Observed seat belt use in Kumasi Metropolis, Ghana.

We conducted an observational survey of seat belt use to determine the use rate of drivers and front-right passengers of vehicles in Kumasi, Ghana. Unobtrusive observations of seat belt use were made at 41 locations composed of signalized intersections and roundabouts where vehicles come to a halt or slow down considerably. The overall driver seat belt use rate was 17.6% compared to 4.9% for front-right passengers. Driver belt use was 33.2% for private cars, 9.0% for taxis, 8.3% for minibus (trotro), 13.1% for large buses and 9.7% for trucks. Overall seat belt use was higher for female drivers than for male drivers (44.8% versus 16.4%, p < .001), was lowest within the Central Business District (CBD) compared to the outskirts of the city (16.3% versus 21.0%, p < .001) and seat belt use rate increased with age. Passengers belted more often if drivers were belted, but about three-quarters of male passengers and 70-80% of female passengers were unbelted even when drivers were belted. In conclusion, the seat belt use rate was generally low in Kumasi, Ghana, and it is a function of occupant seating position, gender, vehicle type and usage, age group, and location setting. The results provide important preliminary data about seat belt use, particularly among male drivers and commercial vehicle occupant population. The study also suggests the need to develop effective strategies and programs that address low seat belt use in Ghana.