The requirements and challenges in preventing of road traffic injury in Iran. A qualitative study

Davoud Khorasani‐Zavareh; Mohammadi, Reza; Khankeh, Hamid Reza; Laflamme, Lucie; Bikmoradi, Ali; Haglund, Bo J.A. · 2009 · OpenAlex-citations

DOI: 10.1186/1471-2458-9-486

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Summary

This qualitative study investigates the barriers to preventing road traffic injuries (RTIs) in Iran, a country with one of the highest RTI mortality rates globally. Motivated by the urgent public health burden of RTIs in low- and middle-income countries and the lack of comprehensive qualitative data on stakeholder perceptions in Iran, the research aims to identify obstacles to RTI prevention and propose facilitators for improvement. The study seeks to understand the complex interactions between road users, vehicles, infrastructure, and organizational structures to inform more effective prevention strategies. The researchers employed a grounded theory approach, conducting 38 semi-structured interviews in 2007 with a diverse range of stakeholders in West Azarbaijan Province and at the national level. Participants included police officers, public health professionals, road administrators, emergency medical service staff, Red Crescent representatives, car industry experts, firefighters, motorcyclists, car drivers, and RTI victims. Data collection continued until theoretical saturation was reached. Interviews were recorded, transcribed, and analyzed using open, axial, and selective coding techniques to identify core variables and categories. The analysis identified "the lack of a system approach to road-user safety" as the core variable. Barriers were categorized into three main areas: human factors, transportation system issues, and organizational coordination. Human factors included an undeveloped traffic safety culture, particularly in rural areas, characterized by speeding, non-compliance with laws (such as helmet and seat belt use), and a general sense of urgency among drivers. Enforcement was hindered by weak legislation, low fines, inadequate police authority, and outdated monitoring methods. Transportation system barriers involved insufficient vehicle safety standards, an aging and incompatible vehicle fleet, and poor road infrastructure, including a lack of separate lanes, inadequate lighting, and numerous accident black spots. Organizational challenges stemmed from the absence of a central coordinating agency, leading to parallel activities, unclear responsibilities, and a lack of comprehensive injury surveillance. The study concludes that while changing human behavior through education and stricter law enforcement is critical, these measures are insufficient without a systemic approach. The authors recommend an integrated organizational structure to coordinate RTI prevention activities, alongside improvements in vehicle safety standards, road infrastructure engineering, and rigorous law enforcement. They emphasize the need for a "National Decision" to unify efforts and shift the focus toward comprehensive road-user safety, addressing both behavioral and environmental factors to effectively reduce RTI mortality in Iran.

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• traffic safety culture

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• Applied Guidance: countermeasure evaluation