Publications
1-10 of 21
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Post-Crash Health Care
Beyond the Numbers: Estimating the Disability Burden of Road Traffic Injuries
November 2023
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Road Safety Data
Improving Road Traffic Injury Statistics in Low- and Middle-Income Countries
November 2023
- National decision-makers recognize the issue of underreporting but tend to dismiss higher estimates by global statistical models.
- Most countries use WHO GSRRS estimates.
- National health surveys and censuses in LMICs often contain relevant information, and minor modifications can greatly improve their usage for such measurements.
- Incorporating national health survey data into global statistical models can help resolve discrepancies and increase confidence in estimates.
- Integrating epidemiological data sources into global statistical models (GBD, GHE, GSRRS) to reduce discrepancies and increase confidence in their estimates.
- Including relevant questions in upcoming national data collections to facilitate epidemiological measurements of road traffic injuries.
- Encouraging local involvement in data production for better estimates.
- Enhancing coordination between the Institute for Health Metrics and Evaluation and the World Health Organization to improve estimates and reduce inconsistencies.
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Road Users
Drink-Driving: A Road Safety Manual for Decision-Makers and Practitioners (2nd ed.)
November 2022
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- international literature and good practices on motorcycle safety;
- assessment of motorcycle crashes, regulations, risk exposure data, risk indicators in African countries (with more detailed analysis of Burkina Faso, Cameroon, Rwanda, and Uganda); and
- consultations with stakeholders.
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This GRSF-funded study explores the medical, economic, and social costs of road traffic accidents (RTAs), particularly focusing on individuals with permanent disabilities. According to the World Health Organization (WHO), RTAs are a global public health crisis, ranked as the 12th leading cause of death and the primary cause of mortality among children and young adults. While the UN's Decade of Action for Road Safety (2021–2030) aims to reduce RTA deaths, the study argues that more focus is needed on injuries and the long-term impact on those left disabled by RTAs.
Building on GRSF’s report Beyond The Numbers: Estimating the Disability Burden of Road Traffic Injuries (Mitra et al., 2023), this project examines data from Namibia and South Africa and interviews with experts to highlight the often-overlooked challenges faced by RTA-related disability survivors. These individuals encounter unique issues—such as brain injuries, psychological trauma, and sudden financial burdens—that require specific support mechanisms beyond general disability frameworks.
Economic losses from RTAs are substantial, with WHO estimating global costs up to $1.8 trillion annually. However, existing research focuses mainly on medical costs and productivity losses, neglecting broader social impacts. Data on the prevalence of permanent disabilities varies, underscoring the need for standardized research.
The study calls for integrating disability concerns into road safety policies, emphasizing that improved enforcement in low- and middle-income countries could prevent disabilities and reduce societal costs. Ultimately, it advocates for recognizing RTA-related disabilities as a critical issue within global health, disability policy, and development agendas.
Road traffic injuries (RTIs) are a critical public health issue in Jordan, as highlighted in the 2022 Annual Report of Traffic Accidents from the Jordan Public Security Directorate. With 169,409 crashes recorded in 2022, resulting in 562 deaths and 11,510 injuries, RTIs have emerged as the leading cause of death for children and young people, and the second-leading cause for adults aged 20–64.
This analytical research study aims to understand RTI-induced disabilities in Jordan, identify contributing factors, and assess the associated costs for road traffic crash victims. Using a mixed-methods approach, the research included quantitative and qualitative data collection through hospital-based surveillance and follow-up surveys at one- and three months post-injury. The study involved six public and private hospitals across Jordan. Key informant interviews with stakeholders from various sectors were conducted to gain comprehensive insights.
The study's findings reveal that most RTI patients were male (79%) with an average age of 34 years. Crashes predominantly occurred during early mornings and night hours, involving mainly cars (72%) and motorcycles/bicycles (40%). A significant number of patients (74%) received prehospital care, primarily from ambulance staff. Most patients (66%) were fully conscious upon arrival at the emergency room.
Injury analysis showed that 58% of patients had a single injury, with extremities being the most affected area. Financially, 49% of patients incurred immediate costs upon hospital admission, and follow-up care also resulted in out-of-pocket expenses, particularly for physiotherapy and medications.
