Multi – Center Study on “Non-standard helmet use”
The MCS represents a leading activity of the RTIRN network towards achieving research capacity development, focusing on senior researchers and using regional workshops to strengthen specific skills in methods related to motorcycle safety. The project was made possible with funding from the World Bank Global Road Safety Facility and Global Forum for Health Research.
The products of the study are expected to be beneficial not only to the individual scientist but also the global community of stakeholders (GRSF/World Bank, WHO, UNRSC) interested in RTI prevention.
Nine collaborating centers in Asia, Africa and Latin America were part of this activity. These teams were selected based on an open call for application that was reviewed by the board of RTIRN.
MCS Participating Centers
|China||George Institute for International Health – China||Dr. James Yu|
|Ghana||Building and Road Research Institute||Dr. Francis Afukaar|
|India||National Institute of Mental Health and Neurosciences||Dr. G. Gururaj|
|Malaysia||University Putra Malaysia||Dr. Kulanthayan Mani|
|Mexico||The National Institute of Public Health of Mexico||Ms. Elisa Hidalgo|
|Nigeria||University of Ibadan||Dr. Eme Owoaje|
|Pakistan||Aga Khan University||Dr. Junaid Razzak|
|Thailand||Thammasat University||Dr. Nitaya Vajanapoom|
|Vietnam||Hanoi Department of Public Health|
Dr Kulanthayan Mani of University Putra Malaysia served as the Study Coordinator.
The project kicked off in May 2008 with the first workshop organized in Kuala Lumpur , Malaysia . Details of this workshop are available at http://www.rtirn.net/Malaysia_may_2008_work_Shp.asp
It is expected that data collection will begin around September 2008 with finalization of the study projected to occur by the end of 2009. The RTIRN presented preliminary results of this study on its parallel session at the 10th World Conference on Injury Prevention and Safety Promotion that took place in London England. The results will also be presented in specialized literature in the near future.
Tayyeb Imran Masud
Health Services Academy, Pakistan
Ayub Medical College, Pakistan
To develop and apply a methodology to estimate the risk and magnitude of RTIs from available data sources, which would be applicable and affordable in low- and middle-income countries
- To assess the adequacy and quality of existing data sources for the estimation of the burden of RTIs
- To develop guidelines for systematically accessing and reviewing the reliability and validity of data sources / databases in a country for road traffic injuries
- To establish guidelines for the estimation of the burden of road traffic injuries
- To pilot test the guidelines to estimate the burden of road traffic injuries in a developing country, Pakistan
METHODS AND RESULTS
A systematic review of peer-reviewed and grey literature on RTIs and burden of disease (BOD) studies was carried out in order to identify variables and available data sources for road traffic injuries in low- and middle-income countries. Leading public health and transportation experts were then consulted regarding the management of the various types of data. These activities resulted in the following guidelines:
- Identify all existing data sources and variables
- Evaluate data sources
- Examine data with respect to its validity and reliability
- Decide on the inclusion or exclusion of data
- Standardize the data
- Generate nati onal level estimates
Although the application of the guidelines may be done at a local/decentralized level, it is suggested that a central team may be setup. The team should include: a public health scientist, a demographer, a social scientist, and a statistician.
Application of guidelines in Pakistan:
A systematic review of the literature was conducted to identify available data on RTIs in Pakistan.
Relevant Ministries, Police, Hospitals and NGOs in the country were then solicited for routine data on RTIs. Once all the available data had been collected and tabulated, it was carefully examined by the study team and local experts who assessed the validity and reliability of the data. Decisions were then taken to include or exclude the data based on the evaluation. All data included in the study were then standardized to common denominators and used to compile estimates of the burden of road traffic injuries in Pakistan.
Table 1: Burden of RTIs in Pakistan
RTI Deaths per 100,000 population
RTI Deaths per 100 traffic Crashes
58.22 per 100 crashes reported
RTI deaths per 1000 km of roads
22 per 1000km
RTI deaths per 10,000 vehicles
14.3 per 10,000 vehicles
The list of data sources at the country level requires careful compilation with repeated updates as more information becomes available.
- Check definitions of data (fatality, injury) as they may vary by source.
Application of the guidelines should provide evidence of whether the available data can be used for national estimates.
