Road Injuries Research Articles

Health impacts of changes in travel patterns in Greater Accra Metropolitan Area, Ghana

BackgroundHealth impact assessments of alternative travel patterns are urgently needed to inform transport and urban planning in African cities, but none exists so far. ObjectiveTo quantify the health impacts of changes in travel patterns in the Greater Accra Metropolitan Area, Ghana. MethodsWe estimated changes to population exposures to physical activity, air pollution, and road traffic fatality risk and consequent health burden (deaths and years of life lost prematurely – YLL) in response to changes in transportation patterns. Five scenarios were defined in collaboration with international and local partners and stakeholders to reflect potential local policy actions. ResultsSwapping bus and walking trips for car trips can lead to more than 400 extra deaths and 20,500 YLL per year than travel patterns observed in 2009. If part of the rise in motorisation is from motorcycles, we estimated an additional nearly 370 deaths and over 18,500 YLL per year. Mitigating the rise in motorisation by swapping long trips by car or taxi to bus trips is the most beneficial for health, averting more than 600 premature deaths and over 31,500 YLL per year. Without significant improvements in road safety, reduction of short motorised trips in favour of cycling and walking had no significant net health benefits as non-communicable diseases deaths and YLL benefits were offset by increases in road traffic deaths. In all scenarios, road traffic fatalities were the largest contributor to changes in deaths and YLL. ConclusionsRising motorisation, particularly from motorcycles, can cause significant increase in health burden in the Greater Accra Metropolitan Area. Mitigating rising motorisation by improving public transport would benefit population health. Tackling road injury risk to ensure safe walking and cycling is a top priority. In the short term, this will save lives from injury. Longer term it will help halt the likely fall in physical activity.

Effect of Periodic Vehicle Inspection on Road Crashes and Injuries: A Systematic Review.

This systematic review was conducted to determine the effect of periodic motor vehicle inspections on road crashes and injuries, compared to less exposure to periodic inspections or no inspections. The Medline, Web of Science, and Scopus databases were used to search the literature. Ecological studies were specifically excluded. A reverse search of the results with these databases and of other identified narrative reviews was also performed. Of the 5065 unique references initially extracted, only six of them met the inclusion criteria and were selected for review: one experimental study, two cohort studies with an internal comparison group, two cohort studies without a comparison group, and one case–control study. Two authors independently extracted the information and assessed the quality of each study. Due to the heterogeneity of the designs and the intervention or comparison groups used, quantitative synthesis of the results was not attempted. Except for the case–control study, which showed a significant association between road crashes and the absence of a valid vehicle inspection certificate, the other studies showed either a small reduction in crash rates (around 9%), no association, or a higher crash rate in vehicles with more inspections. In all observational studies, the risk of residual confounding bias was significant and could have explained the results. Therefore, although the research reviewed here suggests that periodic inspection may be associated with a slight reduction in road crashes, the marked heterogeneity along with probable residual confounding in most reports prevented us from establishing causality for this association.

Monitoring Road Accidents and Injuries Using Variance Chart under Resampling and Having Indeterminacy

The current manuscript proposes a control chart for monitoring road accidents and injuries using repetitive sampling. The proposed chart helps in identifying the shifts in accidents and injuries more quickly than existing charts. The application of the proposed chart will help in reducing and identifying the reasons for road accidents and road injuries efficiently.

Level Crossing Safety Impact Assessments for Vehicle and Pedestrian Crossings

Although the number of deaths and injuries at level crossings in New Zealand is relatively low compared with the national road toll and injury burden, the high severity of crashes involving trains makes it a key “safe system” focus. It is also alarming that the proportion of crashes involving pedestrians and cyclists at level crossings has been increasing over recent years. This in part is owing to the construction of several cycleways and shared paths that travel alongside railway lines. In the past, KiwiRail has relied primarily on the Australian Level Crossing Assessment Model (ALCAM), a crash estimation model, to assess the increased risk of crashes at crossings resulting from a change in use. Although ALCAM is one of the better developed level crossing models internationally, it does have its limitations when used in isolation. ALCAM documentation specifies that other information such as incident data and the opinions of locomotive engineers should be considered in assessing risk. In practice, these factors and ALCAM risk ratings are rarely afforded equal importance. ALCAM does not pick up in sufficient detail the safety impacts created by the surrounding transport network. To better inform decision making, KiwiRail has developed a wider assessment process that includes these factors: the Level Crossing Safety Impact Assessment (LCSIA). This paper outlines the LCSIA process, provides an example of how it has been used, and also discusses the important learnings that have occurred since it was first introduced in 2016.

