Paediatric road traffic injuries in urban Ghana: a population-based study.

OBJECTIVE/SETTING: To provide a population-based analysis of childhood road traffic injuries (RTI) in two communities of the greater Accra region of Ghana, with the goal of establishing an RTI incidence baseline in these communities and to identify RTI characteristics in order to model a targeted injury prevention programme. STUDY DESIGN: Geographical cluster sampling was performed in two separate communities with household surveys administered in person to determine a denominator. The guardian responsible for any household members below the age of 15 years involved in an RTI within the previous 12 months received an in-depth questionnaire. Demographics, incident characteristics, medical attention, injuries and disability days were noted. These are described and compared with injury severity and age-specific tendencies. RESULTS: 5128 children were interviewed in 60 clusters. Of them, 172 were involved in an RTI within the previous 12 months. This resulted in a rate of 34 RTI/1000 person-years, and 43 RTI/1000 person-years in the 5-14-year-old age group. RTI involving a mini-bus taxi, as a pedestrian, correlated with a disability of greater than 30 days, as did fractures. 35.8% of injuries occurred at sunset. Most RTI occurred on a highway and involved the lower extremities. There were two deaths resulting in an incidence of 39.0/100,000 person-years. CONCLUSION: Childhood RTI in this urban west African setting are a major source of disability. Specific injury circumstances are reviewed in detail. This study provides baseline incidence data that may be used to measure injury prevention efforts and to validate secondary data sources.

An evaluation of the effectiveness of televised road safety messages in Ghana.

The goal was to evaluate the effectiveness of recent televised advertisements conducted by the National Road Safety Commission in Ghana. These concerned speeding and alcohol-impaired driving and were targeted towards commercial drivers. Focus group discussions were conducted with 50 commercial drivers in four cities. Discussions addressed coverage, clarity and appropriateness of messages, including suggestions for improvements. Most discussants indicated that the messages were clear and appropriate. Television reached all participants in this urban group. However, they felt that other modes of communication, such as flyers and radio, should also be used to reach drivers who did not own televisions. A particular problem was language. The advertisements had been in English and Akan (the most common vernacular language). Participants wanted the messages diversified into more of the major Ghanaian languages. Some participants were unclear on the behaviour that the advertisements were telling viewers to take. Participants advocated greater involvement by police in road safety and called for laws banning the sale of alcohol at bus stations. The advertisements reached and were understood by most of the target audience. Opportunities for strengthening the messages included using other media; increasing the number of languages; and stressing the change in behaviour being recommended. Overall road safety activities would be strengthened by increasing accompanying law enforcement activities related to speed and alcohol-impaired driving. To the authors' knowledge this is the first formal evaluation of a road safety social marketing programme in a low-income sub-Saharan African country. This evaluation will hopefully assist Ghana and other similar countries in strengthening road safety work.