Road traffic injuries and fatalities are increasing in Ghana. Police-collected crash and injury data for the period 1994-1998 were aggregated and analyzed using the MAAP5 accident analysis package developed by the Transport Research Laboratory, U.K. Published results of recent transport-related epidemiological and other surveys provided an additional data source. According to the 1994-1998 police data, road traffic crashes were a leading cause of death and injuries in Ghana. The other leading causes of death and injuries are occupational injuries which involve non-mechanized farming and tribal conflicts. The majority of road traffic fatalities (61.2%) and injuries (52.3%) occurred on roads in rural areas. About 58% more people died on roads in the rural areas than in urban areas, and generally more severe crashes occurred on rural roads compared with urban areas. Pedestrians accounted for 46.2% of all road traffic fatalities. The majority of these (66.8%) occurred in urban areas. The second leading population of road users affected was riders in passenger-ferrying buses, minibuses and trucks. The majority of these (42.8%) were killed on roads that pass through rural areas. Pedestrian casualties were overrepresented (nearly 90%) in five regions located in the southern half of the country. Efforts to tackle pedestrian safety should focus on the five regions of the country where most pedestrian fatalities occur in urban areas. Policies are also needed to protect passengers in commercially operated passenger-ferrying buses, minibuses and trucks because these vehicles carry a higher risk of being involved in fatal crashes.

Speed has been determined to be one of the most common contributing factors in vehicle crashes. This study explores vehicle speed as a factor in the causation of road traffic crashes, using the example of Ghana. It examines the effectiveness of various speed control measures, based on police-reported traffic crashes in Ghana and published works on speed control measures in both industrialized and developing countries. In Ghana, pedestrians were the main victims of road traffic injuries. The dominant driver error assigned by traffic police was loss of control, with the underlying factor being excessive vehicle speeds. The 'speed factor' alone accounted for more than 50% of all Ghanaian road traffic crashes between 1998 and 2000. While the enforcement of speed limits by traffic police may not be affordable for most developing countries, rumble strips and speed humps were found to be effective on Ghanaian roads. Rumble strips installed on the main Accra-Kumasi highway reduced crashes by about 35% and fatalities by about 55%. Reducing vehicle speeds may be one of the most effective interventions to stem traffic crashes in low-income countries. However, setting lower speed limits is not an effective intervention without the traffic law enforcement resources to ensure that limits are followed. Developing countries must also look to other speed reduction measures such as speed bumps and rumble strips, roads that segregate high- and low-speed users, and technological solutions such as speed governors, as well as greater public awareness of the problem.

Objective: To estimate the prevalence of helmet use among riders and pillion riders of motorcycles in the Tamale Metropolis of Ghana.Methods: Cross-sectional observations of helmet use were made at locations where traffic generally slowed down. Statistical analysis was carried out for variables by calculating chi-square (χ 2 ) tests to assess statistical significance.Results: A total of 3115 riders and 1058 pillion riders (passengers) were observed at 10 different sites. The overall helmet use for riders was 34.2 percent and that for pillion riders was 1.9 percent. Riders' helmet use rate was highest among the elderly (49.6%), followed by adults (34.3%) and lowest for young people (21.9%) and the observed percentage differences were significant (χ 2(2) = 67.1; p < .001). A marked difference (χ 2 (1) = 6.7; p = .0096) in helmet use was observed between riders riding within the central business district (CBD; 36.5%) and those outside the CBD (32.1%). Riders with at least one pillion rider (27.4%) were less likely to wear a helmet compared to riders riding alone without passengers (37.3%; χ 2(1) = 29.347; p < .001).Conclusion: Helmet use by motorcyclists in Ghana is generally low. There is a need for public awareness campaigns on the safety benefits of helmets to increase its prevalence in Ghana. The education on helmet use must be accompanied by sustained enforcement of the road traffic law by the traffic police to ensure compliance and change in attitudes.

We conducted an observational survey of seat belt use to determine the use rate of drivers and front-right passengers of vehicles in Kumasi, Ghana. Unobtrusive observations of seat belt use were made at 41 locations composed of signalized intersections and roundabouts where vehicles come to a halt or slow down considerably. The overall driver seat belt use rate was 17.6% compared to 4.9% for front-right passengers. Driver belt use was 33.2% for private cars, 9.0% for taxis, 8.3% for minibus (trotro), 13.1% for large buses and 9.7% for trucks. Overall seat belt use was higher for female drivers than for male drivers (44.8% versus 16.4%, p < .001), was lowest within the Central Business District (CBD) compared to the outskirts of the city (16.3% versus 21.0%, p < .001) and seat belt use rate increased with age. Passengers belted more often if drivers were belted, but about three-quarters of male passengers and 70-80% of female passengers were unbelted even when drivers were belted. In conclusion, the seat belt use rate was generally low in Kumasi, Ghana, and it is a function of occupant seating position, gender, vehicle type and usage, age group, and location setting. The results provide important preliminary data about seat belt use, particularly among male drivers and commercial vehicle occupant population. The study also suggests the need to develop effective strategies and programs that address low seat belt use in Ghana.

