Activities of the Bloomberg Philanthropies Global Road Safety Programme (formerly RS10) in Russia: Promising results from a sub-national project

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Objective: In Russia, the high Road Traffic Injuries (RTIs) rate has been attributed to two well-known risk factors - the low rates of seatbelt and child restraints use and speeding. Despite the importance of understanding both speeding and seatbelt use patterns for the purpose of direct interventions or monitoring road safety situation, no study has assessed the current status of speeding among all vehicles and seatbelt wearing rates among all vehicle occupants in Russia. We are aware that alcohol is a known risk factor for RTI in the country however the work focused on seat belts and speed. This research was conducted as part of the Bloomberg Philanthropies Global Road Safety Programme and focuses on observed speeding and seatbelt use in two Russian regions: Lipetskaya and Ivanovskaya Oblast. Methods: Data was collected through observational surveys on selected roads in the two interventions sites (Lipetskaya and Ivanovskaya Oblast) between October 2010 and March 2013. The percentage of seatbelt use by drivers and passengers and the percentage of speeding vehicles by speed limit and road types were calculated. Results: Observational studies on speeding show signs that drivers are speeding less from the first survey held in July 2011 in Lipetskaya Oblast and March 2012 in Ivanovksya Oblast. Overall the observational studies showed a consistent reduction in the proportion of vehicles exceeding the speed limit: from 54.7% (2012) to 40.1% (2013) in Ivanovskaya Oblast and from 47.0% (2011) to 26.1% (2013) in Lipetskaya Oblast. Observational studies on seatbelt use demonstrate an increase in seatbelt wearing rates from the first survey held in October 2010 in Lipetskaya Oblast and April 2011 in Ivanovskaya Oblast. The overall prevalence of seatbelt use increased from 52.4% (2010) to 73.5% (2013) amongst all occupants in Lipetskaya Oblast and from 47.5% (2011) to 88.8% (2013) in Ivanovskaya Oblast. Conclusion: Preliminary results show some promising signs that speeding and seatbelt use are moving in the right direction in both intervention sites subsequent to the various countermeasures being implemented under the Global Road Safety Programme. The study demonstrates the need for further targeted interventions to increase drivers' compliance with the speed limit and seatbelt use. However, it is too early to draw any definite conclusions or to fully attribute the effect to the interventions.

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... The remit of this commitment was to (1) strengthen road safety legislation; (2) implement life-saving interventions that increased seatbelt, child-restraint, and helmet use and reduced speeding and drunk driving; (3) survey road networks and recommend infrastructure improvements; (4) build sustainable transport alternatives; and (5) improve the collection of data to evaluate project effectiveness and better target interventions [10,11]. Extensive effort during this time was undertaken to create baseline datasets for local road crash fatalities and risk factors in Brazil [12,13], Cambodia [14][15][16][17], China [18][19][20], Egypt [21][22][23], India [24][25][26][27][28], Kenya [29][30][31][32], Mexico [23,33,34], Russia [23,35,36], Turkey [23,37,38], and Vietnam [39][40][41][42]. These datasets have fed into subsequent global status reports [1,43]. ...
... In order to assess the benefits of these interventions, a range of observational sitebased evaluations have also been funded under the program. Evaluation has shown reductions in risk factors in speeding and increased seatbelt and child-restraint use in regions of Russia [36,46]; an increase in helmet use in provinces of Viet Nam [42]; and an increase in seatbelt use but uneven improvements in speeding in the provinces of Turkey [47]. Evaluations at the city level have shown a decrease in the prevalence of drink driving and speeding in China [19]. ...
