Publications
1-5 of 5
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Post-Crash Health Care
Beyond the Numbers: Estimating the Disability Burden of Road Traffic Injuries
November 2023
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Road Safety Data
Improving Road Traffic Injury Statistics in Low- and Middle-Income Countries
November 2023
- National decision-makers recognize the issue of underreporting but tend to dismiss higher estimates by global statistical models.
- Most countries use WHO GSRRS estimates.
- National health surveys and censuses in LMICs often contain relevant information, and minor modifications can greatly improve their usage for such measurements.
- Incorporating national health survey data into global statistical models can help resolve discrepancies and increase confidence in estimates.
- Integrating epidemiological data sources into global statistical models (GBD, GHE, GSRRS) to reduce discrepancies and increase confidence in their estimates.
- Including relevant questions in upcoming national data collections to facilitate epidemiological measurements of road traffic injuries.
- Encouraging local involvement in data production for better estimates.
- Enhancing coordination between the Institute for Health Metrics and Evaluation and the World Health Organization to improve estimates and reduce inconsistencies.
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This GRSF-funded study explores the medical, economic, and social costs of road traffic accidents (RTAs), particularly focusing on individuals with permanent disabilities. According to the World Health Organization (WHO), RTAs are a global public health crisis, ranked as the 12th leading cause of death and the primary cause of mortality among children and young adults. While the UN's Decade of Action for Road Safety (2021–2030) aims to reduce RTA deaths, the study argues that more focus is needed on injuries and the long-term impact on those left disabled by RTAs.
Building on GRSF’s report Beyond The Numbers: Estimating the Disability Burden of Road Traffic Injuries (Mitra et al., 2023), this project examines data from Namibia and South Africa and interviews with experts to highlight the often-overlooked challenges faced by RTA-related disability survivors. These individuals encounter unique issues—such as brain injuries, psychological trauma, and sudden financial burdens—that require specific support mechanisms beyond general disability frameworks.
Economic losses from RTAs are substantial, with WHO estimating global costs up to $1.8 trillion annually. However, existing research focuses mainly on medical costs and productivity losses, neglecting broader social impacts. Data on the prevalence of permanent disabilities varies, underscoring the need for standardized research.
The study calls for integrating disability concerns into road safety policies, emphasizing that improved enforcement in low- and middle-income countries could prevent disabilities and reduce societal costs. Ultimately, it advocates for recognizing RTA-related disabilities as a critical issue within global health, disability policy, and development agendas.

It is well-documented that road crashes claim around 1.35 million lives each year and rank as the eighth leading cause of death globally, causing huge burdens for economies, health systems, and transport networks. However, beneath the sobering fatality statistics lies a largely unexplored landscape: the staggering toll of disabilities induced by road crashes. Until now, the focus of road safety research and policy discourse has predominantly revolved around fatalities, which has limited our understanding of traffic-related injuries and disability burdens at the individual, community, and national level.
To address this critical knowledge gap, this pioneering study—involving over 2,300 patients hospitalized for road crash injuries—provides valuable insights into the prevalence, causes, and long-term impacts of crash-related disabilities. By broadening the discussion beyond fatalities to the often-overlooked issue of disability, the report paves the way for a more holistic perspective on road safety impacts, which can inform more effective road safety policies.
This report is a call to action for comprehensive and context-specific interventions that encompass both the transport and health sectors. Effective measures may include implementing safety regulations, enhancing emergency services, strengthening rehabilitative care, and expanding social safety nets to ease the financial burden on crash survivors. Collaborative efforts between governments, global and regional organizations, civil society, and other stakeholders will be indispensable.

Road safety is a global health and economic issue that disproportionately affects low- and middle-income countries (LMICs). Precise data is crucial for understanding the full scope of the problem and developing effective interventions, but LMICs struggle to collect comprehensive data due to limited resources, underdeveloped health systems, and inconsistent data collection processes.
To overcome reporting gaps, three major global statistical models are utilized: The Institute for Health Metrics and Evaluation Global Burden of Disease (GBD) study, the World Health Organization (WHO) Global Status Reports on Road Safety (GSRRS), and WHO Global Health Estimates (GHE). However, discrepancies exist among these models and between them and official country statistics. They often estimate significantly higher road traffic fatalities and injuries than official LMIC statistics.
This GRSF study identifies the reasons behind statistical discrepancies and outlines strategies to strengthen modeling efforts. This involved qualitative research, a systematic review of national data availability, and four case studies in Brazil, Cambodia, Ethiopia, and Tanzania.
Key findings include:
Recommendations include:
To achieve the goal of the Second United Nations Decade of Action for Road Safety (reducing road traffic fatalities and injuries by 50% by 2030), substantial resources need to be allocated to road safety and accurate reporting and statistical estimates are required.

Walking is a predominant mode of travel in Addis Ababa representing more than half of the daily trips. The mild climate in Addis Ababa is conducive for this healthy and green mode of transport. However, sidewalks are often narrow, uneven, obstructed, or non-existent, causing discomfort and road safety risks to the most vulnerable road users: pedestrians. Studies done by the WHO and the Government showed that AA has disproportionately high pedestrian fatalities.
The study on Addis Ababa Sidewalk Safety and Improvement takes the approach of integrating digital technology and Urban Inventory in sidewalk surveys, applies the Global Walkability Index in sidewalk assessments, and adapts the global best practice to the local context. The Addis Ababa Sidewalk Design and Maintenance Guidelines seek to promote the development of quality pedestrian infrastructure and environments, based on the condition’s assessment and global best practices. The design specifications and visual rendering provide recommendations for the policy makers to consider when developing the City’s design and maintenance standards for urban roads, sidewalks, public spaces, and transit-oriented development, some of which are being carried out as part of the technical assistance program of the World-Bank financed Transport Systems Improvement Project (TRANSIP).

Road safety is a major public health issue in Cambodia. Reducing the number of road crashes is a priority for the government. Accurate data are needed to design the most effective interventions. Improving the current crash data system will furnish a more comprehensive picture of critical road safety issues in Cambodia and provide the basis for developing policies to save more lives.
In the framework of the development of the Asia Pacific Road Safety Observatory (APRSO), the World Bank and the International Transport Forum (ITF), with the support of the Cambodian Government, initiated a project aimed at assessing the crash data system in Cambodia and developing a road map for strengthening this system.
This project follows up on a previous twinning project between Cambodia and the Netherlands, undertaken in the framework of the International Road Traffic and Accident Database (IRTAD) group of ITF in 2010-2014. That project concerned both a review of the Road Crash and Victim Information System (RCVIS), and training and support to develop a national road safety strategy and related indicators.
The current project started in 2019 and was carried out by the World Bank and the ITF, with support from the Global Road Safety Facility (GRSF) and UK AID. The Dutch Road Safety Research Institute, SWOV, was contracted by the ITF to lead the review.
This report provides conclusions and recommendations on the basis of the data review mission undertaken in December 2019.