Strategy to Improve Road Safety in Developing Countries

8/13/2019 Strategy to Improve Road Safety in Developing Countries

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604 Saudi Med J 2003; Vol. 24 (6) www.smj.org.sa

trategy to mprove roa sa ety ... ener et a

importance of adequate data on traffic injuries. Accurateepidemiological data from many developing countriesare rare or difficult to find.2-14 Data on injury fromdeveloping and Arabian Gulf Countries are primarilybased upon hospital logs2-10or police records.1,3,10,11,14-17 Arapid rise in vehicle ownership occurred during the1960s in Latin America, when accident rates also peakedand have remained at a high level since then. The annual

increase in vehicle ownership in Asia is 12-18%, yetroad networks and safety measures have not kept pace,resulting in a dramatic increase in the number and rate ofaccidents. In most African countries, vehicle ownershipis limited and traffic is generally less crowded.1

However, the dramatic growth of urban populationcaused a rapid rise in urban vehicle ownership andaccidents. This study aims to review the road safetysituation in developed and developing countries,compares this with the road safety in the Arabian GulfCountries and suggests a strategy to improve it. The roleof road engineers in reducing accidents is highlighted.

Methods. Data was obtained from the officialstatistical reports on road traffic accidents, injuries andfatalities and Ministry of Interior's Yearly StatisticalReport and the Annual Reports of the Directorate ofTraffic and Ministry of Health Annual Reports.18Fatalityis included, according to WHO criteria, if it occurswithin 30 days from the accident. The annual statisticalreport contains information on the number of registeredvehicles, number and nature of accidents, causes of roadaccidents, number of fatalities and casualties, age andgender of victims and causal factors. Additional data wasobtained from various sources, including Ministry ofHealth, Health Statistics Annual Report for the periodfrom 1988 and 1998,19 various edition of the WHO

Statistics Annuals, International Road Federation,Transport Road Research Laboratory and Accident Factspublications.

Results. I. Accident rates, trends and costs.Manyparameters have been used to describe the accidentproblem. These include the number of fatalities, fatalityrates,20 (fatality per 10,000 vehicles, per 100,000persons or per million vehicles-km) and fatality index.Comparison of vehicle ownership levels and safetyparameters between developed and developing countriesmay help to highlight the relative seriousness of the roadsafety situation in different countries. The fatality rates

(per population and per vehicles) are selected forcomparison purposes since information on vehicle usageis not yet available in many developing countries. Theresults are shown in Table 1 and in Figure 1. Thechanging pattern in vehicle ownership levels and fatalityrates over time was also investigated for selecteddeveloped and developing countries. The percentagechanges in vehicles per person and in fatality rates overthe 10-year-period (1988-1998) were calculated and theresults are given in Table 2. However, such comparisonsshould be treated with caution due to its variationsbetween countries in definition, degree of motorization

and accuracy of data. In addition misleading conclusionsmay be drawn if only one of the fatality rates isconsidered.21 Attempts have been made to relate vehicleownership and fatality rates per vehicle for bothdeveloped and developing countries resulting in anumber of predictive models. A summary of thesemodels is shown in Table 3. This approach wassubjected to criticism and different models were

produced which incorporate more factors that arebelieved to contribute to traffic accidents. Such modelwas developed for rich developing countries.22 Anattempt was made to test the relationship betweenfatality rate and other parameters that are believed tohave some impact on fatalities in the United ArabEmirates.3The parameters used were as follows: vehicleper-person; gross national product (GNP) per capita;population per physician; population per hospital bed;and percentage of the school age population attendingschools. The reason for choosing parameters is that theyare believed to reflect some social, economic, and healthcharacteristics of Arabian Gulf Countries with sufficientvariable data. Simple regression analysis was carried out

to quantify separately the dependence of the fatality (perlicensed vehicle) on those parameters. The logarithmicvalues of fatality rates per vehicle in Arabian GulfCountries were related to the above parameters. Theresults of regression analysis obtained showed that thefatality rates were found: to decrease with increasingvehicle ownership; to decrease with increasing GNP percapita; decrease with increasing percentage of the schoolage population attending school; increase withpopulation per physician; and increase with populationper hospital bed.

