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Status of Road Safety and Injury Burden: Vietnam

Ivers, Rebecca Q.*; Nguyen, Ha T.; La, Quang N.

Journal of Orthopaedic Trauma: June 2014 - Volume 28 - Issue - p S50–S51
doi: 10.1097/BOT.0000000000000098
Supplement Article

*The George Institute for Global Health, University of Sydney, Sydney, Australia;

School of Population Health, University of South Australia, Adelaide, Australia; and

Hanoi School of Public Health, Hanoi, Vietnam.

Reprints: Rebecca Q. Ivers, The George Institute for Global Health, University of Sydney, PO Box M201, Missenden Rd, Sydney, NSW 2050, Australia (e-mail: rivers@george.org.au).

The authors report no conflict of interest.

Accepted March 13, 2014

In Vietnam, a market economy (“Doi Moi”) was introduced in 1986, which resulted in a rapid economic and social development. Motorization has also increased dramatically over the past 10 years in line with other developments. Ownership of cars has increased at an annual average rate of 12%, whereas motorcycle ownership has increased at an average rate of 40% per year, with a 16.5-fold ratio between 2-wheel and 4-wheel motor vehicles. As of July 2009, there were about 28.3 million vehicles, of which 26,869,025 were motorbikes.1

Not surprisingly, the number of road crashes is also high, with the majority (73.4%) of fatal crashes involving motorcycles.2 In 2008, the National Transportation Safety Committee reported that the national mortality rate due to traffic crashes was approximately 11 deaths per 10,000 motor vehicles, similar to other Southeast Asian countries.3 More recently, reports from the Ministry of Health indicated that in 2011, there were 17,150 road-related deaths (20.14 per 100.000 population) most of which (n = 13, 536) were in men.4 More recent work from a national sample mortality surveillance system reported that age-standardized mortality rates were even higher, at 33.5 and 8.5 per 100,000 for males and females, respectively, again with the majority of deaths in males (79%) and 58% motorcycle users. Head injuries were the most common cause of death (79%).5

Despite variation in the estimates, it is clear that road injuries have a profound impact in Vietnam. An estimate from the Asian Development Bank using data from 2003, found road injuries cost almost VND 3100 billion, or US$ 194 million (US$ 1 = VND 16,000). As a developing economy, with a GDP of VND 575,000 billion (or US$ 36 billion) this was equivalent to approximately 0.54% of the gross domestic product.6 There is evidence that this has increased: the National Transportation Safety Committee estimated that the cost of road crashes in Vietnam is at least 2% of the gross domestic product,2,3 and in a recent report, the World Health Organization reported that the costs of Road traffic injuries in Vietnam were 2.5% of the gross domestic product in 2010.7

The economic impact of injuries also has a significant impact at the household or individual level. In a study on the cost of all unintentional injuries in 1999–2000, 90% of the costs incurred for treatment of road injuries were out of pocket costs from individuals and their families, with only 8% paid by the government and 2% from health insurance agencies.8 Such catastrophic health expenditure frequently leads to significant economic hardship and impoverishment. A recent study found that during the hospitalization period for road injuries, the average cost per injury was US$ 363 or 6 months of average salary.9 One year after the injury, the total costs were US$ 789 or almost 14 months of average salary, and 62.5% of patients and their families faced catastrophic expenditure.10 In terms of impoverishment, 30.8% of patients and their families were pushed below the national poverty line.10

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Risk Factors, Policy, and Future Directions

Over recent years there has been much media attention about progress in road safety in Vietnam, mainly due to the implementation and enforcement of motorcycle helmet legislation, unique in a low-income country setting.11 With the advent of motorcycle helmet legislation and enforcement in 2007, helmet-wearing rates have increased accordingly,12 and head injury rates decreased.13 There is evidence that the media played a positive role in the development of community dialog about motorcycle helmets.11 However, there is an important need to continue focusing on maintaining helmet-wearing rates at high levels, as well as addressing low helmet-wearing rates in children,14 and helmet quality,15 both of which require continued work. Drinking and driving is also a significant concern, with more than 29% of all car drivers and motorcycle riders presenting at hospitals with road injuries exceeding the legal blood alcohol content limit in a recent study.16

With a rising burden of road injury and a substantial impact on the community, it is crucial that the Vietnam Government invests in evidence-based solutions, with the support of the global community. Nonetheless, there have been significant advances in Vietnam in relation to road safety, and with the national policy for accident and injury prevention currently under revision, there are opportunities for further gains.

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REFERENCES

1. Ministry of Transport. Summary of Road Safety in July and the First Seven Months in 2009. Hanoi, Vietnam: Ministry of Transport; 2009.
2. Phong NT. National Road Traffic Safety Strategies: Midterm Report to 2020 and Vision for 2030. Hanoi, Vietnam: Institute of Strategy and Development for Transportation; 2010.
3. Thai NT. Report on Road Traffic Injury in Vietnam for Period 2001-2007. Hanoi, Vietnam: National Transportation Safety Committee of Vietnam; 2008.
4. Lan TTN, Anh LM. Midterm Report of Injury Prevention Planning for 2011-2015 of Health Sector. Hanoi, Vietnam: Department of Health Environmental Management, Ministry of Health; 2013.
5. Ngo AD, Rao C, Hoa NP, et al.. Road traffic related mortality in Vietnam: evidence for policy from a national sample mortality surveillance system. BMC Public Health. 2012;12:561.
6. Asian Development Bank-Association of Aoutheast Asian Nations Regional Road Safety Program. Asian Development Bank; Accident Costing Report AC 10. Vietnam; 2005.
7. World Health Organization. Global Status Report on Road Safety 2013. Geneva, Switzerland: WHO; 2013.
8. Thanh NX, Hang HM, Chuc NT, et al.. The economic burden of unintentional injuries: a community-based cost analysis in Bavi, Vietnam. Scand J Public Health Suppl. 2003;62:45–51.
9. Nguyen H, Ivers RQ, Jan S, et al.. The economic burden of road traffic injuries: evidence from a provincial general hospital in Vietnam. Inj Prev. 2013;19:79–84.
10. Nguyen H. Injury, a Significant Cause of Poverty: Evidence From a Prospective Cohort Study of Adult Injuries in Thai Binh Province, Vietnam. Sydney: University of Sydney; 2012.
11. Hill PS, Ngo AD, Khuong TA, et al.. Mandatory helmet legislation and the print media in Viet Nam. Accident; Anal Prev. 2009;41:789–797.
12. Le LC, Blum RW. Road traffic injury among young people in Vietnam: evidence from two rounds of national adolescent health surveys, 2004–2009. Glob Health Action. 2013;6:1–9.
13. Passmore J, Tu NT, Luong MA, et al.. Impact of mandatory motorcycle helmet wearing legislation on head injuries in Viet Nam: results of a preliminary analysis. Traffic Inj Prev. 2010;11:202–206.
14. Pervin A, Passmore J, Sidik M, et al.. Viet Nam's mandatory motorcycle helmet law and its impact on children. Bull World Health Organ. 2009;87:369–373.
15. Collaborators RTIRN; Ackaah W, Afukaar F, et al.. The use of non-standard motorcycle helmets in low- and middle-income countries: a multicentre study. Inj Prev. 2013;19:158–163.
16. Nguyen NP, Passmore J, Tran LT, et al.. Role of alcohol in hospitalized road trauma in Vietnam. Traffic Inj Prev. 2013;14:329–334.
Keywords:

road injury; Vietnam; fatality

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