Background: According to the World Health Organization (WHO), road traffic crashes kill at least 1.24 million people and injure 50 million each year. Low- and middle-income countries (LMIC) have the highest proportions of road deaths among vulnerable-road-users. This review has documented the scientific evidence about effectiveness of road safety interventions in LMIC.
Objectives:To establish what is known about the effects of road-engineering and traffic laws and regulatory interventions for prevention of fatalities and injuries among vulnerable road users LMIC.
Methods:This review included non-randomised studies. The definition of 'vulnerable road users' included pedestrians, cyclists, and motorcyclists of all age groups in LMIC. Studies were grouped by road engineering and traffic law enforcement and regulatory intervention. The data within this grouping were presented by mortality and morbidity outcomes.
Results: Effect sizes were computed for 18 studies. Five studies assessed the effect of road engineering interventions. In three uncontrolled before-and-after studies, fatalities declined by 48%, however, accidents increased over two times after interventions. In two time-series studies, mean casualties relative to post-intervention declined by 44% in percent change.Thirteen studies assessed the effect of enforcement of traffic laws and regulatory interventions. In ten uncontrolled before-and-after studies, fatalities declined by 6% and injuries by 26% after interventions. In places where a mandatory helmet law was enforced, non-compliance among motorcycle riders reduced by 86%. Red-light and speed-violations were reduced by 61% due to the impact of automated-enforcement-system. In three time-series, the number of road traffic casualties relative to post intervention declined by 38%.
Conclusions:The effect of traffic laws and regulatory interventions showed favourable outcomes after interventions.The effect of road engineering interventions showed mixed results: accident increased, however, fatalities reduced. Meta-analysis results presented heterogeneity, which downsized the study quality of studies from moderate to very low quality.