The Formulation and Implementation of a National Helmet Law: A Case Study from Viet Nam/Formulation et Mise En Pratique D'une Loi Nationale Sur le Port Du Casque: Etude De Cas Du Viet Nam/Formulacion Y Aplicacion De Una Ley Nacional Sobre El Use del Casco: Case Practice De Viet Nam

Introduction Despite the reported magnitude of road traffic injuries, (1) various sources suggest official figures may underestimate the number of deaths by more than 30%. (2) As of January 2009, 27 million vehicles were registered in Viet Nam of which 95% are motorized two-wheelers, a figure that increased by an average 7680 new motorcycles each day in 2008. (1) The effectiveness of motorcycle helmets in preventing head injuries are well documented. (3) Successful examples include China (Province of Taiwan) (4) and Thailand (5) where reductions in head injuries of 33% and 41% respectively were reported after the introduction and enforcement of mandatory helmet laws. History of helmet legislation Despite the long history of motorcycle helmet laws in Viet Nam, low penalties and limited enforcement coverage made them largely ineffective, resulting in approximately 30% compliance. (6) A brief history of helmet legislation in Viet Nam is described in Table 1. Collaborative advocacy from many sectors came to fruition on 29 June 2007 when the Prime Minister, Nguyen Tan Dung passed into law a strategy that represented a dramatic strengthening of helmet wearing requirements. Coming into effect on 15 December 2007, Viet Nam's new helmet law required ALL riders and passengers to wear helmets on ALL roads without exceptions. (7) Loopholes Shortly after the introduction of the legislation, several loopholes that had the potential to reduce its effectiveness were identified. Most loopholes have subsequently been resolved or are in the process of being closed. First, the legislation omitted reference that required helmets to be correctly and securely fastened. Traffic police did not have powers to enforce unfastened helmets until November 2008 when riders and passengers with an unfastened helmet were penalized as if no helmet was worn. (8) While the new law required helmet wearing for all riders and passengers, existing legislation prevented children under 16 years from being fined. (9) Further, legislation did not make adults carrying children financially responsible when the children didn't wear helmets, effectively preventing enforcement of helmet wearing in children. The impact of this was seen in roadside surveys showing helmet wearing averaging 39% in children compared to more than 97% in adults. There are also ongoing challenges over widespread but unfounded beliefs that the weight of helmets increased children's risk of neck injury. (10) Draft legislative revisions have introduced a mechanism that will make adults financially liable when a child passenger under 16 does not wear a helmet. Availability and quality of helmets Past attempts at effective helmet legislation were hampered by quality standards that only included heavy, full-face helmets that the Vietnamese semi-affectionately called "rice cookers". In 2001, the standards were revised to make provisions for a tropical helmet that provided both a high degree of impact protection but was also lighter and more suitable to the tropical climate in Viet Nam. While revised standards provided a well needed boost to the public acceptability of helmets, the quality of helmets has the potential to limit the effectiveness of legislation. A survey in April 2008 by the Viet Nam Standard and Consumer Association found that up to 80% of motorcycle helmets on the market did not meet national standards. (11) In November 2008, the Ministry of Science and Technology introduced revised standards (QCVN2) that strengthened quality assurance requirements to limit market infiltration of substandard products. Enforcement of legislation The new law substantially increased penalties for non-wearing from 20 000-40 000 Viet Nam Dong (VND) (approximately US$1-2) under the 2007 legislation to 100 000-200 000 VND (US$ 6-12) per offence, (12) which represents more than 30% of the average monthly income per capita. …