Characteristics of Road Traffic Injuries to Pedestrians in Nairobi, Kenya: Implications for Urban Safety Planning

Abstract

Every day around the world, almost 16 000 people die from all types of injuries. The category of injuries worldwide is dominated by those incurred in road crashes which account for around 25% of all deaths from injury. Pedestrians comprise 22% of all deaths that occur annually as a result of all traffic crashes worldwide. The incidences of pedestrian injuries and deaths are increasing fast on urban roads in sub-Saharan Africa. Nairobi experiences a high proportion of road traffic crashes and injuries relative to its size and population. A great proportion of those injured and killed are pedestrians. Though the levels of walking in Nairobi is high and studies have consistently shown that pedestrians are overrepresented in traffic fatalities in Nairobi, there is a general lack of published work characterizing road traffic crashes involving pedestrians and providing details on the nature of the pedestrian injuries and intervention strategies. Using a prospective study design, a cross-sectional study design and document search, this study described the characteristics of pedestrians injured in road traffic crashes that occurred in Nairobi over a period of 3 months, from l " June to 31st August 2011 and examined policy response to pedestrian safety in Nairobi. Descriptive statistics were generated for demographic characteristics, category of road user, vehicle involved, day the crash occurred, duration of hospitalization and nature of injury. Analysis was based on frequency tabulation and group comparisons using Analysis of Variance with a p value ::::;0.05considered significant. A total of 176 road traffic injury patients were admitted to KNH. During the same period 107 road traffic injury cases were reported to traffic police in Nairobi. Pedestrians comprised 59.1% of all categories of injured road users admitted to KNH, 61% of total hospital bed-days, and 69.2% of the total road traffic injury cases reported to traffic police in Nairobi. The number of admitted males was significantly higher in all the age groups combined (p=0.00496). Young adults aged 15-44 years constituted 75% of the total road traffic injury hospital admissions, and 85.45% of the total pedestrians admitted in KNH. The mean LOS of pedestrians was not significantly different (p=0.8339) from that of all other road users combined. The highest proportion of pedestrian crashes occurred on Saturdays [26(25.5%)]. Cars were the leading category of motorized four-wheeler vehicles that injured pedestrians admitted to KNH (37.6%) and those reported to traffic police (44.3%). The highest number of pedestrian injuries was reported in: Thika Highway, (15.4%). Most pedestrians were hit while crossing the road (70.3%), about 85% at sites which had no traffic signs and 51% at sites which had no traffic light at the crash site. Although the Integrated National Transport and the Nairobi Metro 2030 policy documents highlight the need to improve safety of pedestrians, only 0.1% of the budget was earmarked for improvement of non-motorized transport in the city and only 0.001 % of its budget for mobility and accessibility in 2008 was budgeted for road safety. Other strategies used in improvement of safety of pedestrians in Nairobi are: traffic law enforcement; road traffic engineering; pedestrian safetyeducation, and non-governmental organizations. There is need for design and development of infrastructure that takes into account the safety of pedestrians. Urban planners and the safety systemplanners in the city of Nairobi should make it a high priority to cater for the safety needs of pedestrians and their physical vulnerability.