In Vietnam, a market economy (“Doi Moi”) was introduced in 1986, which resulted in a rapid economic and social development. Motorization has also increased dramatically over the past 10 years in line with other developments. Ownership of cars has increased at an annual average rate of 12%, whereas motorcycle ownership has increased at an average rate of 40% per year, with a 16.5-fold ratio between 2-wheel and 4-wheel motor vehicles. As of July 2009, there were about 28.3 million vehicles, of which 26,869,025 were motorbikes.1 Not surprisingly, the number of road crashes is also high, with the majority (73.4%) of fatal crashes involving motorcycles.2 In 2008, the National Transportation Safety Committee reported that the national mortality rate due to traffic crashes was approximately 11 deaths per 10,000 motor vehicles, similar to other Southeast Asian countries.3 More recently, reports from the Ministry of Health indicated that in 2011, there were 17,150 road-related deaths (20.14 per 100.000 population) most of which (n = 13, 536) were in men.4 More recent work from a national sample mortality surveillance system reported that age-standardized mortality rates were even higher, at 33.5 and 8.5 per 100,000 for males and females, respectively, again with the majority of deaths in males (79%) and 58% motorcycle users. Head injuries were the most common cause of death (79%).5 Despite variation in the estimates, it is clear that road injuries have a profound impact in Vietnam. An estimate from the Asian Development Bank using data from 2003, found road injuries cost almost VND 3100 billion, or US$ 194 million (US$ 1 = VND 16,000). As a developing economy, with a GDP of VND 575,000 billion (or US$ 36 billion) this was equivalent to approximately 0.54% of the gross domestic product.6 There is evidence that this has increased: the National Transportation Safety Committee estimated that the cost of road crashes in Vietnam is at least 2% of the gross domestic product,2,3 and in a recent report, the World Health Organization reported that the costs of Road traffic injuries in Vietnam were 2.5% of the gross domestic product in 2010.7 The economic impact of injuries also has a significant impact at the household or individual level. In a study on the cost of all unintentional injuries in 1999–2000, 90% of the costs incurred for treatment of road injuries were out of pocket costs from individuals and their families, with only 8% paid by the government and 2% from health insurance agencies.8 Such catastrophic health expenditure frequently leads to significant economic hardship and impoverishment. A recent study found that during the hospitalization period for road injuries, the average cost per injury was US$ 363 or 6 months of average salary.9 One year after the injury, the total costs were US$ 789 or almost 14 months of average salary, and 62.5% of patients and their families faced catastrophic expenditure.10 In terms of impoverishment, 30.8% of patients and their families were pushed below the national poverty line.10 Risk Factors, Policy, and Future Directions Over recent years there has been much media attention about progress in road safety in Vietnam, mainly due to the implementation and enforcement of motorcycle helmet legislation, unique in a low-income country setting.11 With the advent of motorcycle helmet legislation and enforcement in 2007, helmet-wearing rates have increased accordingly,12 and head injury rates decreased.13 There is evidence that the media played a positive role in the development of community dialog about motorcycle helmets.11 However, there is an important need to continue focusing on maintaining helmet-wearing rates at high levels, as well as addressing low helmet-wearing rates in children,14 and helmet quality,15 both of which require continued work. Drinking and driving is also a significant concern, with more than 29% of all car drivers and motorcycle riders presenting at hospitals with road injuries exceeding the legal blood alcohol content limit in a recent study.16 With a rising burden of road injury and a substantial impact on the community, it is crucial that the Vietnam Government invests in evidence-based solutions, with the support of the global community. Nonetheless, there have been significant advances in Vietnam in relation to road safety, and with the national policy for accident and injury prevention currently under revision, there are opportunities for further gains.
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Jun 1, 2016
Samantha Gontijo Guerra + 1
Open Access