Using the Haddon Matrix (Host, Agent, Environment) as a framework for motor vehicle injury (MVI) reduction in Ghana

In 2003 it was reported about 5,000 people die annually in MVI which exceeds a monthly crash of Boeing 747. MVI involves vehicles used for commercial purposes: buses, mini-buses, taxis and trucks. Inadequate healthcare system and less access to care combined with overcrowding on vehicles, poor maintenance, unsafe roads, an uneducated driving public, and lack of enforcement of traffic regulations exacerbate an already unstable infrastructure. Thus in the event of vehicular crashes, effects become synergistic and severely diminishing chances of survival.

In using the Haddon matrix I argue that it can enhance a multi-sector response and mobilization of resources. Host factors include speeding, overtaking in narrow lanes, driving while drunk, not using seat belts; environmental factors include unsafe roads and vehicle designs, overcrowding, and the absence of escape routes in case of emergency because most buses are “manufactured” in Ghana. Thus, the crush-resistant passenger compartments and padded interiors that cut down injury rates in developed countries are lacking. Legislative factors include poor implementation of road safety measures, and inadequate or inaccessible emergency medical services.

Suggested measures include changing the culture of seat belt usage; need for reliable data for policy changes, speedometer checks; highway designs, audit of vehicles' periodic maintenance and driver training and testing, breathalyzer tests, and surveillance, cracking down on police and licensing corruption, development of biometric data to forestall license forgery, changing laws on insurance compensation, improving knowledge of individual rights relating to compensation after sustaining injuries, judicial arbitration, and political will to make needed reforms etc.