Challenges of establishing a road traffic injury surveillance system: a qualitative study in a middle-income country

Abstract

: Background: Establishing effective road traffic injury surveillance is an important priority for low- and middle-income countries since a large proportion of fatal road traffic injuries occur in these countries. A surveillance system can coordinate the activities and compile the data gathered by all road safety organizations. This study aims to explore the challenges of establishing road traffic injury surveillance based on the stakeholders’ experiences. Methods: This is a qualitative content analysis study that was performed in 2018 in Iran. The study was conducted through interviews with 13 participants and employed purposeful sampling. Data generation was continued until concept saturation. Results: Five main categories and 17 sub-categories were identified including: policy-making (legal authority, stakeholders, content policy and plan); process (collection and recording, analysis and interpretation, dissemination and feedback); resources and infrastructure (technology, staff, structure, finance); coherence and coordination (communication, dispersion, cooperation, consensus); and context (socio-cultural, political). Conclusions: By creating a clear structure for a road traffic injury surveillance system, identifying data collection systems and stakeholders in the field of road safety and injury prevention, determining a clear goal for improving road safety, and formulating policies for the dissemination of road traffic crash data among stakeholders, it will be possible to overcome the obstacles to establishing a surveillance system for road traffic injury.

The Challenges of Vision Zero Implementation in Iran: A Qualitative Study

“…The presence of a lead agency is one of the main requirements of the road safety development program (Bliss and Breen, 2009;Khademi and Choupani, 2018;Azami-Aghdash et al, 2019). The lack of a lead agency leads to a lack of coordination among stakeholders and a lack of accountability in terms of safety promotion (Sharifian et al, 2019). The World Bank recommended in a 2009 report that governments should designate a lead agency to manage national road safety measures (Bliss and Breen, 2009).…”

“…Establishing a lead agency for improving road engineering standards and a more precise enforcement of traffic regulations, with both monetary and non-monetary penalties for unsafe traffic behaviors, can help to improve road safety (Tetali et al, 2013). According to a certain research study in Iran, the absence of a lead agency results in a lack of coordination and responsibility for promoting safety among stakeholders (Azami-Aghdash et al, 2019;Sharifian et al, 2019). In Iran, the Road Safety Commission (RSC) Secretariat was founded in 2003 as the official and national agency in charge of road safety leadership.…”

“…Another challenge for Vision Zero implementation in Iran was the lack of information and a road traffic injury surveillance system. Because the incidence of RTCs in these countries is substantial and interventions are often not based on evidence, effectively recording information and implementing a monitoring system for traffic crash victims is a major problem in most LMICs (Sharifian et al, 2019). In LMICs, RTC data are often collected from different sources and are normally undercounted (Sharifian et al, 2019).…”

“…Because the incidence of RTCs in these countries is substantial and interventions are often not based on evidence, effectively recording information and implementing a monitoring system for traffic crash victims is a major problem in most LMICs (Sharifian et al, 2019). In LMICs, RTC data are often collected from different sources and are normally undercounted (Sharifian et al, 2019). High-income countries often have a well-established surveillance system, whereas most LMICs lack or have an incomplete registry trauma and surveillance system (Sharifian et al, 2019).…”

“…In LMICs, RTC data are often collected from different sources and are normally undercounted (Sharifian et al, 2019). High-income countries often have a well-established surveillance system, whereas most LMICs lack or have an incomplete registry trauma and surveillance system (Sharifian et al, 2019). The results of a study indicated that the lack of a road traffic injury surveillance system is one of the important road safety challenges in Iran (Sharifian et al, 2019).…”