Should the health sector be tasked with road safety?

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There is hardly anyone in Nigeria who does not have a personal tale of road crashes to tell. In 2007, my mother died due to complications of a head injury sustained from an ‘‘okada” (commercial motorcycle) crash. It was a painful and an avoidable death. A report by the CLEEN Foundation showed that in 2013, 47% of road crashes in Nigeria were due to okadas. Many okada riders never receive any formal training to ride motorcycles, consistently disobey traffic rules and in large part have constituted themselves into a lawless community. Okada crashes are just a fraction of the hazards that road users face in Nigeria, as a visit to any emergency room will testify. Road safety then is a critical part of public health and ought to be taken seriously.


Road safety is a public health concern because it refers to measures for reducing the risk of a person being killed or seriously injured. Road crashes are the world’s leading cause of death for people between the ages of 15 and 29. In 2011, the United States Centres for Disease Control and Prevention (CDC) identified global road safety as one of the top 10 public health achievements. In Nigeria, road safety is often considered a traffic and transportation issue, but it should also be high on the list of the Ministry of Health’s agenda to provide a healthier society for citizens.

Data on the Nigeria’s Federal Road Safety Corps (FRSC)   drives home the need for advocacy for road safety as a means of ensuring and improving public health. The data highlights that:

  1. All road crashes can be prevented;
  2. Most crashes are caused by drivers’ behaviour and not always as a result of bad roads;
  3. We can reduce deaths and injuries due to crashes by 50% if we make a commitment to not drink and drive, not over speed, wear seat belts and helmets, not use phones or eat while driving, obey traffic rules and tell people about road safety.

There are an unacceptably large number of deaths due to road crashes in Nigeria. In 2015, there were 12,077 road crashes recorded in Nigeria with 5,400 deaths. This is probably an underestimate of the status quo. Simply put, 65% of those involved in road crashes died, and these are just the numbers documented by FRSC. In just nine days in December 2016, the FRSC recorded 289 road crashes involving 2,185 victims with 187 deaths and 100 injuries. Too many Nigerians are dying from preventable causes and not much is being done to influence positive behavioural change among Nigerian motorists.

The recklessness of drivers on Nigerian roads is alarming, and this recklessness cuts across private, government and commercial drivers. An example that a majority of Nigerians might have experienced is that of commercial drivers who operate transport vehicles across states.  Typically, prior to departure, someone offers a prayer for a safe and successful journey, usually including prayers against accidents, breakdown of the vehicle, bad tyres, and the driver falling asleep. The journey begins and immediately the prayers seem to fly out the window as the driver begins to drive incredibly fast, blatantly disobeying road signs and traffic regulations. Despite the preponderance of bad roads, he drives at above 140 kilometres per hour on roads designated for speeds of less than 100 kilometres per hour. He overtakes dangerously, increasing the probability of having a head-on collision with an on-coming vehicle. As passengers in such vehicles many of us have gotten so used to such a display that we keep our eyes peeled to the road throughout the journey and find ourselves arguing with the driver over his recklessness. It’s time to tell ourselves the truth, and that is that most road crashes are preventable.

The latest distraction amongst drivers is the use of mobile phones while driving. It is shocking to see people talking on the phone or texting while driving. How do we engage in such recklessness and not expect catastrophic results? This is one form of multi-tasking that should be abhorred by all. Driver distraction and inattention in its various forms contributes to 20-30% of all road crashes. In the United States of America, it is estimated that between 70 to 90% of drivers use their mobile phones while driving at least some of the time. Using a mobile phone while driving can significantly affect the driver’s ability to maintain speed and position on the road. This practice also reduces reaction time and general awareness of other road users. The use of mobile phones while driving is neither for personal nor public safety, but rather increases risk for both the individual and the public.