Discussion. The above results, bearing in mind

data limitations, shed some light on how social andeconomic parameters might affect the road safetysituation in a particular country. The results alsosuggest that road accidents fatality rates could bereduced by improving medical services and education.The estimation of accident costs is difficult andparticularly in developing countries. Nevertheless,correct costing is needed to accurately determine thecost effectiveness of traffic management schemes.13,16

Traffic accidents in developing countries are costing anenormous amount of money,2,23 (an estimated 1-2% ofGNP) much of which must be paid in hard currency,since vehicles and medicines are usually imported. Onthe average, the total costs of road accidents, including

an economic valuation of lost quality of life, wereapproximately 2.5% of the GNP.24 Excluding thevaluation of lost quality of life, road accidents cost anaverage 1.3% of the GNP. When valuation of lostquality of life is included, costs ranged from 0.5-5.7% ofGNP. When valuation of lost quality of life isdisregarded, costs ranged from 0.3-2.8% of GNP.25

However the losses caused by traffic accidents are quiteheavy in both developed and developing countries (asindicated in Table 4) and if they are to be reducedsubstantially, a comprehensive strategy for accidentreduction and prevention is required.25


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II. Factors contributing to accidents. Most of thefactors affecting accident occurrence and rates may begrouped and labeled as "economical" factors. The WorldBank26 relates much of the accident problem indeveloping countries to a shortage of funds, for bothowners of vehicles and governments.

A study into the factors affecting traffic accidents indifferent countries may conveniently divide them into 2

groups: a) Direct factors - which contribute directly tothe occurrence of individual accidents. These include:road user behavior, driver's ability and attitude, trafficengineering, roads and environment, and medicalservices. b) Indirect factors - that contribute to the totalpopulation and rates of accidents in the country. Theyinclude demographic (population structure anddistribution), and vehicle population and characteristics(number, type, usage and occupancy). Many studieshave shown that these factors contribute to higheraccident risks or to more serious accidents. Indeveloping countries the resource constraints, especiallyof hard currency may produce the following

consequences. Moreover, road user behavior is reckless.Studies show that drivers routinely ignore traffic laws22,27

and pedestrians routinely walk in the middle of streetsand cross without checking for traffic. Hobbs28 hasreported that in general, driver's errors, oftenaccompanied by law violations, are in the chain ofevents leading to more than 90% of all highwayaccidents. However, the nature of behavior differsbetween countries. While alcohol, for example, is foundto be the most common causes of accidents in manydeveloped countries, it is negligible effect in Islamiccountries where the law prohibits alcohol drinking.1-3

Investigations into some aspects of driver behavior insome rich developing countries2,3,29,30 indicated that

drivers acquire many dangerous and harmful drivinghabits and that driver observations of traffic regulationsis poor. In recent years, many countries have launchedintegrated road safety programs which attempt toincorporate all the diverse elements related to accidentsand casualties31 which is expected to increase theefficiency of road safety work and generate newsolutions to the accident problem.

III. Strategies for better roadsafety. Comprehensive strategy for accident reductionand prevention is required to improve road safety in anycountry. World Health Organization13has proposed sucha strategy and produced guidelines that draw a cleardistinction between accident reduction and accidentprevention, with both is being necessary. Theoretically,reduction of accidents requires: (i) Reducing personaltravel (and consequently road traffic). (ii) Reducing therisk, severity and consequences of road accidents. Theseapproaches can be applied in a variety of ways and roadsafety improvement measures may be broadly classifiedinto 2 groups: 1) "Technical" - which are direct measuresintended mainly to improve safety. These includemeasures related to land use development, road and roaduser, vehicle design, traffic laws and their enforcement,medical services and insurance premiums. 2)

"Institutional" - which can improve road safetyindirectly and are related to road safety organization,financing, research and development and staff educationand training. An accident reduction program shouldentail the following stages: a) Identification of problemlocations through the analysis of accident data. b)Diagnosis of the symptoms (namely factors involved inaccident occurrence). c) Selection of the best treatment

and program of work. d) Monitoring of the effects of theprogram.

