Road traffic injuries are a major public health issue in Nigeria, constituting one of the top three causes of death for those aged 5-44. In 2013, an estimated 35,641 deaths occurred due to road traffic accidents in Nigeria. Contributing factors include speeding, drinking and driving, poor vehicle roadworthiness, and inadequate infrastructure such as potholes and lack of proper signage. Potential solutions proposed include establishing and enforcing legislation around drunk driving and seatbelt use, improving emergency response services, increasing public health education, and collaborating internationally on research and planning.

1. Road Traffic Injuries:
Post-2015 Challenges in Nigeria
Dr. Nzechukwu Michael Isiozor
2016

2. NIGERIA
• Region: West Africa
• Population (proj. 2016): 186,988,000
• Gross national income per capita(PPP $ 2013): 5
• Life expectancy at birth m/f (years 2015): 53/56
• Probability of dying between 15 and 60 years
m/f (per 1000 population, 2013) = 357/327
• Total expenditure on health per capita ($, 2014)=
217
• Total expenditure on health as % of GDP (2014) =
3.7

3. Road Traffic Injuries (RTIs)
• Constitute major health and development
problem worldwide (especially in the African
Region)
• RTIs among the three leading causes of
death for people between 5 and 44 years of
age.
• Among young men, RTIs are already the
leading cause of premature death after
HIV/AIDS (in Africa).
• 1.3 million people die and between 20
million and 50 million more are injured as a
result of road crashes, annually.

6. RTIs
• The economic costs associated with RTIs in Africa were estimated to
be US$3.7 billion in 2000, translating to approximately 1–2% of each
country’s gross national product.
• Pedestrians alone account for more than 40% of the total fatalities on
African roads.
• Decade for Action for Road Safety 2011-2020 (Adopted by UN March
2010; Launched May 2011)

7. Source: WHO 2011. Decade Of Action for
Road Safety 2011–2020

8. In Nigeria:
• Estimated number of road traffic deaths (RTDs)(2013): 35 641 [27 949
- 43 332]
• Estimated RTDs (per 100 000 population)(2013): 20.5
• Road Traffic Accidents Deaths in Nigeria reached 51,633 or 2.71% of
total deaths (WHO, May 2014).
• The age adjusted Death Rate is 35.39 per 100,000 of population
(ranking Nigeria #9 in the world).
• Large proportion of injuries are not captured by hospital data.

10. Contributing factors
• Human(visual acuteness, fatique)
 Speeding
 Drinking and driving
 Safety measures
• Vehicular
 Road-worthiness
 Older cars imported/used
 Lack of maintenance/substandard repairs
 Low quality substitute parts(tyres and brakes)
• Infrastructure
 potholes
 sharp/steep bends
 poor maintenance

11. Post-crash challenges
• Transportation
• Emergency nos. and Ambulance services(esp. in rural areas)
• Inadequacy number of trained specialists/trauma centres
• Alternative medicine patronage(herbalist, traditional bomne-setters)
• Economic consequences
• Mental/psychological trauma
• Mortality and morbidity

12. Interventions
• Existence of a national road safety strategy: YES
• Federal Road Safety Corps(est. 1988)(FRSC)
• Federal Road Maintenance Agency(FERMA)
• Pedestrian overcross (in some cities)
• National TV program ( 30mins/wk by FRSC)
• Ban on used cars (more than 10years)
• Availability of funding for national road safety strategy: PARTIALLY

13. Obstacles to interventions
• Politics
• Paucity and inconsistency of road traffic crash data (need to be
reviewed, revised and standardized periodically);
• Limited traffic safety and injury prevention research (research-
expensive; evaluation- can be political);
• Economical situation;
• Culture (regarded as act of God, viewed as accidents)

14. POTENTIAL SOLUTIONS
• Implementation of National Legislation:
 Drink-driving
BAC(Blood Alcohol Concentration) limit (<=0.08g/dl ??)
Seat-belt
Child restraints (Yes ??)
Maximum speed limits
Motorcycle helmet laws
http://apps.who.int/gho/data/node.main.A999?lang=en

15. POTENTIAL SOLUTIONS contd.
• Policy
 policy initiatives to control imports and regulate the safety of vehicles on the
road.
Alternative transport(organized public transport, walking and cycling)
Safety Audits (for all new and existing roads)
Vehicle standards
Driver’s license/Driving schools monitoring
 Eye testing, especially for bus or truck drivers
Penalty for offenders of road-safety measures

16. POTENTIAL SOLUTIONS contd.
• Infrastructure
Roads (regular maintenance)
Road signs, traffic lights
Overpass across highways
Road-worthy vehicles
Breathalyzer for BAC (for law enforcement agents)
Pedestrian walkway/overpass
 Emergency medical services(nos and ambu.) & trauma-care facilities

17. POTENTIAL SOLUTIONS contd.
• Awareness and training:
Training in Emergency Medicine (for Doctors and other health workers)
Public health awareness(media) and education
• International collaboration for road safety research and planning
(UN, NGOs)

19. References
• Chen G. Road traffic safety in African countries - status, trend, contributing
factors, countermeasures and challenges. International Journal Of Injury Control
& Safety Promotion. December 2010;17(4):247-255. Accessed August 18, 2016.
• Labinjo M, Julliard C, Kobusingye OC, Hyder AA. The burden of road traffic injuries
in Nigeria: results of a population-based survey. Injury Prevention 2009;15:157–
162.
• Marquez PV.; Farrington, Jill L. The Challenge of Non-Communicable Diseases and
Road Traffic Injuries in Sub-Saharan Africa : An Overview. 2013. World Bank,
Washington, DC.
https://ncdalliance.org/sites/default/files/The%20Challenge%20of%20Non-
Communicable%20Diseases%20and%20Road%20Traffic%20Injuries%20in%20Sub
-Saharan%20Africa%20-%20AN%20OVERVIEW.pdf Accessed 16 August 2016.

20. References contd.
• Nantulya VM, Reich MR. Equity dimensions of road traffic injuries in low-
and middle-income countries. Inj Control Saf Promot 2003;10:13–20.
• WORLD HEALTH RANKINGS. Nigeria: Road Traffic Accidents.
http://www.worldlifeexpectancy.com/nigeria-road-traffic-accidents.
Accessed on 16August 2016.
• WHO. Ad Hoc Committee on Health Research Relating to Future
Intervention Options (1996) Investing in health research and development.
World Health Organization 1996.
http://www.who.int/tdr/publications/publications/investing_report.htm.
Accessed 16 August 2016.