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Over the past 12 years, Bloomberg Philanthropies (BP) and its partner organisations have implemented a global road safety program in low- and middle-income countries. The program was implemented to address the historically increasing number of road fatalities and the inadequate funding to reduce them. This study evaluates the performance of the program by estimating lives saved from road safety interventions implemented during the program period (2007–2018) through to 2030. We estimated that 311,758 lives will have been saved by 2030, with 97,148 lives saved up until 2018 when the evaluation was conducted and a further 214,608 lives projected to be saved if these changes are sustained until 2030. Legislative changes alone accounted for 75% of lives saved. Concurrent activities related to reducing drink driving, implementing legislative changes, and social marketing campaigns run in conjunction with police enforcement and other road safety activities accounted for 57% of the total estimated lives saved. Saving 311,758 lives with funding of USD $259 million indicates a cost-effectiveness ratio of USD $831 per life saved. The potential health gains achieved through the number of lives saved from the road safety initiatives funded by Bloomberg Philanthropies represent a considerable return on investment. This study demonstrates the extent to which successful, cost-effective road safety initiatives can reduce road fatalities in low- and middle-income countries.
... Seatbelt compliance increased significantly according to our findings, which consistent with what has been reported in other countries. As part of the Bloomberg Global Safety Program, public health interventions in Russia were associated with increasing seatbelt compliance from 47.5 to 88.8% (Slyunkina et al. 2013). In South Korea, a national intervention including awareness campaign and doubling seatbelt fines increased compliance from 23% in 2000 to around 98% in late 2001 (Yang and Kim 2003). ...
... Despite this positive finding in our study, further work is needed to increase seatbelt compliance to similar levels as those from developed countries such as Australia (97%), Canada (96%), and the UK (96%) (Chan 2013). Similar to goals set by international programs to increase seatbelt use, SA should aim to increase seatbelt compliance to 95% among drivers and passengers (Slyunkina et al. 2013). ...
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Background: Because Saudi Arabia (SA) has struggled with the burden of Road Traffic Injuries (RTIs) for decades, a new automated citations system was implemented in 2018 to improve compliance with seatbelt and mobile phone laws. Therefore, the purpose of this study is to evaluate the impact of the system on the prevalence of seatbelt and mobile phone use among drivers in Riyadh. This is an observational study conducted between 2017 and 2018. A Pre-Post evaluation was employed to determine the impact of a camera detection system on seatbelt and mobile phone use. Two research coordinators collected the observations at several highways and inner intersections around Riyadh (n = 3400). We evaluated differences in the prevalence of seatbelt and mobile phone use across the two time periods using a chi-2 test. In addition, we evaluated the association between the new intervention and traffic violation using a logistic regression model. Results: The overall seatbelt compliance increased significantly from 33.9% (95% CI = 31.7-36.2) to 75.8% (95% CI = 73.7-77.8; P < 0.01). In addition, mobile phone use declined significantly from 13.8% (95% CI = 12.2-15.5) to 9.8 (95% CI = 8.8-9.1; P < 0.01). We found the detection system to be associated with a significant increase in seatbelt use and also a significant decline in mobile phone use while driving. After implementing the intervention, drivers were 6.1 times (OR = 6.1, 95% CI = 5.2-7.0) more likely to wear seatbelts than before the technology went into effect. Similarly, drivers observed after implementing the cameras were 32% (OR = 0.68, 95% CI = 0.55,0.84) less likely to use mobile phones while driving than those seen prior to the intervention. Conclusions: This study found a significant reduction in traffic violations following the implementation of a camera detection system in Riyadh. This positive impact is evidence for the role preventative structural strategies play to improve traffic safety and reduce RTI in SA. Therefore, these findings may facilitate further support for policymakers that public health interventions play a significant role to improve traffic safety. Seatbelt and mobile phone use while driving should continue to be monitored, and traffic police may evaluate whether increasing the fine is associated with a significant reduction in traffic violations and associated crashes.
... Observations at each location were conducted in 90-minute slots and were limited to daylight hours. Time periods were selected to capture a representative sample of traffic flow over weekdays and weekends 13,14 (Table 2). ...
... Roadside interview data collection procedures have been published elsewhere. 13,14 A total of 8902 interviews were conducted over the 5 years (Table 2). ...
