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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 8  |  Issue : 4  |  Page : 361-369

Health implications of knowledge, and attitudes for road safety and protective measures among commercial motorcycle riders in a semi-urban setting in Nigeria


1 Department of Healthcare Management, University of Central Nicaragua, 1 cuadra al lago, Managua 12104, Nicaragua
2 Department of National Integrated Specimen Referral Network, AXIOS International, Utako, FCT, Abuja, Nigeria
3 Public Health Department, Triune Biblical University Global Extension, New York, USA

Date of Submission08-Aug-2021
Date of Acceptance18-Oct-2021
Date of Web Publication22-Dec-2021

Correspondence Address:
Dr. Olaide Lateef Afelumo
Department of Healthcare Management, University of Central Nicaragua, 1 cuadra al lago, Managua 12104.
Nicaragua
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mgmj.mgmj_59_21

Rights and Permissions
  Abstract 

Background: Knowledge of road safety and preventive measures effectively reduces accidents associated with motorcycles. This study aimed to assess the knowledge and attitudes of motorcycle riders in the Ado-Odo Ota local government area (LGA) towards road safety and accident preventive measures. Materials and Methods: This study was a descriptive cross-sectional study that used a structured questionnaire to collect data related to knowledge of safety measures from the respondents using a stratified random sampling technique to identify potential respondents. IBM-SPSS version 25.0 for Windows IBM Corp., Armonk, NY, USA, was used for data analysis. Results: There were 374 respondents, of which 69.0% owned the motorcycles, and 31.0% were hired/rented. The knowledge of road safety and preventive measures among respondents was generally poor (46.5%). Rented/hired motorcycle riders displayed better knowledge (55.2%) than owners (42.6%) (P < 0.05). Factors associated with knowledge include being married COR = 2.48 (95% CI = 1.22–5.08; P < 0.05), secondary/higher education COR = 1.90 (95% CI = 1.19–3.05; P < 0.05), and over 6-year of experience COR of 1.69 (95% CI = 1.08–2.63; P < 0.05). Motorcycle owners displayed better attitudes (71.7%) than hired (57.8%) (P < 0.05). Secondary/higher education COR 1.24 (95% CI = 0.78–1.97; P > 0.05), and good knowledge COR = 4.15 (95% CI = 2.50–6.91; P < 0.005) were the determinants of positive attitudes towards safety measures. The overall prevalence of road traffic crashes was 45.2%, higher among riders with insufficient knowledge (47.5%) and negative attitudes (55.7%) towards safety measures. Conclusion: The government and other stakeholders should organize regular training to improve the riders’ knowledge and attitudes towards road safety and preventive measures due to the riders’ inadequate knowledge of safety and protective measures. These actions will help reduce accident rates and consequently reduce road traffic crashes’ medical and economic burdens.

Keywords: Attitudes, knowledge, motorcycle, road safety


How to cite this article:
Afelumo OL, Abiodun OP, Sanni OF. Health implications of knowledge, and attitudes for road safety and protective measures among commercial motorcycle riders in a semi-urban setting in Nigeria. MGM J Med Sci 2021;8:361-9

How to cite this URL:
Afelumo OL, Abiodun OP, Sanni OF. Health implications of knowledge, and attitudes for road safety and protective measures among commercial motorcycle riders in a semi-urban setting in Nigeria. MGM J Med Sci [serial online] 2021 [cited 2022 Jan 18];8:361-9. Available from: http://www.mgmjms.com/text.asp?2021/8/4/361/333323




  Introduction Top


Two-wheeled motorized vehicles, commonly known as ‘Okada,’ constitute a significant mode of transport in Nigeria. The use of motorcycles in rural and urban areas in Nigeria has increased over the past two decades because they can maneuver between vehicles in multiple urban road congestion.[1] As a result, they can easily sail on bad roads and make livelihoods for the team of unemployed young people from Nigeria.[2] The risk of fatal and nonfatal traffic accidents among motorcycles is higher than in other modes of transport.[3] Globally, road traffic crashes (RTCs) account for a large proportion of total morbidity and mortality, 90% of which occur in developing countries.[3]

