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Mesic A, Stewart B, Opoku I, Wagenaar BH, Andoh Mohammed B, Abdul Matinue S, Jmaileh M, Damsere-Derry J, Gyedu A, Mock C, Kitali A, Hardy Wuaku D, Owusu Afram M, Feldacker C. "We are pleading for the government to do more": Road user perspectives on the magnitude, contributing factors, and potential solutions to road traffic injuries and deaths in Ghana. PLoS One 2024; 19:e0300458. [PMID: 38787863 PMCID: PMC11125548 DOI: 10.1371/journal.pone.0300458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/27/2024] [Indexed: 05/26/2024] Open
Abstract
Road traffic collisions disproportionately impact Ghana and other low- and middle-income countries. This study explored road user perspectives regarding the magnitude, contributing factors, and potential solutions to road traffic collisions, injuries, and deaths. We designed a qualitative study of 24 in-depth interviews with 14 vulnerable road users (pedestrians, occupants of powered 2- and 3-wheelers, cyclists) and ten non-vulnerable road users in four high-risk areas in November 2022. We used a mixed deductive (direct content analysis) and inductive (interpretive phenomenological analysis) approach. In the direct content analysis, a priori categories based on Haddon's Matrix covered human, vehicle, socioeconomic environment, and physical environment factors influencing road traffic collisions, along with corresponding solutions. We used inductive analysis to identify emerging themes. Participants described frequent and distressing experiences with collisions, and most often reported contributing factors, implementation gaps, and potential solutions within the human (road user) level domain of Haddon's Matrix. Implementation challenges included sporadic enforcement, reliance on road users' adherence to safety laws, and the low quality of the existing infrastructure. Participants expressed that they felt neglected and ignored by road safety decision-makers. This research emphasizes the need for community input for successful road safety policies in Ghana and other low- and middle-income countries, calling for greater governmental support an action to address this public health crisis. We recommend the government collaborates with communities to adapt existing interventions including speed calming, footbridges, and police enforcement, and introduces new measures that meet local needs.
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Affiliation(s)
- Aldina Mesic
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Barclay Stewart
- Department of Surgery, University of Washington, Seattle, Washington, United States of America
- Harborview Injury Prevention and Research Center, Seattle, Washington, United States of America
| | - Irene Opoku
- Building and Road Research Institute, Kumasi, Ghana
| | - Bradley H. Wagenaar
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Bilal Andoh Mohammed
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sulemana Abdul Matinue
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Manal Jmaileh
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - James Damsere-Derry
- Department of Surgery, University of Washington, Seattle, Washington, United States of America
| | - Adam Gyedu
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Mock
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Surgery, University of Washington, Seattle, Washington, United States of America
- Harborview Injury Prevention and Research Center, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Angela Kitali
- Civil Engineering Program, University of Washington, Tacoma, Washington, United States of America
| | | | | | - Caryl Feldacker
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
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Shahi S, Brussel M, Grigolon A. Spatial analysis of road traffic crashes and user based assessment of road safety: A case study of Rotterdam. TRAFFIC INJURY PREVENTION 2023; 24:567-576. [PMID: 37489942 DOI: 10.1080/15389588.2023.2234530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE To perform a spatial analysis of Road Traffic Crashes (RTCs) and assess road safety issues from the perspective of road users. PROBLEM STATEMENT Although many initiatives have been taken to reduce the occurrence and severity of RTCs, they continue to persist. Existing research often investigates the spatial occurrence of RTCs or the perception of road safety issues from the road user. In doing this, only a limited number of factors that contribute to RTCs can be revealed, whereas in most RTC occurrences a multitude of factors plays a role. A more integrated approach combining both knowledge areas can contribute to improving road safety. METHODS RTCs that occurred from 2018 to 2020 in Rotterdam, in the Netherlands, were spatially analyzed. This was performed using Network Kernel Density Estimation (NKDE) analysis. Two zones within the study area were selected to understand road users' perceptions of road safety through a survey. Furthermore, opinions toward possible recommendations for improving road safety were also collected through key informant interviews. RESULTS NKDE resulted in a hot-spot map of the road segments in the study area that showed the frequency of RTCs using different colors. The road segments were classified based on the number of RTCs from 2018 to 2020, ranging from zero to 17.9 RTCs per kilometer. This led to the selection of a hot and cold spot zone for further analysis. The road user perception survey resulted in the discovery of qualitative responses that can be used to improve road safety in future and the possible recommendations would be well received by them. The key-informant interviews acted as a backup to the opinions given by the road users and provided insights on what is being done in the study area to improve road safety. CONCLUSION The synthesis of findings unveiled why road users perceive some areas as dangerous and which road policies need to be revised to improve road safety in Rotterdam.