DriverSeekers - A mobile designated driver services system

The intention of this project is to determine the limitations of the current market needs where the road injuries and fatalities are a growing concern in Malaysia. Without any hesitation, the resident’s driving pattern and behavior are highly correlated. Hence, the objective of this study is to develop a prototype mobile application DriverSeekers for pairing drivers with users who do not wish or do not have the ability to drive their own vehicles. An in-depth review of other research and literature is conducted to understand the benefits, impact, and features that similar programs are providing. Further, a qualitative survey has been given out to understand the potential users of the application and the feasibility of the proposed system which includes the user’s concern, preferences, and expectations, whereas the respondents are 10 students and 10 people who are employed. Once the data has been gathered and analyzed, the features of the application are build based on the collected data where the application is trying to meet the user requirement. Afterward, there are four testing phases consist of unit testing, integration testing, system testing, and user acceptance testing which are conducted to assure the system features and functions achieve what the users expect. Further, a UAT is conducted to ensure the users are joyed with the result which meets their requirements and expectation. Thus, the objectives of this study were all successfully fulfilled.

Gender equity in global injury research—A case example from Bangladesh

Global injury research and policy too often fail to acknowledge the need for gender-sensitive approaches in their efforts to effectively reduce the detrimental burden of traumatic road injuries. A case example from Bangladesh demonstrates the distinct challenges females face and how addressing those are critical to achieving global health equity.

Motorcycles ‘keep left’ order: Is it viable?


 
 
 
 Motorcyclists swerving in and out of lanes and in between lines of vehicles contribute to traffic conflicts thus creating unnecessary risk of collision. Keeping their travels in dedicated lanes ('keep left' order) as much as possible, may perhaps increase their safety on the road and consequently help reduce road deaths and injuries in Malaysia.
 
 
 

Design of Monitoring Smart Roads with Warning Messages to Diversions according to Climate Conditions as well as Unexpected Events like Accidents or Traffic Jams

This key goal of this research is to avoid road accidents. Most of the studies clearly show that the majority of incidents take place near certain places such as school areas, dining areas, etc. The purpose of the proposed system is, by signalling or warning through WI-FI, to avoid the accident in nearby areas. If the Bridge zone is narrower than 100 meters from vehicles, a mobile warning will be issued via the WI-FI network. The person reduces the vehicle speed following this indication. Just like if a school area closer to vehicles is within 100 meters, the cell phone will be alerted via WI-FI. The person reduces the speed of the vehicle after this indication. Like Fog, it gives message warning to mobile devices via the WI-FI area within 100 meters. The individual decreases the speed of the vehicle following this indication. This sign helps us to reduce road injuries. We use WI-FI, AT89S52, switches for this implementation. The Wi-Fi module is connected to the controller here in this project and can be controlled from any location at the Internet speed. The managed power supply for this project is 5V 500mA. For voltage power, 7805 three voltage terminal regulators are used. Full-wave bridge rectifier is used to rectify the 230/12V transformer secondary ac output.

Characteristics and outcomes following motorized and non-motorized vehicular trauma in a resource-limited setting

IntroductionDespite the ubiquity of motorized vehicular transport, non-motorized transportation continues to be common in sub-Saharan Africa. MethodsWe performed a retrospective analysis of trauma patients presenting to Kamuzu Central Hospital in Malawi from February 2008 to May 2018. Demographic and clinical variables including injury characteristics and outcomes were collected. We performed bivariate and multivariate logistic regression to determine predictors of mortality following non-motorized vehicular trauma. ResultsThis study included 36,412 patients involved in vehicular road injuries. Patients in the non-motorized group had a preponderance of men (84% versus 73%, p<0.01). The proportion of patients with Glasgow Coma Scale > 8 was slightly higher in the non-motorized group (99% versus 98%, p<0.01), though injury severity did not differ significantly between the two groups. A higher proportion in the motorized group had the most severe injury of contusions and abrasions (56% versus 50%, p<0.01). In contrast, the non-motorized group had a higher proportion of orthopedic injuries (24% versus 16%, p<0.01). The crude mortality rate was 4.51% and 2.15% in the motorized and non-motorized groups, respectively. After controlling for demographic factors and injury severity, the incidence rate ratio of mortality did not differ significantly between motorized and non-motorized trauma groups (IRR 0.91, p=0.35). ConclusionsNon-motorized vehicular trauma remains a significant proportion of morbidity and mortality resulting from road traffic injuries. The injury severity and incidence rate ratio of mortality did not differ between motorized and non-motorized trauma groups. Health care providers should not underestimate the severity of injuries from non-motorized trauma.