According to the World Health Organization (WHO),[4] RTCs are frequently portrayed in the news as isolated incidents rather than a significant cause of death and a massive waste on a country’s human, health, and financial resources. “By presenting traffic safety as a health and development issue and providing statistics and in-depth information, journalists may impact how these stories are presented, therefore influencing public behavior and attitudes, influencing legislation, and thereby contributing to lifesaving”.[4]

RTCs are public health issues because the citizens, families, and governments suffer tremendously due to the resulting fatalities. They impose enormous pressure on frequently overcrowded health care systems, occupy limited hospital beds, waste scarce resources, and result in considerable potential and prosperity damages, with profound social and economic consequences.[5],[6]

In Nigeria, around 80% of road traffic accidents involving motorcycles occur on major highways, with human error responsible for 82%; most traffic incidents occur during the day, although more deaths are registered at night. Studies have argued that in many countries, young motorcyclists under the age of 18 years make up a large percentage of road accidents among road users due to a lack of proper knowledge, riding when they are under age, and poor attitudes towards traffic regulations.[7],[8],[9],[10] In addition, as motorcyclists ride over the speed limit recommended, they may lose power, causing an accident; this emphasizes the need for improved knowledge and attitudes of motorcycle riders towards road safety and accident preventive measures.

This study is important to society, particularly developing countries, because it shows the awareness of road safety measures among riders and their attitudes, such as wearing helmets, functional headlamps, protective clothes, and other protective measures. Also, knowledge of road safety and preventive measures effectively reduces accidents associated with motorcycles and the related health and economic challenges. Research by Fagnant[11] revealed that it is less probable that motorcycle riders who have undergone motorcycle training or are knowledgeable in road preventive measures would be involved in an accident. Therefore, motorcycle riders are often encouraged to attend daily training to increase their knowledge of road safety, strengthen their defensive motorcycle maneuvers, and increase their chances of preventing traffic accidents and serious injuries.

A study conducted in Shagamu, Ogun State, Nigeria, found that all (100%) riders had no formal training before riding motorcycles.[12] Experience in motorcycle riding and adequate preparation through training decreases accidents and minimizes injury in accidents.[12],[13] Peltzer[14] found that the resources and capabilities of the training institutions were also a significant concern. To offer adequate training, most training institutions are not adequately equipped and staffed. Rider testing often lacks rigor at the same time and can be quickly passed even by an abysmal candidate.

Factors that cause motorcycle accidents in Nigeria include over-speeding, incorrect overtaking, bad roads, sudden mechanical faults, and alcohol consumption as significant factors.[15] Therefore, poor attitudes towards safety measures increase the risk of one being involved in accidents. Therefore, this study aimed to assess the knowledge and attitudes of motorcycle riders in the Ado-Odo Ota local government area (LGA) towards road safety and accident preventive measures.


  Materials and methods Top


Research design

This study used a descriptive cross-sectional design. This study was carried out in Ado Odo Ota, a LGA of Ogun State, Nigeria. Ado Odo Ota is one of the 19 LGAs of Ogun State, Nigeria. Structured questionnaires were used in collecting data from the respondents.

Population and sampling procedure

According to the Central Department of Statistics, Ministry of Finance, there were 620 registered motorcycles in Ado-Odo LGA in 2017.[16] Therefore, these people formed the study target population. However, there is no latest information regarding the number of registered motorcycles with many unregistered motorcycles in the LGA but operating within this axis in connection with Lagos and other LGAs in Ogun state. Therefore, it is assumed that the number of Okada riders in this local government is far higher than the number of registered motorcycles in the LGA.

Sample size calculation

The sample size for the study was estimated based on the previous 67% knowledge of road safety and preventive measures recorded among Okada riders in Nigeria.[17] The preliminary sample size was calculated using the formula:



where: n is the sample size, Z = 1.96 for 95% confidence level. p is the knowledge of road safety and preventive measures among Okada riders in Nigeria (67% = 0.67), and q = 1–p (1–0.67 = 0.33), d is the accepted bias for p sample equals 0.05.