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Affiliation(s)
- Sachita Shahi
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands
| | - Mark Brussel
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands
| | - Anna Grigolon
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, Netherlands
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Khadka A, Gautam P, Joshi E, Pilkington P, Parkin J, Joshi SK, Mytton J. Road safety and heavy goods vehicle driving in LMICs: Qualitative evidence from Nepal. JOURNAL OF TRANSPORT & HEALTH 2021; 23:101247. [PMID: 34976734 PMCID: PMC8683746 DOI: 10.1016/j.jth.2021.101247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 08/04/2021] [Accepted: 09/01/2021] [Indexed: 05/29/2023]
Abstract
BACKGROUND Heavy goods vehicle drivers are an influential driving population in Nepal, with over 90% of goods in the country are transported by road. Due to the time spent on the road, drivers have long periods of exposure to the risk of crash involvement. The study explores the perceptions and experiences of heavy goods vehicle drivers and representatives from their professional association regarding road danger. METHODS We conducted semi-structured interviews with fifteen heavy goods vehicle drivers regularly driving on the East-West highway of Makwanpur District, Nepal. A focus group was conducted with eleven members from a major transportation entrepreneur's association in Nepal. The focus group and interviews were audio-recorded, transcribed, translated, and analyzed using thematic analysis. RESULTS Four themes were developed- assumptions of blame; perceptions of safety culture in the trucking industry; influence of road infrastructure; and behaviours of road users. The road and traffic environment, enforcement, and the safety culture in the heavy vehicle industry not only influenced the attitudes of the road users towards traffic safety but also legitimized and encouraged behaviours that affect safety. General and industry-related road safety improvements suggested by participants included: making provision for heavy good vehicles parking areas, separating the highway with a median strip, improving crash investigation capacity, conducting road safety awareness and training programs, strictly enforcing the speed limit and laws about driving under the influence of alcohol/drugs, and formulating strategies to create a safe, supportive working environment in the heavy vehicle industry. CONCLUSION Heavy goods vehicle drivers and members of the professional association can provide rich information regarding the barriers and facilitators of road risk in Nepal. Their perceptions and opinions can contribute to devising interventions at individual, societal, organizational, and governmental levels, and inform efforts to develop a positive safety culture within the heavy vehicle transport industry.
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Affiliation(s)
- Anish Khadka
- Nepal Injury Research Centre, Kathmandu Medical College Public Limited, Bhaktapur, Nepal
| | - Preeti Gautam
- Nepal Injury Research Centre, Kathmandu Medical College Public Limited, Bhaktapur, Nepal
| | - Elisha Joshi
- Nepal Injury Research Centre, Kathmandu Medical College Public Limited, Bhaktapur, Nepal
| | - Paul Pilkington
- Centre for Public Health and Wellbeing, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - John Parkin
- Centre for Transport and Society, Faculty of Environment and Technology, University of the West of England, Bristol, UK
| | - Sunil Kumar Joshi
- Nepal Injury Research Centre, Kathmandu Medical College Public Limited, Bhaktapur, Nepal
| | - Julie Mytton
- Centre for Public Health and Wellbeing, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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M. Selveindran S, Samarutilake GDN, Vera DS, Brayne C, Hill C, Kolias A, Joannides AJ, Hutchinson PJA, Rubiano AM. Prevention of road traffic collisions and associated neurotrauma in Colombia: An exploratory qualitative study. PLoS One 2021; 16:e0249004. [PMID: 33765057 PMCID: PMC7993809 DOI: 10.1371/journal.pone.0249004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 01/07/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Neurotrauma is an important but preventable cause of death and disability worldwide, with the majority being associated with road traffic collisions (RTCs). The greatest burden is seen in low -and middle- income countries (LMICs) where variations in the environment, infrastructure, population and habits can challenge the success of conventional preventative approaches. It is therefore necessary to understand local perspectives to allow for the development and implementation of context-specific strategies which are effective and sustainable. METHODS This study took place in Colombia where qualitative data collection was carried out with ten key informants between October and November 2019. Semi-structured interviews were conducted and explored perceptions on RTCs and neurotrauma, preventative strategies and interventions, and the role of research in prevention. Interview transcripts were analysed by thematic analysis using a framework approach. RESULTS Participants' confirmed that RTCs are a significant problem in Colombia with neurotrauma as an important outcome. Human and organisational factors were identified as key causes of the high rates of RTCs. Participants described the current local preventative strategies, but were quick to discuss limitations and challenges to their success. Key barriers reported were poor attitudes and knowledge, particularly in the community. Suggestions were provided on ways to improve prevention through better education and awareness, stricter enforcement and new policies on prevention, proper budgeting and resource allocation, as well as through collaboration and changes in attitudes and leadership. Participants identified four key research areas they felt would influence prevention of RTCs and associated neurotrauma: causes of RTCs; consequences and impact of RTCs; public involvement in research; improving prevention. CONCLUSION RTCs are a major problem in Colombia despite the current preventative strategies and interventions. Findings from this study have a potential to influence policy, practice and research by illustrating different solutions to the challenges surrounding prevention and by highlighting areas for further research.
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Affiliation(s)
- Santhani M. Selveindran
- Department of Clinical Neurosciences, Addenbrooke’s Hospital, Cambridge, United Kingdom
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
| | - Gurusinghe D. N. Samarutilake
- Directorate of Healthcare Quality and Safety, Ministry of Health, Colombo, Sri Lanka
- Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - David Santiago Vera
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Meditech Foundation, Cali, Colombia
| | - Carol Brayne
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Christine Hill
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Angelos Kolias
- Department of Clinical Neurosciences, Addenbrooke’s Hospital, Cambridge, United Kingdom
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
| | - Alexis J. Joannides
- Department of Clinical Neurosciences, Addenbrooke’s Hospital, Cambridge, United Kingdom
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
| | - Peter J. A. Hutchinson
- Department of Clinical Neurosciences, Addenbrooke’s Hospital, Cambridge, United Kingdom
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
| | - Andres M. Rubiano
- NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, United Kingdom
- Meditech Foundation, Cali, Colombia
- Neuroscience Institute, Universidad El Bosque, Bogotá, Colombia
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