Epidemiology of prehospital trauma deaths in Malawi: A retrospective cohort study.

IntroductionTrauma is among the leading causes of death and disability in both adults and children worldwide. In Malawi, trauma patients are commonly brought in dead (BID). We aimed to describe the prevalence, sociodemographic, and injury-related characteristics of patients BID to Kamuzu Central Hospital (KCH), a referral hospital in Lilongwe, Malawi.MethodsWe retrospectively reviewed records of all patients BID in the trauma surveillance registry at KCH from February 2008 to September 2019. We excluded patients BID that did not present to the emergency centre, and were instead taken to the mortuary directly. We used descriptive statistics to evaluate the epidemiology of patients BID.ResultsWe reviewed 106,198 trauma records and 1889 (1.8%) were BID patients. Most patients BID were male, in both adult (n = 1337/1528, 88.4%) and children (n = 231/360, 64.9%) cohorts. The mean age was 34.7 (SD 11.9) years in adults and 7.8 (SD 5.4) years in children. Among the adult BID patients, 33.2% were unemployed, 25.6% were construction workers, and 10.1% were small business owners or managers. The common injury mechanisms in adults were road traffic-related injuries (RTIs) (47.1%) and assaults (23.6%). In children, injuries resulted from RTIs (39.7%), with 74.4% of those were pedestrians hit by cars, drowning (22.9%), and burns (12.4%). In both groups, most injuries occurred on roads (60.2%) or at home (22.1%). Reported alcohol use at the time of trauma was present in 6.3%. The police (57.9%) and privately-owned vehicles (26.6%) transported most BID patients to KCH.ConclusionEfforts to reduce prehospital trauma mortality must focus on improving prehospital care, including training the police and community in basic life support and improving resources towards prehospital trauma care. Further efforts to reduce prehospital mortality must aim to decrease injuries on the roads and at home.

Динамика изменений показателей свободно-радикального окисления при изолированном переломе бедренной кости в условиях системной озонотерапии

Введение. Изолированные переломы бедренной кости (ИПБК) составляют более 10% от числа всех дорожных травм. Реакция организма в ответ на травму сопровождается нарушением гомеостаза, активацией процессов свободно-радикального окисления. Одним из перспективных направлений коррекции метаболических нарушений при хирургической патологии является озонотерапия. Цель исследования - оценка в динамике показателей свободно-радикального окисления в плазме крови у пациентов с изолированным переломом бедренной кости в условиях применения системной озонотерапии. Методика. Исследование выполнено на 36 пациентах с ИПБК и 20 условно здоровых лицах. Содержание изопропанол- и гептан-растворимых первичных, вторичных и конечных продуктов перекисного окисления липидов (ПОЛ) в плазме оценивали на 5-7-е сут после травмы до начала хирургического лечения, а также на 18-е сут после травмы, хирургического лечения и стандартного курса терапии, в том числе дополненного курсом малой аутогемотерапии (МАГТ), - 7-9 инъекций с озонированием крови (концентрация озона 20 мг/л). Результаты. Ранний посттравматический период у пациентов с ИПБК до оперативного лечения сопровождается накоплением первичных (диеновые конъюгаты), вторичных (ацилгидроперекиси, кетодиены и сопряженные триены) и конечных (основания Шиффа) продуктов ПОЛ в гептановой фазе липидного экстракта плазмы, а также вторичных и конечных продуктов ПОЛ в изопропанольной фазе липидного экстракта плазмы. У пациентов с ИПБК после оперативного лечения на фоне стандартной консервативной терапии сохраняется высокий уровень продуктов ПОЛ в гептановой и изопропанольной фазах липидного экстракта плазмы, что свидетельствует об эскалации окислительного стресса. Применение процедуры МАГТ с озонированием крови приводит к снижению и полному восстановлению уровня продуктов ПОЛ в изопропанольной фазе, снижению и частичному восстановлению продуктов ПОЛ в гептановой фазе липидного экстракта плазмы. Заключение. Применение МАГТ с озонированием крови оптимизирует состояние про- и антиоксидантных систем крови и ограничевает эскалацию окислительного стресса. Introduction. Isolated femoral fractures (IFF) account for more than 10% of all road injuries. The body responds to trauma with homeostatic disorders and activation of free radical oxidation. The ozone therapy is one of promising directions for correction of metabolic disorders in surgical pathology due to the pleiotropic effects of reactive oxygen species. The aim of the study was to evaluate changes in indexes of free radical oxidation in plasma of patients with isolated femoral fracture during the systemic ozone therapy. Methods. The study included 36 patients with IFF and 20 healthy individuals. Plasma concentrations of isopropanol and heptane-soluble primary, secondary, and end products of lipid peroxidation (LPO) were measured at 5-7 days after the injury, prior to the surgical treatment, and at 18 days after the injury following the surgical treatment and a standard therapy, including a course of minor autohemotherapy (7-9 injections of ozonated blood with ozone concentration of 20 mg/l). Results. The early post-traumatic period preceding the surgical treatment was associated with accumulation of LPO primary (conjugated dienes), secondary (ketodienes, and conjugated trienes) and end (Schiff bases) products in the heptane phase of plasma lipid extract, as well as LPO secondary and end products in the isopropanol phase of plasma lipid extract. In patients with IFF after the surgical treatment in combination with a standard, conservative therapy, high levels of LPO products remained in the heptane and isopropanol phases of plasma lipid extract, which indicated escalation of oxidative stress. The use of minor autohemotherapy with blood ozonation resulted in a decrease and complete restoration of the level of LPO products in the isopropanol phase and a decrease and partial return to the normal level of LPO products in the heptane phase of plasma lipid extract. Conclusions. The use of minor autohemotherapy with blood ozonation improved the condition of pro- and antioxidant blood systems and restricted the escalation of oxidative stress.