III.1 Strategy for developing countries. The modelderived by Jacobs and Cutting27using 1980 data from 20developing countries and that derived by Smeed32 using1938 data from 20 developed countries (Table 3) suggestthat the situation in developed countries in 1938 issimilar to that in developing countries in 1980. In termsof vehicle ownership and general approaches to thesafety problem, this may well be the case. However, thesuggestion of similarity is not true in many other aspectsaffecting road safety such as roads, user behavior andlaw enforcement. Wider social and behavioral

differences between developed and developing countriesmust be considered when assessing the potential for roadaccident reduction in developing countries.2-4,10 A multi-directional approach should be considered for the overallreduction of traffic accidents in developing countries. Atraffic safety management system as shown in Figure 2could be adopted and the activities coordinated andapplied collectively. Based on findings of the WorldBank report,33this stresses the importance of improvingsystems for data collection and analysis; establishmentof official, national coordinating committees and a smallteam working full time on road safety; and trainingtraffic engineers to analyze accidents, conduct limitedsafety studies to identify the most important problems,

convince officials to take action and design and evaluatecorrective measures. Finally, the complexity of factorsinfluencing road safety and the wide variety of availablecounter measures call for a systemic approach of roadsafety activities. Carlsson and Hedman34 suggestedsimplified framework for such an approach as follows:setting of goals, data collection and analysis,identification of safety measures, setting of priorities,and activities related to the selected safety programswhich include design, financing, implementation,monitoring, and evaluation.

III.2 Strategy for developed countries. Well-planned and timed strategy should be launched againstRTAs. These accidents cause high mortality and inflictheavy economical losses. This strategy should becomprehensive and not incremental. In developedcountries, where there is a better appreciation of theproblem, the remedy requires commitment from both theofficials and the public and should take the form of apositive strategy from a coordinated group of decisionmakers. The study should outline the policy andstrategy, the means and the resources needed to face thisserious problem and set targets to achieve during setperiods of time.35 It produced a policy that called forroad safety management on national and local levels.


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Table 1 - Motorization levels and fatality rates for various countries duringthe period of 1988-1998.

Countries

Developing countriesBrazilChileEthiopiaJordanKorea (South)MalaysiaMorocco*NigerPakistanThailandTunisia

Arabian Gulf countriesBahrainKuwaitOmanKingdom of Saudi Arabia

United Arab EmiratesQatar

Eastern European countriesBulgariaHungaryYugoslavia

Developed countries (Western)DenmarkFinlandFranceGermany (W)Great BritainJapan*

New Zealand Spain

United States of America

Vehs/10,000persons

1000.7 748.6 8.9 770.9

391.51111.0 341.0 50.1 40.4 277.6 573.0

2458.93014.11395.54193.2

1892.32186.6

1452.11756.11329.2

3666.52219.24698.34854.74545.54078.45950.33111.7

77403.2

Fats/10,000vehicles

4.22 12.79292.06 17.73 44.72 21.88 31.08 46.68121.44 12.98 21.24

6.57 4.84 16.37 6.36

11.29 7.34

8.85 8.45 12.75

3.71 3.05 3.76 2.68 2.13 1.87 4.03 4.85 2.30

Fats/10,000persons

0.420.960.261.371.752.431.060.230.490.361.22

1.621.462.282.66

2.101.58

1.281.481.78

1.361.181.771.300.970.762.401.511.80

Data source: International Road Federation. World Road Statistics.VariousEditions (1988-1998)

*death within 24 hours, death within 6 daysVehs - vehicles, Fats - fatalities

Figure 1 - Road accident fatalities (deaths per 10,000 vehicles) in selectedcountries, 1988-1998.

Table 2 - Percentage change in vehicle ownership and fatality rates inselected countries during the period of 1988-1998.

