income countries. Data to characterize the cause and risk factors associated with childhood injuries in these countries are, however, very scarce. The aim of this study is to describe the injuries sustained among children, and possib...

The central objective of the Road Traffic Injury Research Network (RTIRN) is to support the development and strengthening of research agendas and research capacity on road traffic injury in low- and middle-income countries. Specifically, the network advocates for research to reduce the burden of road traffic injuries in low- and middle-income count...

Injury is a significant cause of death and morbidity among children from the age of one, increasing to become the leading cause of death among children aged 10 to 19 years. Adolescents, particularly girls and young women, are increasingly seen as driving forces in global health and yet are a neglected cohort. There is a growing consensus on the nee...

The Save LIVES: a road safety technical package was produced and launched in May 2017 by the WHO to support road safety decision makers and practitioners in their efforts to significantly reduce the number of road traffic deaths in their countries. This Special Feature explains the process used to develop the package and how and why the 22 interven...

Background: This study reports dose-response estimates for the odds ratio (OR) and population attributable risk of acute alcohol use and road traffic injury (RTI). Methods: Data were analyzed on 1,119 RTI patients arriving at 16 emergency departments (EDs) in Argentina, Brazil, Costa Rica, Dominican Republic, Guatemala, Guyana, Mexico, Nicaragua...

The United Nations Road Safety Collaboration (UNRSC) was set up in 2004 in response to the recognised need for the United Nations (UN) system to encourage efforts to address the global road safety crisis. In 2010, the UN General Assembly Resolution 64/255 declared 2011-2020 the Decade of Action for Road Safety with the overarching goal of stabilisi...

Road traffic crashes have been an increasing threat to the wellbeing of road users worldwide; an unacceptably high number of people die or become disabled from them. While high-income countries have successfully implemented effective interventions to help reduce the burden of road traffic injuries (RTIs) in their countries, low- and middle-income c...

Urban and regional planning has a contribution to make toward improving pedestrian safety, particularly in view of the fact that about 273,000 pedestrians were killed in road traffic crashes in 2010. The road is a built environments that should enhance safety and security for pedestrians, but this ideal is not always the case. This article presents...

More than 875,000 children die from preventable injuries annually. Developing effective interventions to prevent child and adolescent injuries remains a major challenge for the field. A number of intervention strategies such as the use of helmets, seat-belts, and pool fences, have been shown to be effective at preventing injury-related deaths in ch...

Objective: To determine the magnitude, socio-demographic and epidemiological characteristics of injury at a Provincial referral hospital. Methods: This review was conducted on all trauma patients admitted at the Mthatha Hospital Complex and Nelson Mandela Academic Hospital from the 1(st) January 1997 to the 31(st) December 2000. Results: The i...

This study draws on information from two recently published documents on pedestrian safety and global status of road safety to draw attention to the need to prioritize safe walking in planning and policy at local, national and international levels. The study shows that each year, more than 270 000 pedestrians lose their lives on the world's roads....

The use of non-standard motorcycle helmets has the potential to undermine multinational efforts aimed at reducing the burden of road traffic injuries associated with motorcycle crashes. However, little is known about the prevalence or factors associated with their use. Methods Collaborating institutions in nine low- and middle-income countries un...

Readers of Injury Prevention will be aware that the WHO launched the first ever report on the state of global road safety in 2009.1 At that time, a total of 178 countries took part in the survey, which revealed that approximately 1.23 million people in these countries died as a result of road traffic crashes in 2007. The first Global Status Report...

The World Health Organization (WHO) released the Global Status Report on Road Safety 2013: Supporting a Decade of Action in March 2013, in Geneva, Switzerland. The report presents 2010 data for 182 participating countries and provides a baseline for monitoring the Decade of Action for Road Safety (2011 - 2020) declared by the United Nations General...

Background: The use of non-standard motorcycle helmets has the potential to undermine multinational efforts aimed at reducing the burden of road traffic injuries associated with motorcycle crashes. However, little is known about the prevalence or factors associated with their use. Methods: Collaborating institutions in nine low- and middle-incom...

Background Social marketing campaigns can be effective in inducing behavioural change. However, to better target the messages, it is necessary to thoroughly investigate motivations behind unsafe behaviours. Aims To describe how social marketing campaigns on seat-belt use and speed control were developed in the Russian Federation under the framework...

This workshop focuses on the global road safety interventions project in 10 countries supported by the Bloomberg Philanthropies. Key to the initiative is the demonstration that established interventions on road safety make a significant impact on public health. The project has been running for 2 years, and key lessons have been learnt on defining t...

Background Seat-belt wearing is the single most effective road safety measure a car occupant can take to prevent deaths and injury. However its use in the Russian Federation remains low. Aims To increase seat-belt use in Lipetsk Region (1,2 million inhabitants). Methods Under the framework of the project Road Safety in 10 Countries, WHO implemented...

Yearly, more than 1.2 million people are killed by road traffic injuries (RTIs) around the globe, and another 20 to 50 million are injured. The global burden of RTIs is predicted to rise. We explored the need for concerted action for global road safety and propose characteristics of an effective response to the gap in addressing RTIs. We propose th...

Appendices A–D: Modelling the impact and cost of road safety interventions (A), estimates of road safety effect size (B), estimates of resource inputs and prices (C), and results of probabilistic uncertainty analysis (D)

General appendix (referred to by all the papers in this cluster)

To identify and estimate the population costs and effects of a selected set of enforcement strategies for reducing the burden of road traffic injuries in developing countries. Cost effectiveness analysis based on an epidemiological model. Two epidemiologically defined World Health Organization sub-regions of the world: countries in sub-Saharan Afri...

Objective To identify and estimate the population costs and effects of a selected set of enforcement strategies for reducing the burden of road traffic injuries in developing countries. Design Cost effectiveness analysis based on an epidemiological model. Setting Two epidemiologically defined World Health Organization sub-regions of the world: coun...

Water safety education programmes (including swimming lessons) for children over 5 years have been demonstrated to increase knowledge and improve swimming performance, thereby adding a layer of protection to prevent drowning. In order to increase participation in these programmes some countries in Europe have made such education a compulsory part o...