A study on Private Car Accidents

In this study, road traffic injury (RTI) was defined as any injury resulting from a road traffic accident irrespective of severity and outcome. Road traffic accident (RTA) was defined as any crash on the road involving at least one moving vehicle, irrespective of it resulting in an injury. This could include collision with a vehicle or any non`moving object while driving/riding a vehicle, collision with a moving vehicle while walking/running/standing/ sitting on the road, or fall from a moving vehicle. The burden of road traffic accidents (RTA) is a leading cause of all trauma admissions in hospitals worldwide. Road traffic injuries cause considerable economic losses to victims, their families, and to nations as a whole. These losses arise from the cost of treatment (including rehabilitation and incident investigation) as well as reduced/lost productivity (e.g. in wages) for those killed or disabled by their injuries and for family members who need to take time off work (or school) to care for the injured. Road traffic fatality in the Kingdom of Saudi Arabia (KSA) is the highest, accounts for 4.7% of all mortalities. Road injuries also are reported to be the most serious in this country, with an accident to injury ratio of 8:6. In this study, we try to focus on some causes of the accidents in KSA, so we can implement the prevention plan.

Associating ridesourcing with road safety outcomes: Insights from Austin, Texas.

Improving road safety and setting targets for reducing traffic-related crashes and deaths are highlighted as part of the United Nations sustainable development goals and worldwide vision zero efforts. The advent of transportation network companies and ridesourcing expands mobility options in cities and may impact road safety outcomes. We analyze the effects of ridesourcing use on road crashes, injuries, fatalities, and driving while intoxicated (DWI) offenses in Travis County, Texas. Our approach leverages real-time ridesourcing volume to explain variation in road safety outcomes. Spatial panel data models with fixed-effects are deployed to examine whether the use of ridesourcing is significantly associated with road crashes and other safety metrics. Our results suggest that for a 10% increase in ridesourcing trips, we expect a 0.12% decrease in road crashes, a 0.25% decrease in road injuries, and a 0.36% decrease in DWI offenses in Travis County. On the other hand, ridesourcing use is not significantly associated with road fatalities. This study augments existing work because it moves beyond binary indicators of ridesourcing availability and analyzes crash and ridesourcing trips patterns within an urbanized area rather than their metropolitan-level variation. Contributions include developing a data-rich approach for assessing the impacts of ridesourcing use on the transportation system’s safety, which may serve as a template for future analyses for other cities. Our findings provide feedback to policymakers by clarifying associations between ridesourcing use and traffic safety and uncover the potential to achieve safer mobility systems with transportation network companies.

