Forjuoh Samuel N
Texas A&M University System, Health Science Center, College of Medicine, Scott & White Memorial Hospital, Temple, TX, USA.
Inj Control Saf Promot. 2003 Mar-Jun;10(1-2):109-18. doi: 10.1076/icsp.10.1.109.14115.
Traffic-related injuries have become a major public health concern worldwide. However, unlike developed or high-income countries (HICs), many developing or low-income countries (LICs) have made very little progress towards addressing this problem. Lack of the progress in LICs is attributable, in part, to their economic situation in terms of their governments' lack of resources to invest in traffic safety, cultural beliefs regarding the fatalism of injuries, competing health problems particularly with the emergence of HIV/AIDS, distinctive traffic mixes comprising a substantial number of vulnerable road users for whom less research has been done, low literacy rates precluding motorists to read and understand road signs, and peculiar political situations occasionally predominated by dictatorship and non-democratic governments. How then can LICs tackle the challenge of traffic safety from the experiences of HICs without reinventing the wheel? This paper reviews selected interventions and strategies that have been developed to counter traffic-related injuries in HICs in terms of their effectiveness and their applicability to LICs. Proven and promising interventions or strategies such as seat belt and helmet use, legislation and enforcement of seat belt use, sidewalks, roadway barriers, selected traffic-calming designs (e.g., speed ramps/bumps), pedestrian crossing signs combined with clearly marked crosswalks, and public education and behavior modification targeted at motorists are all feasible and useable in LICs as evidenced by data from many LICs. While numerous traffic-related injury policy interventions and strategies developed largely in HICs are potentially transferable to LICs, it is important to consider country-specific factors such as costs, feasibility, sustainability, and barriers, all of which must be factored into the assessment of effectiveness in specific LIC settings. Almost all interventions and strategies that have been proven effective in HICs will need to be evaluated in LICs and particular attention paid to the effectiveness of enforcement measures. It behooves LIC governments, however, to ensure that only standard, approved safety devices like helmets are imported into their countries. Additionally, LICs may need to improvise and innovate in the traffic safety technology transfer.
与交通相关的伤害已成为全球主要的公共卫生问题。然而，与发达国家或高收入国家不同，许多发展中国家或低收入国家在解决这一问题上进展甚微。低收入国家缺乏进展，部分原因在于其经济状况，即政府缺乏投资交通安全的资源、对伤害宿命论的文化信仰、尤其是随着艾滋病毒/艾滋病出现而产生的相互竞争的健康问题、独特的交通构成（包括大量弱势道路使用者，针对他们的研究较少）、低识字率使驾车者无法阅读和理解道路标志，以及偶尔由独裁和非民主政府主导的特殊政治局势。那么，低收入国家如何借鉴高收入国家的经验来应对交通安全挑战，而又无需从头做起呢？本文回顾了一些为应对高收入国家与交通相关伤害而制定的干预措施和策略，评估其有效性以及对低收入国家的适用性。许多低收入国家的数据表明，诸如使用安全带和头盔、安全带使用的立法与执法、人行道、道路障碍物、某些交通稳静化设计（如减速带）、带有清晰标记人行横道的人行横道标志，以及针对驾车者的公众教育和行为改变等已证实且有前景的干预措施或策略，在低收入国家都是可行且可用的。虽然许多主要在高收入国家制定的与交通相关伤害的政策干预措施和策略有可能转移到低收入国家，但考虑特定国家因素如成本、可行性、可持续性和障碍很重要，所有这些因素都必须纳入对低收入国家具体环境中有效性的评估。几乎所有在高收入国家已证明有效的干预措施和策略都需要在低收入国家进行评估，尤其要关注执法措施的有效性。然而，低收入国家政府有责任确保仅向本国进口标准的、经批准的安全设备，如头盔。此外，低收入国家在交通安全技术转让方面可能需要临时应变并进行创新。