Adding 10% allowable attrition = 0.1 × 340 = 34

Therefore, the total sample size is 340 + 34 = 374

Data collection technique

The researcher used stratified random sampling to identify potential respondents in the study. First, stratified sampling was used to get the sample from the population of Okada operators. Then, a multistage probability sampling method was used; 374 Okada riders were selected from all motorcycle parks listed according to their division. By stratified random sampling, a total of twenty parks were identified: four motorcycle parks from each of the five main divisions. The following sampling stage included data collection by simple random sampling technique of 19 respondents from 15 more significant parks and 18 from 5 smaller parks from each of the previously selected parks. The data collected include demographic characteristics, knowledge, attitude, safety devices, and safety measures among individual Okada riders and the hired ones.

Data analysis

This study used a quantitative method of analysis of data. First, the completed interview guides were coded, and the IBM-Statistical Package did the data processing for Social Sciences (IBM-SPSS) version 25.0 for Windows IBM Corp., Armonk, New York, USA. Then, descriptive statistics and the details presented in the distribution frequency and percentage tables were used to interpret the data to provide a clear image of the results.

Inclusion and exclusion criteria

The motorcycle rider must be working within the Ado-Odo Ota LGA to be included in this study, must be 18 years and below 60 years, must have been riding a motorcycle for at least 1 year, and must be a full-time rider. Riders that did not meet inclusion criteria were excluded.

Ethical considerations

Approval was obtained from the National Health Research Ethics Committee of Nigeria (NHREC) with NHREC/01/01/2007–20/01/2021. The local government authority was also informed, and approval was obtained before the study was conducted. All information obtained from the respondents was confidential and only used for the task. The study procedure was explained to each participant, and written consent was obtained before administering the questionnaire. Therefore, no data collected can be used to identify the respondents.

Variable definition

The knowledge of road safety measures was evaluated with 13 questions including understanding the manufacturer’s manual, road signs, speed limits, safety equipment, causes of accidents, information about drivers’ license, Nigerian highway code, a documentary on accident prevention, information on safety leaflet, road safety flier, films or movies on road safety, television and radio programs on road safety, and knowledge of signposts of road signs and safety measures. A 70% or more score was considered high, whereas scores below 70% were deemed inadequate.[18]

Attitudes towards road safety measures were tested with 13 questions, including the use of protective jackets, use of helmets, speed limits (50 km/h), riding while feeling tired, riding while drunk, availability and the use of direction indicators, overtaking two or more vehicles at a time, over speeding, overtaking in corners/bends, overtaking from the left, reckless driving, carrying more than one passenger, receiving/making phone calls while riding, and riding in the rain. A 70% or more score was considered high, whereas scores below 70% were deemed inadequate.[18]


  Results Top


Sociodemographic profile of the respondents

Sociodemographic distribution of knowledge of road safety and preventive measures

The overall knowledge of safety measures is displayed in [Table 1]. The knowledge of road safety and preventive measures among those who rented/hired motorcycles was higher (55.2%) than those who owned motorcycles (42.6%) (P < 0.05). Respondents aged 18–24 years had better knowledge (76.5%) compared to respondents aged 35–44 years who had the slightest knowledge (42.3%) (P > 0.05). Married respondents also displayed a higher level of awareness (49.8%) than those that were single (39.7%), while the divorced/widowed were the least knowledgeable (9.5%) (P < 0.05). The level of knowledge significantly increased with education attainment from 15.4% among those without formal education to 55.9% among those who attained tertiary education (P < 0.05). Also, insignificantly higher knowledge was found among respondents without children (51.4%) than those with children (46.0%) (P > 0.05). Knowledge of road safety and preventive measures was higher among respondents who have developed over 6 years’ experience (55.4%), followed by those with 1–3 years (50.8%) and then respondents with 4–6 years (31.2%), which was the least (P < 0.05).
Table 1: Sociodemographic distribution of knowledge of road safety and preventive measures

