Traffic health challenges in road safety management and policy: experts and Road Safety Commission viewpoints since 5 years

Abstract

Introduction: Road traffic injuries (RTIs) are one of the important causes of death and major health challenges worldwide, especially in Iran. "Lead Agency" is the key component in road safety promotion. It is expected that the role of health as one of the main issues of road safety sufficiently be considered in the policies and interventions of this agency. The purpose of this study is to identify health challenges from experts' point of view and review policies related to health subjects in the approvals of the national (Road Safety Commission) and regional (provincial executive commissions) lead agency. Materials and Methods: This qualitative study was conducted using the framework analysis method in two parts. In the first part; the approvals of the National Road Safety Commission and the executive commission the three provinces of Isfahan, EastAzarbaijan and Tehran were reviewed during 2014-2018. Then extraction, coding and categorization of the concepts obtained from the documents were done using MAXQDA software in the framework of the five pillars that defined by the World Health Organization (WHO). To identify health policies, health-specific codes were separated from other codes. In the second part; health challenges in the field of traffic management were extracted from the transcribed texts resulting from experts' discussions in the group meetings of the "National Traffic Health and Safety Document". For this purpose, 17 experts in the various fields of RTIs were selected by purposive and heterogeneous sampling method to reach informational saturation. These were the participants who had been invited and interviewed for the special meetings of the "National Traffic Health and Safety Document" previously. The interviews were "semi-structured". The texts were analyzed based on the road safety pillars defined by the WHO. Results: In the first part, unlike the general words "transportation", "Safety", and "road" with the most frequency, health-specific words such as "rehabilitation of the injured, mental disorders, drugs affecting driving, etc." were not seen in the text of the approvals of the commissions or their frequency was below 1%. The total number of codes extracted was 1535 codes from all the documents. Of these, 84codes(5.4%) were specifically related to health only. In addition, 51.8% of the health-specific codes belonged to the "post-crash response" theme. After that, the highest number of health-specific codes belonged to the themes of "road safety management", "safer road users", "safer vehicles" and "other" respectively. The theme "safer roads & mobility" had no health-specific code. In the second part, the concepts related to health obtained from the document were grouped into three themes: "road safety management" with 10 subthemes, "safer road users" with 8 subthemes, and "post-crash response" with 2 subthemes, most of these concepts weren't in the first part. Conclusion: The various aspects of health that were discussed by the experts have been seen less in the five-year content of the reviewed approvals due to the insufficient attention of the participants to the health subjects in the meetings of the commissions; and the few approvals with health-specific subjects have often dealt post-crash issues too; which can have different reasons, such as "the lack of the proper place of health subjects in the attitude of these people, the role of health being less known due to low awareness and the low participation of experts and health officials in decisions". Paying attention to the role of health in road safety management and making proportional policies with it can reduce the incidence of road traffic injuries by promoting road safety.