Abstract
BackgroundRoad safety has been receiving increased attention through the United Nations Decade of Action on Road Safety, and is also now specifically addressed in the sustainable development goals 3.6 and 11.2. In an effort to enhance the response to Road Traffic Injuries (RTIs), this paper aims to examine the cost effectiveness of proven preventive interventions and forms part of an update of the WHO-CHOICE programme.MethodsGeneralized cost-effectiveness analysis (GCEA) approach was used for our analysis. GCEA applies a null reference case, in which the effects of currently implemented interventions are subtracted from current rates of burden, in order to identify the most efficient package of interventions. A population model was used to arrive at estimates of intervention effectiveness. All heath system costs required to deliver the intervention, regardless of payer, were included. Interventions are considered to be implemented for 100 years. The analysis was undertaken for eastern sub-Saharan Africa and Southeast Asia.ResultsIn Southeast Asia, among individual interventions, drink driving legislation and its enforcement via random breath testing of drivers at roadside checkpoints, at 80% coverage, was found to be the most cost-effective intervention. Moreover, the combination of “speed limits + random breath testing + motorcycle helmet use”, at 90% coverage, was found to be the most cost-effective package. In eastern sub-Saharan Africa, enforcement of speed limits via mobile/handheld cameras, at 80% coverage, was found to be the most cost-effective single intervention. The combination of “seatbelt use + motorcycle helmet use + speed limits + random breath testing” at 90% coverage was found to be the most cost-effective intervention package.ConclusionThis study presents updated estimates on cost-effectiveness of practical, evidence-based strategies that countries can use to address the burden of RTIs. The combination of individual interventions that enforces simultaneously multiple road safety measures are proving to be the most cost-effective scenarios. It is important to note, however, that, in addition to enacting and enforcing legislation on the risk factors highlighted as part of this paper, countries need to have a coordinated, multi-faceted strategy to improve road safety.
Highlights
Road safety has been receiving increased attention through the United Nations Decade of Action on Road Safety, and is addressed in the sustainable development goals 3.6 and 11.2
Population‐level effects of interventions The effectiveness of interventions are reported in healthy life years (HLYs) gained due to the specific intervention (Tables 3 and 4)
The legislation “motorcycle helmet use”, and its enforcement, was found to be the second most effective single intervention; this is consistent with the high proportion of motorcycles in this region and the percentage of road fatalities among this road user group (24%, Fig. 1)
Summary
Road safety has been receiving increased attention through the United Nations Decade of Action on Road Safety, and is addressed in the sustainable development goals 3.6 and 11.2. Road traffic injuries (RTIs) represent the tenth leading cause of death among all age groups [2], and are predicted to be the seventh leading cause of death by 2030 [1]. RTIs are the leading cause of death among persons aged 15–29 years [1], and pedestrians, bicyclists, and motorcyclists represent 49% of all road traffic deaths [1]. In recognition of the scale of the problem, road safety has been receiving increased attention through the United Nations Decade of Action on Road Safety, and it is addressed in two of the sustainable development goals (SDGs). SDG target 3.6 calls for halving the number of global deaths and injuries from road traffic accidents by 2020 [3]
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