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Road traffic injuries are a leading cause of morbidity and mortality in the world. In Russia, a road safety program was implemented in Lipetskaya and Ivanovskaya oblasts (regions) as part of a 10-country effort funded by Bloomberg Philanthropies. The program was focused on increasing seat belt and child restraint use and reducing speeding. The primary goals of this monitoring and evaluation study are to assess trends in seat belt use, child restraint use, and speed compliance in the two oblasts over the 5 years and to explore the overall impact of the program on road traffic injury and death rates. Primary data via roadside observations and interviews, and secondary data from official government sources were collected and analyzed for this study.
... Determining the type of injury, the vehicle involved, and the risk group through the system by collecting information may be valuable key elements not identifying and assessing preventive actions. Those measures have critical clinical implications concerning these patients' care prevent traffic fatalities in middle or low-income countries 1,24,25 . In Ecuador, according to the National Traffic Agency (NTA), the annual record of misfortunes has been decreased in the last four years, but for Manabí Province, this number was increased 26,27 . ...
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Traffic accidents are serious public health problems, account for profound economic costs to individuals, families, and societies. The social impacts range from physiological to economic causes, which could be a serious negative effect, especially in undeveloped countries. To further elucidate this problem, the prevalence of injuries caused by traffic accidents in a Santa Ana Health Centre, Portoviejo, Ecuador, was studied. This registry-based retrospective study analyzed data on Santa Ana, from Enero 2016 to Diciembre 2019, and the medical records of patients who had been admitted were extracted and analyzed. Passengers cars, motorcycles, and bicycles involved in collisions were included, and the information collected was relating to sex, age, and type of injuries. In total, 75%±6.34 patients victims of road traffic injuries were males, and their mean age was 20 and 49 years. There was a cooperative agreement between total injury occurrence (%) and type of vehicle. Bus and car accidents had lower relation (R2 = 0.44, 078) (p = 0.063, 0.005) with total occurrence. The highest relation was found in motorbikes (R2 = 0.98 p = 2e-05), since it's the primary or most popular means of transportation in the city. The best of our knowledge is the first study to reporting data on road traffic injuries in the Province of Manabí, the third-largest province in extension in Ecuador. Additional studies with larger populations are thus necessary to construct a robust data system in undeveloped countries that can facilitate the flow of reliable information about road traffic injuries.
... An observational study in Russia on the risk factors under global road safety programme (i.e. seat belt use and speed) led to an increase in seat belt use and a reduction in speeding between October 2010 and March 2013 [3]. ...
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Background Road traffic law enforcement was implemented on 1st April 2011 (the first intervention) and traffic ticket fines have been increased on 1st March 2016 (the second intervention) in Iran. The aim of the current study was to evaluate the effects of the law enforcement on reduction in the incidence rate of road traffic fatality (IRRTF), the incidence rate of road traffic injuries (IRRTI) and the incidence rate of rural road traffic offenses (IRRRTO) in Iran. Methods Interrupted time series analysis was conducted to evaluate the impact of law enforcement and increased traffic tickets fines. Monthly data of fatality on urban, rural and local rural roads, injuries with respect to gender and traffic offenses namely speeding, illegal overtaking and tailgating were investigated separately for the period 2009–2016. Results Results showed a reduction in the incidence rate of total road traffic fatality (IRTRTF), the incidence rate of rural road traffic fatality (IRRRTF) and the incidence rate of urban road traffic fatality (IRURTF) by –21.44% (–39.3 to –3.59, 95% CI), –21.25% (–31.32 to –11.88, 95% CI) and –26.75% (–37.49 to –16, 95% CI) through the first intervention which resulted in 0.383, 0.255 and 0.222 decline in casualties per 100 000 population, respectively. Conversely, no reduction was found in the incidence rate of local rural road traffic fatality (IRLRRTF) and the IRRTI. Second intervention was found to only affect the IRURTF with –26.75% (–37.49 to –16, 95% CI) which led to 0.222 casualties per 100 000 population. In addition, a reduction effect was observed on the incidence rate of illegal overtaking (IRIO) and the incidence rate of speeding (IRS) with –42.8% (–57.39 to –28.22, 95% CI) and –10.54% (–21.05 to –0.03, 95% CI which implied a decrease of 415.85 and 1003.8 in monthly traffic offenses per 100 000 vehicles), respectively. Conclusion Time series analysis suggests a decline in IRTRTF, IRRRTF, and IRURTF caused by the first intervention. However, the second intervention found to be only effective in IRURTF, IRIO, and IRS with the implication that future initiatives should be focused on modifying the implementation of the traffic interventions.
