Availability of population-level data sources for tracking the incidence of deaths and injuries from road traffic crashes in low-income and middle-income countries

Abstract

IntroductionTracking progress towards Sustainable Development Goal (SDG) 3·6 of reducing traffic deaths and serious injuries poses a measurement challenge in most low-income and middle-income countries (LMICs) due to large discrepancies between reported official statistics and estimates from global health measurement studies. We assess the extent to which national population censuses and health surveys can fill the information gaps.MethodsWe reviewed questionnaires for nationally representative surveys and censuses conducted since 2000 in LMICs. We identified sources that provide estimates of household ownership of vehicles, incidence of traffic deaths and non-fatal injuries, and prevalence of disability.ResultsWe identified 802 data sources from 132 LMICs. Sub-Saharan African countries accounted for 43% of all measurements. The number of measurements since 2000 was high, with 97% of the current global LMIC population having at least one measurement for vehicle ownership, 77% for deaths, 90% for non-fatal injuries and 50% for disability due to traffic injuries. Recent data (since 2010) on traffic injuries were available from far fewer countries (deaths: 21 countries; non-fatal injuries: 62 and disability: 12). However, there were many more countries with recent data on less-specific questions about unintentional or all injuries (deaths: 41 countries, non-fatal: 87, disability: 32).ConclusionTraffic injuries are substantially underreported in official statistics of most LMICs. National surveys and censuses provide a viable alternative information source, but despite a large increase in their use to monitor SDGs, traffic injury measurements have not increased. We show that relatively small modifications and additions to questions in forthcoming surveys can provide countries with a way to benchmark their existing surveillance systems and result in a substantial increase in data for tracking road traffic injuries globally.

Comparing estimates of road traffic deaths and non-fatal road traffic injuries in Cambodia

“…For example, while WHO’s models are calibrated only on countries with high-quality national vital registration data, GBD uses many more sources, including health surveys, verbal autopsies and data representative at the subnational level. Such differences often result in fairly large discrepancies between country-level estimates in many LMICs 6. In fact, as our results for Cambodia show (figure 1), changes in the modelling strategies between the various revisions of GBD alone result in large changes in estimates.…”

“…often result in fairly large discrepancies between country-level estimates in many LMICs. 6 In fact, as our results for Cambodia show (figure 1), changes in the modelling strategies between the various revisions of GBD alone result in large changes in estimates.…”

“…5 Our recent review of population-representative data sources in LMICs found that it is increasingly common for national health surveys and censuses to include questions on the incidence of traffic deaths and non-fatal injuries, the prevalence of disability from such injuries and household ownership of different types of vehicles. 6 These data sources are rarely included in WHO and IHME's statistical models providing an opportunity for external validation of these models. Furthermore, local epidemiological data that have been collected by local agencies are often viewed as more legitimate by national stakeholders.…”

The neglected epidemic—Risk factors associated with road traffic injuries in Mozambique: Results of the 2016 INCOMAS study

“…Future research should collect information on the source of RTI (motorized vehicle occupant, non-motorized vehicle occupant or pedestrian) as well as assess the severity of the RTI, along with spatial and temporal patterns. Broadly, research in this area should prioritize improved coordination and use of systematic traffic injury measurements in order to strengthen surveillance and contribute effectively to RTI mitigation globally [33].…”

Estimates of road traffic deaths in Tanzania

“…Despite extensive global advocacy, the first UN Decade of Action on Road Safety ended in 2020 without a marked increase in evidence-based road safety programmes in most low-income and middle-income countries (LMICs), especially in the sub-Saharan African region 1 2. One important reason for the low priority of traffic injuries in the national policy agenda of LMICs is that the scale of the problem is underestimated by country governments 3. Therefore, in recent years, researchers and international agencies have sought to highlight under-reporting in official statistics of the incidence of road traffic injuries 3–5.…”