The study indicated that 79% of patients experienced some disability at the one-month follow-up, with varying degrees from mild to extreme. By the third month, 73% reported no disability, though 26% continued to experience mild impairments.
This study underscores the significant burden of RTIs and associated disabilities in Jordan, highlighting the need for targeted interventions to reduce injuries and robust long-term care to support affected individuals.
It is well-documented that road crashes claim around 1.35 million lives each year and rank as the eighth leading cause of death globally, causing huge burdens for economies, health systems, and transport networks. However, beneath the sobering fatality statistics lies a largely unexplored landscape: the staggering toll of disabilities induced by road crashes. Until now, the focus of road safety research and policy discourse has predominantly revolved around fatalities, which has limited our understanding of traffic-related injuries and disability burdens at the individual, community, and national level.
To address this critical knowledge gap, this pioneering study—involving over 2,300 patients hospitalized for road crash injuries—provides valuable insights into the prevalence, causes, and long-term impacts of crash-related disabilities. By broadening the discussion beyond fatalities to the often-overlooked issue of disability, the report paves the way for a more holistic perspective on road safety impacts, which can inform more effective road safety policies.
This report is a call to action for comprehensive and context-specific interventions that encompass both the transport and health sectors. Effective measures may include implementing safety regulations, enhancing emergency services, strengthening rehabilitative care, and expanding social safety nets to ease the financial burden on crash survivors. Collaborative efforts between governments, global and regional organizations, civil society, and other stakeholders will be indispensable.
Road safety is a global health and economic issue that disproportionately affects low- and middle-income countries (LMICs). Precise data is crucial for understanding the full scope of the problem and developing effective interventions, but LMICs struggle to collect comprehensive data due to limited resources, underdeveloped health systems, and inconsistent data collection processes.
To overcome reporting gaps, three major global statistical models are utilized: The Institute for Health Metrics and Evaluation Global Burden of Disease (GBD) study, the World Health Organization (WHO) Global Status Reports on Road Safety (GSRRS), and WHO Global Health Estimates (GHE). However, discrepancies exist among these models and between them and official country statistics. They often estimate significantly higher road traffic fatalities and injuries than official LMIC statistics.
This GRSF study identifies the reasons behind statistical discrepancies and outlines strategies to strengthen modeling efforts. This involved qualitative research, a systematic review of national data availability, and four case studies in Brazil, Cambodia, Ethiopia, and Tanzania.
Key findings include:
Recommendations include:
To achieve the goal of the Second United Nations Decade of Action for Road Safety (reducing road traffic fatalities and injuries by 50% by 2030), substantial resources need to be allocated to road safety and accurate reporting and statistical estimates are required.
This manual provides guidance and evidence for decision-makers and practitioners that should lead to an increase in the use of vehicle occupant restraints, such as seat-belts for adults and car seats for babies and children. It draws on experience from countries that have succeeded in achieving and sustaining high levels of vehicle occupant restraint use, and builds on new evidence, including from low and middle-income countries.
Safe, quality helmets reduce the risk of death in a road crash by over six times, and reduce the risk of brain injury by up to 74%. Head trauma is the leading cause of death for riders, and motorcycles continue to proliferate rapidly. Yet the use of helmets in many low and middle-income countries remains low.
The second edition of the Helmets Manual offers guidance to help decision makers and practitioners put in place the comprehensive set of laws, regulations and actions needed to increase the use of safe, quality helmets to save lives.
This manual provides guidance for decision-makers and practitioners to reduce the prevalence of drink driving and associated road trauma. It draws on experience from countries that have succeeded in achieving and sustaining reductions in alcohol-related road trauma, and includes recommendations for developing and implementing drink driving legislation, and advice on how to monitor and evaluate progress.