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Generally, the knowledge of road safety and preventive measures among Okada riders in Ado-Odo Ota LGA was relatively low. Only 46.5% had a good understanding, and 53.5% had poor knowledge, as shown in [Table 2]. Also, a slightly higher proportion of riders with inadequate knowledge of road safety and preventive measures (47.5%) have been involved in accidents in the previous 12 months than those who knew (42.5%), P > 0.05.
Table 2: Respondents’ attitude towards road safety and preventive measures

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Attitudes of the motorcycle riders towards safety protective measures: As shown in [Table 2], riders who own motorcycles exhibited a better attitude (71.7%) than those who hired or rented motorcycles (57.8%) (P < 0.05). Similarly, a positive attitude towards road safety and preventive measures increased with age from 52.9% among riders aged 18–24 years, 59.7% among 25–34 years, and 75.4% among 35–44 years of riders, with a slight decline to 68.1% among 45–54 years (P < 0.05). More married riders (68.9%) showed a positive attitude than single and divorced riders (P > 0.005). A positive attitude towards safety measures was significantly higher among those who attained secondary education (74.6%) compared to others, with riders lacking formal education being the least (42.3%) (P < 0.005). Riders without children had a slightly better attitude (74.3%) than riders with children (66.7%) (P > 0.05). Riders that had 1–3 years of riding experience showed a similar attitude (69.8%) with others (P > 0.005). Also, respondents with good knowledge of safety measures were showed positive attitudes (81.0%) than those that lacked adequate knowledge (55.5%) (P < 0.05). However, [Table 3] shows that most respondents had a good attitude (67.4%) towards safety measures than a poor attitude (32.6%). More than half (55.7%) of riders with negative attitudes towards road safety and preventive measures have been involved in accidents in the previous 12 months than those with positive attitudes (40.1%), P < 0.05.
Table 3: Multivariate analysis of knowledge and attitudes towards road safety and accident preventive measures

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Multivariate analysis of knowledge and attitudes towards road safety and accident preventive measures

As shown in [Table 3], logistic regression analysis shows that four factors were associated with knowledge of road safety and accident preventive measures (ownership, marital status, education, and years of experience). Still, the multivariate analysis excluded ownership, leaving three associated factors. First, those that rented/hired motorcycles were COR = 1.66% (95% CI = 1.07–58; P > 0.05) times more aware of road safety and accident preventive measures than owners. Second, married respondents were COR = 2.48 (95% CI = 1.22–5.08; P < 0.05) times more likely to be aware of safety and accident preventive measures. Finally, respondents with secondary/higher education were COR = 1.90 (95% CI = 1.19–3.05; P < 0.05) times more knowledgeable about road safety and accident preventive measures than respondents with no formal/primary education. Also, respondents with more than 6 years’ experience had COR of 1.69 (95% CI = 1.08–2.63; P < 0.05] more knowledge than respondents with six or fewer years experience.

These four factors (ownership, age category, education, and knowledge of safety measures) were associated with the attitudes towards road safety and accident preventive measures but multivariate analysis excluded education, leaving ownership, age category, and knowledge of safety measures. Respondents who owned their motorcycles had COR = 2.29 (95% CI = 1. 1.39–3.79; P < 0.05) times likely to have better attitudes than those who rented/hired motorcycles. Respondents 35 years or older also had COR of 2.17 (95% CI = 1.32–3.55; P < 0.05) positive attitudes than those below 35 years. Riders with secondary/higher education also displayed COR 1.24 (95% CI = 0.78–1.97; P > 0.05) better attitude towards road safety and accident preventive measures than those with lower education. Finally, respondents who were aware of road safety and preventive measures were COR = 4.15 (95% CI = 2.50–6.91; P < 0.005) times more likely to have a positive attitude than those without adequate safety measures.


