Data and global violence prevention:

WHO's perspective

Data and global violence prevention:

WHO's perspective

Dr Christopher MiktonViolence and Injury Prevention and Disability

World Health Organization

1.Define & describe

What is the Problem?

2.Identify risk What are the risk

factors and causes?

4. Scaling up and cost-effectiveness

Implement on large-scale & cost

3.Develop andevaluate

interventionsWhat works and

for whom?

Data at heart of the public health approach Data at heart of the public health approach

Determinants of political priority of global public health problems (Schiffman and Smith, 2007)Determinants of political priority of global public health problems (Schiffman and Smith, 2007)

Description Factors shaping political priority

Actor power Strength of individuals and organizations

Policy community cohesionLeadershipGuiding institutionsCivil society mobilization

Ideas How the issue is understood and portrayed

Internal frameExternal frame

Political contexts

Environments in which actors operate

Policy windowsGlobal governance structure

Issue characteristics

Features of the problem Credible indicatorsSeverityEffective interventions

1.6

1.5

1.3

1.1

0.8

0 0.5 1 1.5 2Millions of deaths per year

Malaria

Road traffic

Violence

Tuberculosis

HIV/AIDS

Source: WHO Global Burden of Disease estimates, 2011 update.

Data on violence: Fatal violence

35%35%35%35%

11%11%11%11%

54%54%54%54%

Data on violence: non-fatal violence – global estimatesData on violence: non-fatal violence – global estimates

Consequences of non-fatal violence (severity)

• Behavioural changes• smoking• alcohol• drugs

Cancer

Cardio-vascular diseases

Other NCDs

Mental health effects

• Depression

• Anxiety, insomnia, etc

• Injuries

• HIV and other STDs

• Unwanted pregnancies Abortion + consequences

• Disability

Suicidal behaviour

Credible indicators?Credible indicators?

Many gaps in the data:

•Fatalities• WHO cause of death registration data for 79/157 countries

• UNODC Crime Trends Survey data: 50% countries in world

• GSRVP: Similar gaps (fewest data on "armed violence").

•Non-fatal • Few countries have reliable data on non-fatal violence

• More surveys are being done

• GSRVP: huge gaps

•Difficult to set baselines or measure prevention progress

Effective interventionsEffective interventions

• Few widely tested; • Limited evidence for cost-effectiveness; •Most involve complex change;•Gun control politically sensitive;•Strategies to impact social determinants poorly developed;•But field is young & there is lots of emerging evidence

WHO's response: recent WHO resolutionWHO's response: recent WHO resolution

• Urges Member States to• Collect more data

• Increase prevention

• Strengthen services

• Requests WHO to• Deliver Global status report on

violence prevention

• Develop global plan of action

• Enhance data collection, collation, synthesis ad reporting

• Strengthen support for prevention and services

Global status report on violence preventionGlobal status report on violence prevention

• Baseline information on national responses

• data collection

• prevention (laws, programmes)

• services

• Joint WHO/UNDP/UNODC publication

• Input to global plan of action

• Likely to be repeated every four years

Global information system on violence preventionGlobal information system on violence prevention

• Database & user-friendly web-site

• Integrated in GHO

Child maltreatment

Youth violence

Intimate partner violence

Sexual violence

Elder maltreatment

Homicide (cross-cutting)

1. Definitions 2. Main survey instruments

3 Prevalence 4. Consequences 5. Risk factors 6. Prevention and response strategies and programmes

7. Evidence-based programmes that have been scaled-up

8. Measures countries are taking to prevent and respond to violence