An analysis on the risk of being injured and killed in road travel injuries in Namibia

Road traffic injuries (RTIs) are a major, global problem. Few studies on RTIs have been conducted in Namibia, despite having one of the highest RTI rates globally. We conducted multinomial logistic regression on national Namibian datasets on RTIs 2012–2014. Being a motorcyclist was associated with the greatest risk of being injured (adjusted Relative Risk Ratio (aRRR) 82.1 (95% CI 47.2–142.9)) or killed (aRRR 202.1 (112.7–362.7)). Risks were also elevated for cyclists (57.3 (23.6–139.5)), pedestrians (15.8 (13.2–18.9), passengers (6.1 (5.2–7.2)), relative to drivers. Among those admitted to hospital, the method of transportation to hospital had the largest association with the risk of dying. To our knowledge this study presents new information on vulnerability of different road users, which can be of use to policymakers to develop specific and targeted interventions to protect the most vulnerable road users.

Estimated number of seriously injured road users admitted to hospital in France between 2010 and 2017, based on medico-administrative data

BackgroundIn France, like in most developed countries, the number of road accident fatalities is estimated from police data. These estimates are considered to be good-quality, unlike estimates of road injuries admitted to hospital, and especially serious injuries.MethodsThe present study aimed to supply such data from French hospital medical information data-bases (PMSI). In the PMSI data-bases, road accident victims are identified by external causes of morbidity and mortality, which should be systematically recorded in case of injury, but are often missing. We therefore modeled presence/absence of external cause from the relevant subset of the medicine-surgery-obstetrics PMSI data-base using a logistic regression, and then weighting the results by inverse estimated probability. As ICD-10 coding does not include injury severity, we used the AAAM10 conversion instrument developed by the American Association for Automotive Medicine, originators of the Abbreviated Injury Scale, so as to conform to the European Commission’s definition of serious injury.ResultsThe number of road-accident related hospital admissions is estimated to be about 100000 per year; serious injuries increased from about 18000 in 2010 to almost 20000 in 2017, with almost 17000 in 2012 and 2013, with a mean of one fatality per 5 serious injury admissions.ConclusionsThese serious injury estimates are close to those obtained by our team from other data and with a different estimation method. The present method has the advantage of using ICD codes for injured people admitted to hospital. This classification and data source (hospital discharge registry) are also used by most european countries reporting serious injury estimates to the Commission. It allows cost estimation of hospital care, and could be applied to other types of accidental injury.

Design and Monitoring of Smart Roads Based on Weather Data by using IoT

The key goal of this research is to avoid road accidents. Most of the studies clearly show that the majority of incidents take place near certain places such as school areas, dining areas, etc. The purpose of the proposed system is, by signaling or warning through WI-FI, to avoid the accident in nearby areas. If the Bridge zone is narrower than 100 meters from vehicles, a mobile warning will be issued via the WI-FI network. The person reduces the vehicle speed following this indication. Just like if a school area closer to vehicles is within 100 meters, the cell phone will be alerted via WI-FI. The person reduces the speed of the vehicle after this indication. Like Fog, it gives message warning to mobile devices via the WI-FI area within 100 meters. The individual decreases the speed of the vehicle following this indication. This sign helps us to reduce road injuries. We use WI-FI, AT89S52, switches for this implementation. The Wi-Fi module is connected to the controller here in this project and can be controlled from any location at the Internet speed. The managed power supply for this project is 5V 500mA. For voltage power, 7805 three voltage terminal regulators are used. Full-wave bridge rectifier is used to rectify the 230/12V transformer secondary ac output.

