Approaches to the Effective Prevention of Road Traffic Injuries in Sub-Saharan Africa: A Systematic Review

Abstract

Introduction: Road traffic injuries (RTI) are projected to become the 7th leading cause of mortality worldwide by the year 2030. It is projected that 90% of the global road traffic injury burden will be borne by Low and Middle-Income countries (LMICs), including sub-Saharan Africa. We undertook a systematic literature review to assess the effectiveness of implemented traffic injury prevention initiatives in sub-Saharan Africa. Methodology: A systematic review of the English literature was undertaken per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies were identified by searching the electronic databases Embase, Pubmed, Medline, The Cochrane Library and an additional review of reference lists. In addition, published studies from 1990 to 2020 were extracted and analysed. Results: The literature search generated 638 articles. Twenty-two duplicates were removed, and after title and abstract screening and full-text screening, 22 articles were retained. The interventions were broadly categorised into education, enforcement, Legislation, speed control, road safety and combined interventions. Conclusion: Combined multi-faceted injury prevention strategies are most effective in Sub-Saharan Africa. Enforcement of safety regulations ensures compliance and sustainability of prevention interventions. Speed control measures are useful in calming vehicular speeds, but poor design and citing can endanger road users. Road safety, education and Legislation have little to no effect when implemented alone; however, when combined with other measures, they can lead to significant reductions in road traffic injuries and fatalities.