  Discussion Top


Sociodemographic profile of the respondents

This study assessed the knowledge and attitudes towards road safety and protective measures among commercial motorcycle riders in Ogun State, Nigeria’s Ado-Odo Ota LGA. The study found that most motorcycle riders were primarily youths and young adults (25–44 years), constituting more than 60% of the study respondents. This finding aligns with the previous reports that motorcycle riders are primarily at their prime.[19],[20],[21] The high number of youths in commercial motorcycling jobs might be due to the high unemployment rate in Nigeria, as previously reported in the literature.[22],[23] More than half of the riders in this study had secondary education, which agrees with previous studies in Nigeria and outside the country that most motorcycle riders only attain secondary education.[7],[22],[24],[25],[26] The involvement of young men in the riding business underscores the need for interventions to improve their knowledge and attitudes towards road safety measures; this will significantly help reduce the deaths of young people who are primarily the breadwinners and the future leaders of the riding business country.

Knowledge of safety protective measures among motorcycle riders in Ado-Odo Ota LGA

The overall awareness of road safety protective measures was minimal among Okada riders in Ado-Odo Ota LGA. However, respondents who rented/hired motorcycles were more aware of these safety measures than those who owned the motorcycles. The knowledge of riders was tested on ‘road signs,’ ‘speed limits,’ ‘safety equipment, ‘causes of accidents,’ ‘television and radio programs/documentary on road accident prevention measures, ‘the Nigerian highway code,’ availability of road safety leaflets and fliers from Federal Road Safety Corps (FRSC), ‘films or movies on road signs,’ and ‘availability of sing posts showing road signs and safety measures. The inadequate knowledge of safety measures found in this study is similar to the reports in Lagos and Ile-Ife, the same South-West region as the current study. The study showed that though respondents professed that they were aware of road safety and preventive measures, their responses showed poor knowledge of these measures.[27]

Similarly, another study conducted in Ibadan, South-West Nigeria, reported inadequate road safety and preventive measures among commercial motorcycle riders despite operating in an urban setting.[28] The low awareness of road safety measures found in this study has also been reported in other parts of Nigeria. For example, a recent survey conducted in Sokoto State, North-west Nigeria, found that over 60% of commercial motorcycles that participated in the study lacked sufficient knowledge of road safety and preventive measures.[17]

Poor knowledge of road safety measures has been reported to be significantly associated with a high rate of accidents.[12],[17],[27],[28] This report suggests an urgent need for awareness creation among Okada riders in Ota and Nigeria. Factors associated with knowledge of road safety and preventive measures in this study include being a motorcycle owner, being married and having children, younger age, higher education attainment, and 1–3 years of working experience. These findings oppose the study’s results in Sokoto, where age, marital status, and education were not significantly associated with knowledge of safety measures.[17]

Attitudes of the motorcycle riders towards safety protective measures

The perspectives examined in this study to develop an overall score include ‘regular wearing of bright/reflective clothing’ use of protective jacket,’ ‘use of helmet’ and ‘speed not more than 50 km/h.’ The respondents’ overall attitude towards road safety and preventive measures was positive but significantly better among motorcycles owners than the hired motorcycles. On the other hand, poor attitudes towards safety measures among those who rented/hired motorcycles might be due to the limited period they have to pay fully for the motorcycles and become owners or due to specific amounts to be remitted daily or weekly to the owners. Also, failure to meet the payment deadline or the amount to be delivered to the owners may result in forfeiting their agreement and thus losing their means of livelihood, so they often drive recklessly.

The study found that older riders displayed an overall positive attitude than the younger ones. Also, married riders showed better positive attitudes than those who were not currently married. Education attainment was also associated with a positive attitude towards safety measures. However, the highest positive attitude among respondents who attained a maximum of secondary education might be because most riders reached secondary education. However, no association was established between having children and a positive attitude towards safety measures (P > 0.05).