Countries

Developing countriesBrazilChileEthiopiaJordanKorea (South)MalaysiaMorocco*NigerPakistanThailandTunisia

Arabian Gulf countriesBahrainKuwaitOmanKingdom of Saudi Arabia

United Arab EmiratesQatar

Eastern European countriesBulgariaHungaryYugoslavia

Developed countries (Western)DenmarkFinlandFranceGermany (W)Great BritainJapan*

New Zealand Spain

United States of America

Vehs/10,000persons

48.9*467.543.6

124.0*417.8* 83.1* 16.0* 7.3* 86.2* 74.5* 78.8*

39.7*-9.5

567.3*192.0*

68.4* 77.2*

89.4* 113.0*

50.5*

13.6* 14.5

29.2* 35.8* 26.3* 45.6* 30.5* 60.3* 10.2*

Fats/10,000vehicles

5.751.540.6*63.469.943.837.024.943.264.128.2

60.053.445.265.0

25.349.5

42.358.852.8

26.347.244.560.839.832.917.428.723.5

Fats/10,000persons

40.2*18.7

20.4 18.1

55.8*2.9*

26.919.36.1*

37.428.8*

44.855.9

305.1*3.8

15.49.1

9.3*12.225.6

16.321.328.346.823.9 2.3 7.8*14.2*15.8

Data source: International Road Federation. World Road Statistics.VariousEditions (1988-1998)

*increasing, decreasingVehs - vehicles, Fats - fatalities

Table 3 - A summary of models relating vehicle ownership and fatalityrate.

Year ofdata

193819801978-19801980

1982

Type of countries

DevelopedDevelopingDevelopingDeveloped

Gulf and MiddleEastern

N ofcountries

20203520

11

Model

*F/ V = 0.0003 (V/P) -0.66F/ V = 0.00036 (V/P) -0.65F/ V = 0.00039 (V/P) -0.64F/ V = 0.00021 (V/P) -0.72

F/ V = 0.00052 (V/P) -0.60

*Smeed,32Jacobs and Cutting,27Jadaan23

F - fatalities from road accidents, V - number of vehicles, P - population

COUNTRIES


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Table 4

Countries

Developing countries

Ethiopia

IndiaJordanRich developing countries Kuwait Libya Kingdom of Saudi Arabia

Developed countries Australia New Zealand United Kingdom United States of America

Year

1981

19831985

198219781985

1978198319811980

Currency

GBP

IRsJD

KDUSDSR

AUDNZDGBPUSD

Cost (USD)millions

10.6

2,367641.4 (62.7)

115 (396.6)160

7,366 (1,959)

1,591 5102.18257,199

Ref.no.

5

2624

630 2

26262626

GBP - Great Britain Pound, IRs - Indian Rupees, JD - Jordanian Dollar, KD -Kuwait Dinar, USD - US Dollar, SR - Saudi Riyals,AUD - Australian Dollar, NZD - New Zealand Dollar

Table 4 -Indicative cost of traffic accidents in selected countries.

Figure 2 -Traffic safety management system for developing countries.

Figure 2


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IV. Role of engineers. Road accidents areconsidered a "public health" problem, which confrontssociety generally. Engineers must, therefore, workclosely with experts in other scientific disciplines suchas educators, health and enforcement agencies toeffectively tackle the problem. Engineeringimprovements to road safety can be convenientlysubdivided into 3 categories:36 improvements to the road

and its environment; improvements to road vehicles; andimprovements aimed at assisting other scientificdisciplines. Road and vehicle engineering measureshave been well proven effective in reducing accidents.Road safety is more appreciated in developed countriesand their accident rates are generally improving. Incomparison, the problem may appear of little concern indeveloping countries and their accident and casualtyrates are higher than developed countries. It is unlikelythat much progress can be made in substantiallyreducing accident cost unless a comprehensive strategyis adopted. A multi-directional approach should beconsidered in developing countries and a safety

management system is proposed. Road traffic accidentscontinue to be a major cause of mortality and morbidityin the Gulf Countries leading to substantial wastage oflife and national resources. Further investigation isessential and will require close intersectorialcollaboration between, traffic police, health, law, andtransport authorities. Developing a research strategy forprevention will reduce casualties and deaths on the road.

Acknowledgment. We would like to thank Prof. LeonardEvans (United States of America), Mr. David Lynam (TransportResearch Laboratory, United Kingdom), and Ms. Sarah Groombridge(Transport Research Laboratory, United Kingdom) for their valuableinformation for the preparation of this paper.

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Strategy to Improve Road Safety in Developing Countries