The problems in determining international road mortality

Variations in sub-national road traffic fatality trends in a low-income country

Background:

In most low- and middle-income countries (LMICs), road traffic fatality (RTF) trends are presented in aggregated form at the national level. This practice omits important information regarding RTF risk at sub-national levels.

Objective:

This ecological study assesses the extent of RTF variations at different sub-national levels in Pakistan, a low-income country.

Materials and Methods:

Based on official statistics, significant variations in three RTF indicators i.e. per population, per registered vehicles, and per crash were compared by regression analyses at two sub-national levels i.e. provincially (2000-2009) and district-wise (2004).

Results:

The national RTF counts are based on data from four provinces. From 2000 to 2009, RTF per population and per registered vehicles decreased in all provinces except Balochistan. RTF per crash in Punjab decreased from 0.61 to 0.56 (beta coefficient (β) year = –0.0082, P = <0.001), whereas in Balochistan it increased from 0.40 to 0.58 (β year = 0.0708, P = <0.001) over the same period. District-level comparisons were possible only in Punjab where RTF per crash varied from 0.25 to 2.15 and correlated (β = 0.50, P = 0.003) with RTF per population.

Conclusions:

Sub-national RTF surveillance is necessary in LMICs like Pakistan in order to prioritize available resources on high-risk jurisdictions such as the Balochistan province and districts of Punjab where high RTF per population and per crash exist.

Are road traffic crash fatality rates converging among OECD countries?

This article examines the trends of road traffic crash (RTC) fatality rates in OECD countries over the past four decades. Based on recent developments in the economic growth literature we propose and test the hypothesis that RTC fatality rates initially increase with economic development, peak, and then gradually decrease. The theory predicts that, as a result, the RTC fatality rates of different countries will tend to converge over time. Our results for the period 1961-2007 reveal no evidence of the convergence of RTC fatality rates across the OECD as a whole for that time period. Nevertheless, there is evidence of convergence among sub-groups of countries. This evidence may assist policymakers as an additional way of benchmarking their country's performance against that of its peers and to identify the next-closest peer in country sub-groups with superior road safety performance.

Challenges in evaluating the decade of action for road safety in developing countries: a survey of traffic fatality reporting capacity in the Eastern Mediterranean region

OBJECTIVE

The United Nations have proclaimed the "Decade of Action for Road Safety 2011-2020" to reduce traffic fatalities worldwide, particularly in low- and middle-income countries (LMICs). It is estimated that the LMICs in the Eastern Mediterranean Region (EMR) have the highest traffic fatality rates. This study evaluated the capacity of current traffic fatality reporting in the EMR to indicate the impact of future interventions.

METHODS

The World Health Organization's (WHO) SMART (specific, measurable, achievable, realistic, timely) criteria for indicators were used to assess traffic fatality reporting in the 17 LMICs in the EMR.

RESULTS

Official statistics accounted for less than 60 percent of estimated fatalities in 12 of the 17 EMR countries. Police data were the main source of reporting for 11 LMICs, only 3 had a specific traffic fatality surveillance system, the standard definition of fatality was used for 7 LMICs, local fatality distributions were available for 5 LMICs, multiple data sets were available for 6 LMICs, and only 7 regularly published fatality data.

CONCLUSIONS

These reporting problems could easily undermine the evaluation of any future preventive efforts in the EMR. International cooperation and financial assistance from experienced high-income countries, focusing on building capacity, might be useful in strengthening the current reporting systems in LMICs in the EMR.