Objective To establish the associations between pedestrian injury and explanatory variables such as vehicular characteristics, temporal trends, and road environment. Methods A retrospective analysis of de-identified pedestrian crash data between 2002 and 2006 was conducted using the Building & Road Research Institute’s crash data bank. We estimated the odds ratios associated with casualty fatalities using a multinomial logistic regression. Results There were 812 pedestrian casualties reported, out of which 33% were fatal, 45% sustained serious injuries requiring hospitalization, and 22% were slightly injured but were not hospitalized. Crossing the roadway accounted for over 70% of all pedestrians deaths. Whereas fatalities in 2002 and 2003 were statistically indistinguishable from those of 2004(p>0.05), in comparison with 2004, there were significantly fewer fatalities in 2005 and 2006 (78% and 65% reduction respectively). According to police report, the probability that a pedestrian fatality occurring in Ghana is attributable to excessive speeding is 65%. The adjusted odds ratio of pedestrian fatality associated with speeding compared with driver inattentiveness was 3.6(95% CI: 2.5 to 5.2). It was also observed that generally, lighter vehicular masses were associated with lower pedestrian fatalities. Compared with buses, pedestrians were less likely to die when struck by private cars (52%), pick-up trucks (57%), and motorcycles (86%). Conclusion Pedestrian death remains the leading cause of fatality among urban road users in Ghana. Risk factors associated with pedestrian fatality include being hit by heavy vehicles, speeding, and roadside activities such as street hawking, jaywalking and nighttime walking. Steps which may contribute to reducing pedestrian fatalities include measures to reduce vehicles speeds in settlements, providing traffic medians and lighting streets in settlements, and discouraging street and roadside activities such as hawking.

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Objectives: Each year, pedestrian injuries constitute over 40% of all road casualty deaths and up to 60% of all urban road casualty deaths in Ghana. This is as a result of the overwhelming dependence on walking as a mode of transport in an environment where there is high vehicular speeds, and inadequate pedestrian facilities. The objectives of this research were to establish (1) the impact of traffic calming measures on vehicle speeds and (2) the association between traffic calming measures and pedestrians' injury severity in built-up areas in Ghana. Method: Vehicle speeds were unobtrusively measured in 38 selected settlements comprising 19 "with" and 19 "without" traffic calming schemes. The study design used in this research was a matched case-control. A regression analysis compared case and control casualties using a conditional logistic regression. Results: Generally, the mean vehicle speeds and the proportion of vehicles exceeding the 50 km/ hour speed limit were significantly lower in settlements which have traffic calming measures compared with towns without any traffic calming measures. Additionally, the proportion of motorists who exceeded the speed limit was 30% or less in settlements which have traffic calming devices whilst the proportion who exceeded the speed limit was 60% or more in towns without any traffic calming measures. The odds of pedestrian fatality was significantly higher in settlements which have no traffic calming devices compared to those which have, OR=1.98; (95% CI=1.09 to 4.43). The protective effects of a traffic calming scheme which has a speed table was notably higher than where there were no speed tables. Conclusion: It was clearly evident that traffic calming devices reduce vehicular speeds and for that matter, the incidence and severity of pedestrian injuries in built-up areas in Ghana. However, the fact that they are deployed on arterial roads is increasingly becoming a road safety concern. Given the emerging safety challenges associated with speed calming measures, we recommend their use to be restricted to residential streets but not on arterial roads. Long term solutions for improving pedestrian safety proposed herein include bypassing settlements along the highways to

Synopsis Injuries result in nearly 6 million deaths and incur 52 million disability-adjusted life years annually, comprising 15% of the global disease burden. More than 90% of this burden occurs in low- and middle-income countries (LMICs). Given this burden, it’s not unexpected that injuries are the leading cause of death among travelers to LMICs, namely from road traffic crashes and drowning. Opportunely, the majority of injuries are preventable. Therefore, pre-travel advice regarding foreseeable dangers and how to avoid them may significantly mitigate injury risk, such as: wearing seatbelts, helmets and personal flotation devices when appropriate; responsibly consuming alcohol; and closely supervising children. Upon return, travelers to LMICs are in a unique position; having shared injury risks while abroad, travelers can advocate for injury control initiatives that might make the world safer for travelers and local populations alike.