In developing countries with inadequate public transport and road infrastructure, motorcycles present a fast, cheap, and efficient transport alternative. Motorcycles are widely used in many African countries for personal and public transport, as well as for service delivery. In some African countries, motorized two and three-wheelers constitute the largest proportion of the motorized vehicle population. However, despite their benefits, motorcycles expose their riders and passengers to a high risk of serious injury or death in the event of crashes. Motorcycle safety is therefore a significant problem in Africa. On average, 22.5% of road traffic deaths in 2016 involved riders/passengers of two- and three-wheelers, according to the last data published by World Health Organization (WHO, 2018).
This research study presents comprehensive strategic recommendations on how to improve motorcycle safety in Africa. The study will serve as policy advice and technical assistance to the Bank’s regional member countries (RMCs). The study focuses on motorcycle safety conditions in Cameroon, Burkina Faso, Rwanda, and Uganda, where the use of motorcycles for daily activities is reputedly high. Recommendations are predicated on an examination of the major causes of motorcycle crashes and injuries, as well as an extensive body of knowledge from various sources, notably:
An evaluation of the various Emergency Medical Services (EMS) models and mechanisms in place in Sub-Saharan Africa (SSA) is critical in order to have a better understanding of what can be improved upon for effective pre-hospital and emergency care services (PECS). With grant funding provided by the World Bank’s Global Road Safety Facility (GRSF), this report aims explore the State of EMS Systems in Sub-Saharan Africa through a review of the models and mechanisms being developed across various States.
The premise of the report focuses on the fundamentals for effectively providing satisfactory treatment to those in need of urgent medical care, while also recognizing that there are multiple pathways, framed by the respective legislative, legal and regulatory enabling environments, towards a more formal and sustainable EMS model. It represents an effort to identify the major similarities and differences, as well as potential opportunities for greater coordination or collaboration, that can lead to the development of sound policy recommendations for fostering and expanding post-crash response services in the region.
High-level system information has been collected through questionnaires distributed to National Respondents in each country, for which 25 of 44 countries substantially responded as of April 2019 (collectively hereinafter referred to as SSA countries): Botswana, Burkina Faso, Burundi, Cabo Verde, Cameroon, Central African Republic, Chad, Comoros, Congo Brazzaville, Gabon, Lesotho, Liberia, Madagascar, Malawi, Mauritania, Niger, Rwanda, Senegal, Sierra Leone, Sudan, Tanzania, Togo, Uganda, Zambia and Zimbabwe. Missing data and discrepancies triggered a detailed review of laws and other regulatory acts, policy and plan.
The Report does not consider the advantages and disadvantages for the EMS models adopted by SSA countries, nor does it take a position on which regulatory approach should be applied, or measure the degree of EMS standards implementation and the success or failure of implementing various EMS policies. The principal aim of this report is to capture the current range of the standards and regulations in key areas of EMS systems across SSA.
The State of Emergency Medical Services in Sub-Saharan Africa is supported by UK Aid through the World Bank’s Global Road Safety Facility.
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In many countries around the world, deficiencies in data or data quality impair evidence-based road safety policy making. While many countries collect road safety data, the collection is not necessarily comprehensive. Further, many countries can be unaware of data gaps in their system, which prevents them from soundly analyzing their road safety problems. Therefore, road safety data definitions and collection methods must converge into standard international criteria, thus allowing for comparisons in space - across countries - and in time.
This is the raison d’etre of regional road safety observatories, which have been developed, for example, in Latin America (OISEVI), Africa (ARSO), and Asia-Pacific (APRSO). They present an opportunity for joint regional efforts to improve, in a harmonized way, road safety data collection and analysis. Regional road safety observatories promote the adoption of a common set of road safety indicators based on common definitions and serve as an avenue to assist countries in improving the management of their crash data systems.
This document is designed to support reviewers in the assessment of road safety data collection; the complete range of safety data should be considered. This task can be complicated because collection of road safety data is often not achieved by activities dedicated to this purpose, but rather through piggybacks on other sources. For example, activity reports from police or hospitals are used to provide material for legal or medical purposes. The routines involved frequently have a long history in which gathering reliable and complete statistics has had secondary priority, at best. The various actors involved reflect the complex structure of a country’s judicial and executive system, which, generally, are not coordinated. Consequently, any review of the data collection process requires some “detective work.”