Download PDF Version of Pakistan Study
Erastus K. Njeru
University of Nairobi, Nairobi, Kenya
Moi University, Eldoret, Kenya
To identify potentially feasible and effective interventions for the prevention of road traffic injuries using participatory methods with stakeholders
- To identify different stakeholders’ perceptions on the burden, causes, risk factors and interventions for Road Traffic Injuries
- To review national and global data on the burden, causes, risk factors and effective interventions for Road Traffic Injuries
- To compare information from stakeholders with the evidence in the literature to generate a priority list of consensus-based and context-specific interventions on Road Traffic Injuries
METHODS AND RESULTS
A purposive sampling of stakeholder groups involved in the field of urban transport and public health was taken, representing the following groups:
- Public sector (Ministries of Health, Ministry of Transport; Law Enforcement)
- Private for profit (Transport Operators, Insurance Industry, Private Health Providers)
- Civil society (Automobile Associations, Medical Associations, Legal Society, Engineer’s Associations, Media)
- Road users (Passengers, Pedestrians, Drivers, Private Motorists)
- Development partners
Qualitative methods including focus groups, key informant interviews and consensus workshops were used to identify stakeholder perceptions on the causes of road traffic injuries and strategies for the prevention of these injuries. These results were then compared to the evidence collected through a systematic review of the current literature on road traffic injuries.
The causes of road traffic crashes identified by study participants can be grouped into five categories:
- Individual behavior
- Mechanical condition of vehicles
- Policy/law enforcement
- Climatic and environmental conditions
The following interventions were proposed by stakeholder groups:
- Standardize training of drivers
- Road safety awareness raising campaigns targeting the general public
- Improve of the public image of law enforcement officers
- Intensify licensing procedures, frequent and proper inspection with certification of regular maintenance from accredited garages
- Implement instant fines for road traffic offences
- Standardize terms of employment of PSV drivers, touts
- Implement community policing programs
The views and perceptions of the stakeholders closely matched those found in the literature reviewed on the causes and interventions for road traffic injuries.
- A multi-faceted approach involving all stakeholder groups in preventing road traffic injuries must be adopted in Kenya.
- Networking and collaboration among stakeholders needs to be improved to prevent duplication of services and to foster the creation of a unified voice in road safety.
Download PDF Version of Keyna Study
Olive C. K obusingye
Injury Control Center,
Makerere Medical School, Uganda
Nazarius Mbona Tumwesigye
School of Social Sciences,
University of South Hampton, UK
Makerere University Institute of
Public Health, Uganda
- To identify the types of visibility enhancement materials currently available that can be used in Uganda
- To determine the acceptability of visibility enhancement materials among motor- and pedal-cyclists in Uganda
- To identify strategies for the distribution of visibility enhancement materials to motor- and pedal-cyclists
- To identify potential study populations and sample sizes for evaluating VEM-based interventions
- To identify outcome measures for evaluating the effectiveness of VEM-based interventions
METHODS AND RESULTS
A cross sectional sample of motor- and pedal-cyclists in the peri-urban community of Kampala, Uganda was taken. Qualitative methods such as focus groups and in-depth interviews were used to solicit participant preferences for visibility enhancement materials as well as strategies for the distribution of VEMs in Uganda.
A range of VEMs are currently available including garments with reflective materials on them (T-shirts, aprons, arm and head bands, specialty footwear), and adhesive strips/tape that can be attached to bikes and helmets. The two types of VEMs most preferred by cyclists were the apron worn by the riders and reflective tapes installed onto the bike. Aprons were preferred because riders could wear them over any clothing while tapes were preferred because they stayed in place at all times.
Reasons for non-use of VEMs included lack of awareness of VEMs and their effectiveness, discomfort of wearing VEMs in certain weather conditions, and the lack of legislation mandating VEM use.
Proposed strategies for the distribution of VEMs on a large scale included the use of administrative chairpersons of cyclist “stages” (parking communities), city council authorities and through bike and spare parts retailers. Measuring crash rates through the use of police data and self-reports is a good means of evaluating the effectiveness of VEMs. Using hospital data is challenging due to the fact that injuries are not always recorded by cause.
- VEMs should be introduced on a wider scale as a preventative measure against road traffic injuries in Uganda.
- VEMs such as reflective tapes should be installed on the bikes at the point of purchase.
- Local manufacturers and distributors need to be involved in the distribution of VEMs.
- Efforts to make the VEMs such aprons less costly through the removal of sales taxes on these items.
- VEMs that are worn by cyclists need to look stylish and be promoted by celebrity cyclists in order to appeal to young riders.
- A randomized control trial should be carried out in cooperation with local authorities in the urban and peri-urban Uganda to test the effectiveness of VEMs in preventing road traffic injuries.
Download PDF Version of Uganda Study