Priority Areas for Adolescent Health Measurement

PurposeWe establish priority areas for adolescent health measurement and identify current gaps, aiming to focus resources on the most relevant data to improve adolescent health. MethodsWe collected four critical inputs to inform priority setting: perspectives of youth representatives, country priorities, disease burden, and existing measurement efforts. Health areas identified from the inputs were grouped, mapped, and summarized according to their frequency in the inputs. Using a Delphi-like approach, international experts then selected core, expanded, and context-specific priority areas for adolescent health measurement from all health areas identified. ResultsAcross the four inputs, we identified 99 measurement areas relevant to adolescent health and grouped them under six domains: policies, programs, laws; systems performance and interventions; health determinants; health behaviors and risks; subjective well-being; and health outcomes and conditions. Areas most frequently occurring were mental health and weight status in youth representatives' opinions; sexual and reproductive health and HIV/AIDS in country policies and perspectives; road injury, self-harm, skin diseases, and mental disorders in the disease burden analysis; and adolescent fertility in measurement initiatives. Considering all four inputs, experts selected 33 core, 19 expanded, and 6 context-specific adolescent health measurement areas. ConclusionThe adolescent health measurement landscape is vast, covering a large variety of topics. The foci of the measurement initiatives we reviewed do not reflect the most important health areas according to youth representatives' or country-level perspectives, or the adolescent disease burden. Based on these inputs, we propose a set of priority areas to focus national and global adolescent health measurement.

The Impact of driver distraction and secondary tasks with and without other co-occurring driving behaviors on the level of road traffic crashes

Driving safety is typically affected by concurrent non-driving tasks. These activities might negatively impact the trips’ outcome and cause near-crash or crash incidents and accidents. The crashes impose a tremendous social and economic cost to society and might affect the involving individuals’ quality of life. As it stands, road injuries are ranked among top-ten leading causes of death by the World Health Organization. Distracted driving is defined as an attention diversion of the driver toward a competing activity. It was shown in numerous studies that distracted driving increase the probability of near-crash or crash events. By leveraging the statistical power of the large SHRP2 naturalistic data, we are able to quantify the preponderance of specific distractions during daily trips and confirm the causality factor of an ubiquitous non-driving task in the crash event. We show that, except for phone usage which happens more frequently in near-crash and crash categories than in baseline trips, both distracted driving and secondary tasks occur almost uniformly in different types of trips. In this study, we investigate the impact of the co-occurrence of distracted driving with other driving behaviors and secondary tasks. It is found that the co-occurrence of distracted driving with other driving behaviors or secondary tasks increase the chance of near-crash and crash events. This study's findings can inform the design and development of more precise and reliable driving assistance and warning systems.

The burden of injuries in Mexico: Secondary data analysis from the Global Burden of Disease Study, 1990 to 2019

Injuries have been a major cause of premature mortality and short-term and long-term disability in Mexico. To report the findings from the Global Burden of Disease 2019 study on injuries in Mexico at a national and subnational scale from 1990 to 2019. Following the 2019 Global Burden of Disease study we examined injury mortality, premature mortality, years lived with disability and disability-adjusted life-years according to 14 subcategories. We calculated the Pearson correlation coefficient between the injury burden and the socio-demographic index. While the number of deaths from injuries increased significantly, the changes in the age-standardized mortality rates trended towards declines. Interpersonal violence, road injuries, falls and self-harm accounted for 8 of every 10 deaths from injury in 2019. Injury mortality and the disability-adjusted life-years rates decreased nationally and in most states in the period as a whole, but have increased since 2007. The injury burden was higher for men in all age groups. Interpersonal violence caused the highest disability-adjusted life-years rate in males and road injuries in females. The socio-demographic index increased in all states, while the injury age-standardized disability-adjusted life-years rates between 1990 and 2019 decreased, but there was no statistical association between both indicators. This study represents a comprehensive review of injury burden of disease in Mexico. The injury burden decreased, but improved heterogeneously among states. To further reduce the injury burden of disease, it's necessary for federal, state and local governments to prioritize safety promotion and injury prevention programs, infrastructure improvements, legislation, and enforcement at a national and subnational level. Mexico's injury prevention efforts should also be tailored for specific age groups, such as males aged 20-49 years or females in the younger and older age groups, and high-burden areas.

Road traffic injuries in Namibia: health services, public health and the motor vehicle accident fund

Namibia is one of five countries in sub-Saharan Africa that has a fuel tax levy designed to support road injury victims. This study examines how the scheme operates from the perspective of seriously injured or permanently disabled beneficiaries. Using qualitative methods, we conducted semi-structured interviews with RTI survivors in Namibia, and healthcare workers involved in caring for them, in order to investigate the role played by the MVAF. While some wealthier drivers continue to buy private insurance, most Namibians now rely on the MVAF. The analysis show the MVAF is effectively helping to enhance access to rehabilitation and other health services for RTI survivors. There however exist some weaknesses in the system which can be addressed. It is hoped these findings will contribute to discussions about whether the current system is fit for purpose and could serve as a replicable model in other low and middle-income countries (LMICs).