Road traffic injuries, deaths and its impact on individuals and families in nepal

Abstract

Road Traffic Injuries (RTIs) are a major public health issue, leading to numerous deaths, injuries, and disabilities worldwide. In a low-income country like Nepal, the road safety situation is alarming. This mixed-methods study aims to: i) assess the status of road traffic deaths and injuries; ii) identify factors contributing to these deaths; and iii) explore the impact on victims and their families. Methods In this dissertation, the systematic review, quantiative analysis of the national level road crash information based on Nepal Police data for 2018/19, and qualitative information obtained by face-to face in-depth interviews were presented. It consists of four different nalysis: a) systematic review, b) descriptive analysis of road traffic death and injuries, c) prediction of road traffic attributes by utilizing Random Forest Model, and d) qualitative nalysis on the impact of road traffic crashes to the victims and their families. A mixed method of quantiative and qualitative approaches has been used to obtained information on road traffic crashes in Nepal. Results There is limited road safety research in the SAARC region, and studies about the impact of road crashes on victims and families are almost non-existent in this region. In 2018/19, there were 14,197 road crashes in Nepal, resulting 23,319 injuries and 2,192 deaths. The mean age of the victims was 30.89 years, and 75% of the crash incidents occurred among males, and approximately 40% of the victims were aged 15-29. The asualty rate was 96.29 per 100,000 population, with the highest number of deaths and injuries occurring between 4:00 pm and 8:00 pm, particularly on Saturdays. The months of April, October, and November also have a higher number of road crash incidents. Road traffic injuries (RTIs) were most prevalent in Bagmati Province (40%), followed by Lumbini (19%) and Madhesh Province (17%), with the highest chances of death in Sudurpaschim. The uses of two-wheelers were found to be major contributing factor for increasing the number of road traffic deaths and injuries in Nepal. The Random Forest (RF) model predicted that tractor crashes were the most risky in causing road traffic deaths, followed by the passenger bus, two-wheeler and truck crashes. Similarly, the likelihood of road crash deaths was high in Sudurpashchim province followed by Lumbini Province. The findings of the qualitative survey found that the pre-hospital care is limited, with most crash victims inadequately transported to the health services and very few cases transported in an ambulance. Improper transportation of the crash victim appeared as one of the causes of increased injury severity among the road crash victims. RTIs often lead road traffic crash victims to long-term health complications, financial hardship, job loss, school/campus dropout, disturbance in family relation and social problems. It was identified that there is a great need to create emergency road crash treatment fund for emergency rescue, treatment, and rehabilitation. Rehabilitation services and proper counselling can help in speedy recovery, even after hospital discharge. Additionally, sharing experiences with others in similar situations helps reduce stress and offers motivation. Conclusion This study provides a new dimension to mortality and morbidity research. It identifies the huge knowledge gap on road crash, deaths, injuries, and the serious impact of crashes on victims and families in Nepal. Importantly, it highlights the urgent need for road safety research to identify crash causes and impacts, enabling evidence-based prevention. Keyword: Road crashes, deaths, injuries, impact, crash victims