Global Violence Prevention: Additional Activities

Understanding the Problem: Gathering Information on Violence

Almost half the countries in the world do not have any formal systems to gather information on fatal injuries. And most low- and middle-income countries do not have any systems to gather information on nonfatal injuries.

CDC, the World Health Organization, and other partners saw the need for systematic data on injury—especially in low/middle-income countries, where 90 percent of injury-related deaths occur. Therefore they published accepted standards for data collection on injury in 2001, including the Injury Surveillance Guidelines [PDF 792 KB] and the International Classification for External Causes of Injuries. In addition, the Injury Surveillance Training Manual, created by CDC, walks professionals through the steps of establishing and maintaining an injury surveillance system. A course based on the manual has been taught in Argentina, Brazil, Costa Rica, El Salvador, Honduras, Nicaragua, Peru, and other countries.  

CDC assisted several countries in Africa, Eastern Europe, and Latin America in developing hospital-based injury surveillance systems to gather information on injuries. These systems help officials figure out how to best prevent injuries.

Understanding the Economic Costs of Violence

In 2004, CDC provided technical assistance and funding to the World Health Organization for a comprehensive literature review, The Economic Dimensions of Interpersonal Violence [PDF 398 KB]. The report looks at:

• The economic effects of interpersonal violence in a variety of socioeconomic and cultural settings
• The economic effects of programs to reduce interpersonal violence
• The effects of different economic conditions and policies on interpersonal violence, such as poverty, structural adjustment, income inequality, and social investment

In 2008, as a follow-up to The Economic Dimensions of Interpersonal Violence,  CDC and the World Health Organization jointly published the Manual for Estimating the Economic Costs of Injuries Due to Interpersonal and Self-Directed Violence. It provides guidance on how to measure direct medical costs of violence-related injuries and deaths, such as hospitalization, outpatient visits, and transportation to the hospital, and indirect costs, including productivity losses from violence-related injuries and deaths. The manual includes pilot case studies in Brazil, Jamaica, and Thailand.  Through financial support from CDC, these costs are currently being studied in Kenya and Uganda.

CDC Training and Technical Assistance in Violence Prevention

CDC provides training and technical assistance in violence prevention to organizations, governments, and other partners around the world. For example:

• Through the School of Public Health at the University of Antioquia, CDC offers technical assistance to the city of Medellin, Colombia, and its 10 surrounding municipalities in the selection, development, and evaluation of evidence-based strategies to prevent violence against children.
• CDC is providing technical assistance to the Núcleo de Estudos da Violênca at the Universidade de São Paulo for a home visitation program for teenage mothers to prevent child maltreatment and improve children’s health and development. The project team has completed a training manual and evaluation methodology, and is creating evaluation methods.
• CDC helped the World Health Organization develop Preventing Child Maltreatment: A Guide to Taking Action and Generating Evidence [PDF 253KB], The guide offers technical assistance in developing policies and programs for child maltreatment prevention that use a scientific, evidence-based approach and follow public health principles. The World Health Organization has supported new pilot prevention programs in Brazil and the Philippines based on the guide.
• In 2010, CDC gave technical assistance and funding to the World Health Organization to develop Preventing Intimate Partner and Sexual Violence against Women: Taking Action and Generating Evidence [PDF 1MB]. This important tool for violence prevention researchers, practitioners, and advocates gives a framework for developing policies and programs to prevent intimate partner and sexual violence. It outlines the size of the problem and consequences of intimate partner and sexual violence. It also gives strategies to prevent such violence against women, and describes how to adapt the strategies to fit different needs and resources. It emphasizes the importance of using scientific evaluation in all prevention activities to expand the general knowledge of what works.
• The World Health Organization, with technical assistance and funding from CDC, established MENTOR-VIP, a global mentoring program to build skills in injury and violence prevention research and programming, and TEACH-VIP, a global training course on injury and violence prevention.
• CDC supports the Institute of Medicine in the development of a Global Violence Prevention Forum. The forum helps a group of United States and international government and private sector organizations to: exchange information and ideas about violence prevention, especially in low- and middle-income countries; clarify policy, research, and practice priorities for further study or investment, and use workshops and reports to educate the public and leaders about the scientific basis and public health needs for global violence prevention.

More:

• CDC collaborated with the World Health Organization to develop Guidelines for Conducting Community Surveys on Injuries and Violence. The guidelines, published in 2004, provide a way to collect robust, reproducible, and relatively easy-to-obtain injury data in the community.
• In 2006, CDC provided technical assistance and funding to the World Health Organization to publish Developing National Policies to Prevent Violence and Injuries: a Guideline for Policy-Makers and Planners. This document examines the rationale for such policies, the importance of the health sector in their development, and the link between national policies and legislation.
• CDC provided funding and technical assistance to the World Health Organization to develop the Handbook for the Documentation of Interpersonal Violence Prevention Programs [PDF 253 KB]. The handbook, which documents proven and promising prevention strategies, was pilot tested in Brazil, India, Jamaica, Jordan, Macedonia, Mozambique, the Russian Federation, and South Africa. The handbook aims to capture information about all types of violence prevention programs and includes information on the intervention strategies employed, the level at which programs seek to intervene (that is, individual, relational, community, societal), or the stage of development of the program. It is applicable to programs with or without formal mechanisms for monitoring, evaluating, and documenting their effects.
• CDC participated in the evaluation of the Pan American Health Organization Integrated Response to Intimate Partner Violence in Central America. The Pan American Health Organization published the findings in Violence against Women: the Health Sector Responds in 2003. The report included lessons learned from Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama.
• In June 2007, CDC played a key role in the Institute of Medicine's Workshop on Violence Prevention in Low- and Middle-Income Countries. The purpose was to build the public health and business case for greater investment by U.S. agencies and foundations in violence prevention in such countries.
• The Global Campaign for Violence Prevention was launched after the release of the World Report on Violence and Health in 2002. The objectives are to raise awareness about the problem of violence; highlight the crucial role public health can play in addressing its causes and consequences, and encourage action at every level of society. Every other year, the World Health Organization, with financial and technical assistance from CDC, organizes Milestone Meetings that allow countries to show how they have used recommendations from the report. The third meeting held in 2007 was a platform for discussing increased country-level use and efforts to measure effectiveness, such as looking at rates for violence-related deaths, nonfatal injuries, and other violence-related health conditions over time.
• CDC is supporting the development of the Violence Prevention Atlas of WHO-Related Activities. This atlas will allow countries to share their violence-related activities. In addition, it will keep the World Health Organization abreast of violence prevention activities and of the best strategies for using limited resources.