The Journal of Bone and Joint Surgery (American). 2008;90:915-923.
doi:10.2106/JBJS.G.00637
© 2008 The Journal of Bone and Joint Surgery, Inc.
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The Burden of Musculoskeletal Injury in Low and Middle-Income Countries: Challenges and Opportunities

David A. Spiegel, MD1, Richard A. Gosselin, MD2, R. Richard Coughlin, MD3, Manjul Joshipura, MD4, Bruce D. Browner, MD5 and John P. Dormans, MD1

1 Division of Orthopaedic Surgery, Children's Hospital of Philadelphia, 2nd Floor Wood Building, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104. E-mail address: spiegeld@email.chop.edu
2 The University of California at Berkeley School of Public Health, 506 Warren Hall, Berkeley, CA 94720-7360
3 Department of Orthopaedic Surgery, University of California at San Francisco, 1001 Potrero Avenue, #3A36, San Francisco, CA 94110
4 Academy of Traumatology, A/35, Someshvara II, Satellite Road, Ahmedabad 380015 India
5 Department of Orthopaedic Surgery, University of Connecticut Health Center, 10 Talcott Notch Road Farmington, CT 06034-4037
Investigation performed at Children's Hospital of Philadelphia, the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; the University of California at Berkeley School of Public Health, Berkeley, California; San Francisco General Hospital, the University of California at San Francisco School of Medicine, San Francisco, California; Academy of Traumatology, Ahmedabad, Gujarat, India; and the University of Connecticut Health Center, University of Connecticut School of Medicine, Farmington, Connecticut

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   Introduction
 
The global burden of injury is substantial, and injuries are predicted to be a leading cause of death and disability over the next few decades1-6. The majority of this burden will be borne by low and middle-income countries, where preventive strategies are often nonexistent and barriers to the timely and appropriate care of the injured include absent or inefficient systems for the delivery of trauma care, inadequacies in the number and the distribution of health-care facilities and workers, a lack of infrastructure and/or physical resources, and a lack of education and training. Addressing the burden of injury in low and middle-income countries has become a public health priority. So-called essential services, which are low-cost, high-yield, and target major health problems, should be made available to every person in the world7-10. While surgery has been traditionally viewed as a high-cost treatment lying outside the realm of the traditional public . . . [Full Text of this Article]


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Home page
 Inj. Prev.Home page
P. A Scuffham
Cost-effectiveness analyses for injury prevention initiatives in low- and middle-income countries
Inj. Prev., August 1, 2008; 14(4): 217 - 219.
[Full Text] [PDF]