This is a New Year and we all must commit to road safety. It is really all about saving lives and preventing unnecessary injuries. Road crashes should be classified as issues of urgent of public health importance Road traffic safety enforcement agencies must tighten the cracks in the policies that ensure that road users are certified to drive. The Federal Government through the legislature has already imposed laws that say that people must go through standard tests before driving. It’s just that many drivers fall through the numerous cracks in the implementation of the law and are never certified. In addition to compulsory driving lessons, penalties on disobedience of traffic rules should be meted out strictly, swiftly, and across all classes of road users, whether private, government, or commercial. Government vehicles who drive recklessly should especially be held to account as they are endangering the health and the lives of citizens whom they are sworn to serve. Good roads with standard road signs are also essential components to prevent road crashes.

Since road safety is for public health, Federal, State, and Local Government health authorities should be involved. Let’s apply the same programmatic approaches to tackle road safety the way other issues of public health importance are addressed.

In 2017, please don’t drink and drive, don’t use mobile phones while driving, don’t go over the speed limit, obey traffic rules and wear seat belts and helmets. Your loved ones need you alive without injuries.

Dr. Ifeanyi M. Nsofor is a 2018 New Voices Fellow at the Aspen Institute and a 2006 Ford Foundation International Fellow. He is the CEO of EpiAFRIC (a public health consulting firm based in Abuja, Nigeria) and Director of Policy & Advocacy at Nigeria Health Watch. He is a graduate of Medicine and Surgery from the Nnamdi Azikiwe University School of Medicine. He was a 2006 Ford Foundation International Fellow at the Liverpool School of Tropical Medicine and obtained a Masters in Community Health degree. He is an alumnus of the Harvard University Kennedy School of Government Executive Education on Strategic Frameworks for Nonprofit Organizations. Ifeanyi was a 2016 DAAD/EXCEED Scholar on Modern Teaching Methods at Ludwig-Maximilians University, Munich, Germany. He has taken several short courses in Global Health at the University of Oxford, Imperial College London, University College London. Ifeanyi is a leading advocate for Universal Health Coverage in Nigeria. He is a public health physician, researcher and epidemiologist. He speaks English, Hausa and Igbo languages fluently. He has core expertise in the conduct of qualitative and quantitative evaluations. In the last 4 years, he has led 12 research projects across Sierra Leone, Liberia, Guinea, Ghana and nine Nigerian States. He has worked in several locations in Nigeria across 28 States. For 19 years post-graduation, he has worked with TY Danjuma Foundation, Pathfinder International, Micronutrient Initiative and Nigeria’s National Programme on Immunization and has conducted several short-term consultancies. Consequently, he has developed sound skills in managing small and large grants. He was co-lead for EpiAfric’s evaluation of African Union Support to Ebola Outbreak in West Africa in Sierra Leone, Liberia and Guinea. He leads EpiAFRIC "Health Meets Tech" Hackathons, designed to create an ecosystem of health and tech practitioners who will disrupt the health space in Nigeria and across Africa. Ifeanyi enjoys cycling to work and is a fitness buff. His dog, Simba, daily assists him in maintaining excellent cardiovascular health.

Discussion3 Comments

  1. Thank you for the insightful article. It is all so true and your suggestions are supported by so many sources of evidence. You could not have put it better. Good job!

    (I am so sorry for the loss of your mother).

  2. Thanks for all the beautiful write ups. Good points on federal road safety and okada incident.
    I am suggesting that we apply british system for drivers and re- inforcement officers to avoid drinking while on duty. They should be tested and fined.
    Road safety, doing a great job but more is expected. i saw the was they move people in accident spot and i think it’s horrible. They should be properly trained on manual handling and how to move people in cases of accident and head injuries. There is a different way of moving casualties in an emergency situation to avoid causing more havoc and maintain safety . we also need to train paramedics to assist in cases of emergency and save life.
    some police men also create more problems by stoping vehicles on the high way. it is completely unacceptible to suddenly stop a vehicle on the high road in a high speed. it creates more problems.
    Finally, there is need to reduce speed limit on the highway, check tires and breaks more regular. Road safety should focus on their wonderful job. They are doing great so far.

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