Background Road construction work has specific risks and safety issues which have not been adequately addressed in most low- and middle-income countries, especially Africa. The objective of this study was to determine the prevalence of personal protective equipment (PPE) use during road construction activities by workers in foreign- owned against locally-owned road construction companies in Ghana. Methods An institution-based cross-sectional survey was undertaken during January – March, 2020 to study 389 road construction workers who were actively working on site. They were unobtrusively observed to capture whether or not they wore the appropriate PPE at the time of the survey. The PPE of interest were: hard hat, goggles, shoes, nose masks, hearing protection, gloves and reflective vests/apparel. On-site posted PPE signage was also checked. Results Majority of workers were males (96.9%) and labourers (53.5%). Similar numbers of workers in locally-owned (195) and foreign-owned (194) companies were studied. Use of PPE varied considerably by type: shoes (78.7%), reflective vest (44.5%), gloves (30.6%), hard hat (27.0%), nose mask (17.2%), goggles (11.3%) and hearing protection (10.8%). For all types of PPE, use was higher for workers in foreign-owned companies compared with locally-owned companies: goggles (Odds ratio [OR] 55.2), hearing protection (OR 52.0), gloves (OR 23.7), hard hat (OR 20.2), nose mask (OR 17.8), reflective vest (OR 5.3) and shoes (OR 4.1), (p<0.001 for all ORs). No site had any signage to promote PPE use. Conclusions Majority of workers used shoes. Less than half of workers used other types of PPE and use of some types (goggles and hearing protection) was minimal. Workers in foreign-owned companies were significantly more likely to use all the seven types of PPE than locally-owned companies. Although there is still room for improvement in foreign-owned companies, locally-owned companies should be able to attain similar PPE use to that in foreign-owned companies. Necessary PPE should be provided and site supervisors should encourage workers to wear PPE when on site.

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The Ghana Highway Code is the official state-recognised traffic teaching and learning ma­terial widely used in traffic schools and by motorists in Ghana. Ghana changed its traffic from left-hand to right-hand drive in 1974; the Code was subsequently published to, besides other reasons, guide road users to be reconditioned to a fresh standard of behaviour. However, 46 years after its publication, the content of the Code has been outgrown by new developments in the road environment and traffic systems, rendering the Code ineffective. Content analysis was used to ascertain the validity and reliability of the Code. Out of 95 mo­torists interviewed, 91.5% indicated they use or had ever used the Code, while 3.2% had not used it before and 5.3% did not know about it at all. Hundred percent of driving schools used the Code as teaching and learning material. It was concluded that the Code was an obsolete teaching and learning material. The implication was that, the wide user population of the Code had an adverse impact on learners. It was recommended that the Code be revised and republished as new edition.

Background: Road construction work has its own specific set of risks and safety issues. It has not been adequately addressed in most low- and middle-income countries, especially in Africa. The objective of this study was to determine the prevalence of personal protective equipment (PPE) use during road construction activities by workers in foreign-owned against locally-owned road construction companies in Ghana.Methods: An institution-based cross-sectional survey was undertaken during January – March, 2020 to study 389 road construction workers who were actively working on site. They were unobtrusively observed to capture whether or not they wore the appropriate PPE at the time of the survey. The PPE of interest were: hard hat, goggles, shoes, nose masks, hearing protection, gloves, and reflective vests/apparel. On-site posted PPE signage was also checked. Results: Majority of workers were labourers (53.5%) and males (96.9%). Similar numbers of workers in foreign-owned (194) and locally-owned (195) companies were studied. Use of PPE varied considerably by type: goggles (11.3%), hard hat (27.0%), safety shoes (78.7%), gloves (30.6%), hearing protection (10.8%), reflective vest (44.5%) and nose mask (17.2%). For all types of PPE, use was higher among workers in foreign-owned companies compared with locally-owned companies: goggles (Odds ratio [OR] 55.2), hard hat (OR 20.2), safety shoes (OR 4.1), gloves (OR 23.7), hearing protection (OR 52.0), reflective vest (OR 5.3) and nose mask (OR 17.8) (p<0.001 for all ORs). No site had any signage to promote PPE use. Conclusions: Majority of workers used safety shoes. Less than half of workers used other types of PPE and use of some types (goggles and hearing protection) was minimal. Workers in foreign-owned companies were significantly more likely to use all of the types of PPE. Although there is still room for improvement in foreign-owned companies, locally-owned companies should be able to attain similar PPE use to that in foreign-owned companies. Road construction companies should place a premium on health and safety issues by hiring safety managers with professional training, providing staff with PPE, and training them on proper usage, as well as adopting safety protocols.

School children form majority of injured children on Ghanaian roads. The objective was to observe the road use behaviour of public primary school pupils in Ablekuma Education Circuit, Accra. This unobtrusive observational study targeted Primary one to six pupils. Five behaviours were studied: Walking while crossing road; Stopping at the kerb; Looking left-right-left before crossing; Keep looking left-right-left while crossing and Facing traffic while walking. 882 pu­pils on their way to or from school were observed from eight schools. A little over two in three children stopped at the kerb before crossing the road while almost three in four children looked for cars before stepping off the kerb. A little over three in four children walked while crossing and less than one in four children kept looking while crossing. Not looking for cars before crossing, not facing on-coming traffic and not keeping looking for cars while crossing, were more associated with boys than girls (p < 0.001; 95%CI in all cases). Girls behaved significant­ly more safely than boys. In stopping at the kerb, there was no difference in gender behaviour (p < 0.135; 95%CI). Child Road Safety Education in Schools and Communities is recommended.