|
Affiliation
|
Faculty of Health and Applied Sciences, The University of the West of England , Bristol , BS16 1QY , UK. |
|
Abstract
|
OBJECTIVE: To identify, critically appraise, summarise and synthesise evidence from Cost-Effectiveness Analyses (CEA) of interventions aimed at preventing Road Traffic Injuries (RTIs) in Low- and Middle-Income Countries (LMICs) by age group and road users targeted.
METHODS: A search strategy was applied to twelve electronic databases for studies published between May 2002 and August 2015 that met pre-specified inclusion criteria. Additional studies were identified by contacting authors and searching bibliographies. Included studies were critically appraised against published criteria and a narrative synthesis was conducted including a use of the strength of evidence criteria.
RESULTS: Five studies were included in the final review that reported nine interventions. Only two out of nine interventions (drink-drive legislation with enforcement via breath testing campaign, and combined interventions for reducing RTIs) showed moderate evidence of being cost-effective while the evidence of cost-effectiveness of other interventions was weak. Only two interventions (bicycle and motorcycle helmet use legislation and enforcement) were explicitly targeted to children, young people and vulnerable road users such as pedestrians and cyclists. The cost-effectiveness of interventions to prevent RTIs in LMICs ranged from US$4.14 per DALYs averted for building speed bumps at the most dangerous junctions that caused 10 percent of junction deaths in the area studied, to US$3,403 per DALYs averted for legislation and enforcement of helmet use by motorcyclists in the WHO sub-Saharan Africa region.
CONCLUSIONS: Evidence of cost-effectiveness of interventions to prevent RTIs in LMICs is limited, particularly for children, young people and vulnerable road users. Evaluation of the effectiveness and cost-effectiveness of a larger number of possible road safety interventions in a variety of LMIC settings are warranted to generate the evidence base for effective traffic injury prevention programmes.
Language: en |