... Establishing simple yet robust data systems in LMICs would facilitate the flow of continuous, reliable, and systematic information on key variables to all stakeholders (Chandran, Hyder, and Peek-Asa 2010;Hofman and others 2005;Kruk and others 2010;Lett, Kobusingye, and Sethi 2002;Mock and others 2004;Razzak, Sasser, and Kellermann 2005). Integrating systems for collecting key information on risk factors and outcomes into new and existing programs to address RTIs in LMICs therefore is essential to begin closing this gap (Bachani, Koradia, and others 2012;Bachani and others 2013;Hyder and others 2013;Slyunkina and others 2013). ...
... Controlling traffic participants is performed using legal practice and social marketing campaigns aimed at prevention of traffic rule violations. The efficiency of law enforcement, social marketing campaigns and their combinations is proved by results obtained within the framework of the Global Road Safety Project (RS-10) held in 2010-2014 in the Russian Federation [Slyunkina et al. (2013), Kondratiev et al. (2015)]. ...
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Developing an objective approach to take decisions aiming at reducing the number of injuries and damage inflicted by the road traffic incidents and accidents has become a top priority issue. A rational solution deals with setting up an intelligent road safety expert system comprising a complex software system that allows gathering the knowledge and applying it to improve road safety control.
Background: Between 1990 and 2015, the global injury mortality declined, but in countries where the poorest billion live, injuries are becoming an increasingly prevalent cause of death. The vulnerability of this population requires immediate attention from policy makers to implement effective interventions that lessen the burden of injuries in these countries. Our aim was two-fold; first, to review all the evidence on effective interventions for the five main types of unintentional injury; and second, to estimate the potential number of lives saved by effective injury interventions among the poorest billion. Methods: For our systematic review we used references in the Disability Control Priorities third edition, and searched PubMed and the Cochrane database for papers published until Sept 10, 2016, using a comprehensive search strategy to find interventions for the five major causes of unintentional injuries: road traffic crashes, falls, drowning, burns, and poisoning. Studies were included if they presented evidence with significant effects sizes for any outcome; no inclusions or exclusions made on the basis of where the study was carried out (ie, low-income, middle-income, or high-income country). Then we used data from the Global Burden of Disease 2015 study and a Monte Carlo simulation technique to estimate the potential annual attributable number of lives saved among the poorest billion by these evidence-based injury interventions. We estimated results for 84 countries where the poorest billion live. Findings: From the 513 papers identified, 47 were eligible for inclusion. We identified 11 interventions that had an effect on injury mortality. For road traffic deaths, the most successful interventions in preventing deaths are speed enforcement (>80 000 lives saved per year) and drink-driving enforcement (>60 000 lives saved per year). Interventions potentially most effective in preventing deaths from drowning are formal swimming lessons for children younger than 14 years (>25 000 lives saved per year) and the use of crèches to supervise younger children (younger than 5 years; >10 000 lives saved per year). We did not find sufficient evidence on interventions for other causes of unintentional injuries (poisoning, burns, and falls) to run similar simulations. Interpretation: Based on the little available evidence, key interventions have been identified to prevent lives lost from unintentional injuries among the poorest billion. This Article provides guidance to national authorities on evidence-based priority interventions that can reduce the burden of injuries among the most vulnerable members of the population. We also identify an important gap in knowledge on the effectiveness and the mortality impacts of injury interventions. Funding: Partly supported by the Fogarty International Center of the US National Institutes of Health (Chronic Consequences of Trauma, Injuries, Disability Across the Lifespan: Uganda; #D43TW009284).