Even though most riders do not drink alcohol when riding, in the rain, when tired. They do not overtake at the bends, yet, nonregular use of helmets, riding above 50 km/h, nonwearing of protective jackets and indicators, over-speeding, and carrying more than one passenger is risky behavior negative attitudes that can end up in road accidents. This finding underscores the need for regular training on the right mindset for motorcyclists in this LGA. Furthermore, studies have found a significant association between carrying more than one passenger and a high incidence of motorcycle accidents and suggested regulations that motorcyclists should not take more than one passenger.[13],[29] Also, scholars have proposed enforcing reflective jackets, helmets, and safety gears as preventive measures against motorcycle accidents.[30] Furthermore, the literature showed a significant association between the high rate of motorcycle accidents with speeding,[31],[32],[33] reckless driving,[2],[24],[31],[33] and overlading.[31],[32],[34],[35],[36] The overall attitude (64.8%) in the present study is slightly lower than reports of some other studies such as 69.4% in Sokoto North-West,[17] 95.2% in Zaria, North-Central,[37] and 67.6% found in Tanzania[38] but higher than 32.7% in Lagos and Ile-Ife, South-West,[27] and 18.7% in Benin City, South-South[39] in Nigeria.

Health and economic implication of inadequate knowledge and negative attitudes towards road safety and preventive measures

This study found a high prevalence of accidents among motorcycle riders (45.2%) in Ado-Odo Ota LGA, particularly among those with inadequate knowledge (47.5%) and negative attitudes towards safety and preventive measures (55.7%). These findings show a significant connection between accidents rates and attitudes towards safety measures. It is challenging to disregard the economic burden of motorcycle accidents due to inadequate knowledge and negative attitudes towards safety and preventive measures. Studies have shown that accidents as injuries from road traffic burden individuals, national economies, and family members, even though they are underreported.[4],[40],[41] They significantly influence the economically active age group or those set to contribute to the family, society, and the population in general in low and middle-income countries.[20] There are a variety of ways that motorcycle accidents impact families. For example, the loss of a breadwinner, the costs of extended medical treatment, or the additional strain of caring for a family member injured by a road traffic accident drives many families deeper into poverty.[31],[42] Motorcycle-related accidents impact a country at the macro level, not just on its working population but also on families where breadwinners are most of the riders. Most adult survivors of road accidents suffer severe psychological and medical trauma and life disturbance.[14] Some have post-traumatic stress disorder, driving phobias, and anxiety or affective disorders associated with them. A correlation between the survival of a severe road traffic accident and poor results in mental health, especially post-traumatic stress disorder and major depressive disorder, has been reported.[19]

The cost of extended treatment, the loss of the primary breadwinner, funeral costs, and the failure of income due to a disability can drive a family into poverty in many low-income and middle-income nations and often in high-income countries as well.[43] Children are particularly affected by the process of impoverishment. Similarly, fatal accidents result in higher costs, including serious injuries, minor injuries, and property damage.[44] As reported in Nigeria,[45] the proportion of severely injured people who have a permanent disability is as high as 78%, comparable to the experience in Tanzania. Thus, the effect on the society of road traffic accidents is even more than what the economic loss suggests. Okebiro[15] argues that the outcome will plunge the family into poverty at the household level when the single bread earner dies in a crash or suffers a permanent disability because very few road users have adequate insurance to enable them to recover financially. If this public health problem is not curtailed through improving the knowledge and attitudes (among other factors) of road users towards safety measures, the rate of accidents may be further intensified.

The major limitation of this study is the difficulty in completing interviews with the respondents (riders) who were constantly on the lookout for passengers was the critical challenge faced during the study. However, questionnaires were primarily administered during off-peak when the Okada riders were less busy, enabling the researcher to overcome this limitation.


  Conclusion Top


This study discovered that a high proportion of motorcycle riders in Ado-Odo Ota LGA were not aware of some safety and protective measures. Regular training of the right attitudes towards road safety and preventive measures is essential for all riders and other road users. These actions will help reduce accident rates and consequently reduce RTCs’ medical and economic burdens. Therefore, it is recommended that riders be trained on road signs, speed limits, and other protective equipment. Also, billboards, signposts, and road signs should be made available on the roads to help the riders understand the right things to do.

Financial support and sponsorship

Nil

Conflicts of interest

There are no conflicts of interest.

Ethical consideration

The present study, the informed consent document, and any subsequent modifications were reviewed and approved by the National Health Research Ethics Committee of Nigeria vide their letter no. NHREC/01/01/2007–20/01/2021 dated 20 January 2021.



 
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