Reducing vehicle speed is among the most effective road safety strategies. We assess how a new policy in Russia that eliminates fines for driving up to 20 km/h above the speed limit has affected the prevalence of speeding. We measured speeds periodically in 13 districts of two Russian regions during 2011-2013 and analysed the effect of the policy using difference-in-differences to control for seasonality. We find that the prevalence of speeding was declining steadily but half of the gains since mid-2011 were lost immediately after the new policy. Overall speeding increased significantly by 13 percentage points (pp, 95% CI 4 to 19). Speeding more than 10 km/h above the limit increased significantly by 10 pp (95% CI 2 to 12), and extreme speeding increased but not significantly (1.7 pp, 95% CI -1.1 to 4.5). Road traffic injuries will likely increase in Russia unless speeding fines are reinstated.
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Yearly, more than 1.2 million people are killed by road traffic injuries (RTIs) around the globe, and another 20 to 50 million are injured. The global burden of RTIs is predicted to rise. We explored the need for concerted action for global road safety and propose characteristics of an effective response to the gap in addressing RTIs. We propose that a successful response includes domains such as strong political will, capacity building, use of evidence-based interventions, rigorous evaluation, increased global funding, multisectoral action, and sustainability. We also present a case study of the global Road Safety in 10 Countries project, which is a new, 5-year, multipartner initiative to address the burden of RTIs in 10 low- and middle-income countries.
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To estimate the association of rear seat safety belt use with death in a traffic crash. Matched cohort study. The US during 2000 through 2004. Drivers (10,427) and rear seat passengers (15,922) in passenger vehicles that crashed and had at least one driver or rear passenger death. Data from the Fatality Analysis Reporting System. The adjusted relative risk (aRR) of death for a belted rear seat passenger compared with an otherwise similar unbelted rear passenger. Safety belt use was associated with a reduced risk of death for rear car occupants: outboard rear seat aRR 0.42 (95% CI 0.38 to 0.46), and center rear seat aRR 0.30 (95% CI 0.20 to 0.44). For rear occupants of light trucks, vans, and utility vehicles, the estimates were: outboard aRR 0.25 (95% CI 0.21 to 0.29), center aRR 0.34 (95% CI 0.24 to 0.48). If the authors' estimates are causal, traffic crash mortality can be reduced for rear occupants by approximately 55-75% if they use safety belts.
The report contains an analysis of the life saving benefits resulting from the 55 mph NMSL from 1974 to 1979. Monthly fatality data from 1970 to 1979 was used in a time series model to arrive at the estimated safety benefits (lives saved). The time series model relates changes in monthly fatalities to changes in monthly vehicle miles traveled, introduction of safety improvements and the implementation of the 55 mph NMSL law. Increases in highway fatalities in 1976 to 1979 compared to the 1974 to 1975 level led to a detailed examination and analysis of the composition of these fatalities in order to determine possible causes for the increases. Based upon the available data, it was concluded that 55 mph compliance had eroded somewhat in 1977 and 1978 thus resulting in some fatality increases.
In 1998, nearly 600 child occupants of motor vehicles aged younger than 4 years died in motor vehicle crashes. Yet approximately 29% of children aged 4 years and younger do not ride in appropriate child safety seat restraints, which, when correctly installed and used, reduce the need for hospitalization in this age group by 69% and the risk of death by approximately 70% for infants and by 47% to 54% for toddlers (aged 1 to 4 years). The systematic review development team reviewed the scientific evidence of effectiveness for five interventions to increase child safety seat use. For each intervention, changes in the use of child safety seats or injury rates were the outcome measures evaluated to determine the success of the intervention. Database searching was concluded in March 1998. More than 3500 citations were screened; of these citations, 72 met the inclusion criteria for the reviews. The systematic review process identified strong evidence of effectiveness for child safety seat laws and distribution plus education programs. In addition, community-wide information plus enhanced enforcement campaigns and incentive plus education programs had sufficient evidence of effectiveness. Insufficient evidence was identified for education-only programs aimed at parents, young children, healthcare professionals, or law enforcement personnel. Evidence is available about the effectiveness of four of the five interventions we reviewed. This scientific evidence, along with the accompanying recommendations of the Task Force elsewhere in this supplement, can be a powerful tool for securing the resources and commitment required to implement these strategies.
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