KENYA: UNCOVERING THE SOCIAL DETERMINANTS OF ROAD TRAFFIC ACCIDENTS. IN: CHALLENGING INEQUITIES IN HEALTH: FROM ETHICS TO ACTION

One of the burgeoning worldwide public health problems are road traffic accidents (RTAs), with a 1990 estimate of over 500,000 deaths and 10 million people injured or crippled per year. The forecast for the year 2020 raises it to third position, just behind heart disease and clinical depression. In developing countries although underreported, RTAs are rapidly becoming the leading cause of death and disability at rates far exceeding those in most of the developing countries. The rising number of RTAs in Kenya and the magnitude of associated deaths and injuries have raised public awareness and concern. This chapter, part of a larger study of RTAs in Kenya, discusses the contextual determinants of unsafe roads with a spcific focus on the matatu (privately operated minibuses). The study identifies some of the following factors associated with RTAs: vehicle factors such as seatbelts; human factors such as speeding, overloading, drunk driving, fatigue; and the physical environment such as rural/urban migration, road conditions, and weather conditions. The interplay among all those determinants takes place within the overreaching socioeconomic environment, insufficient and fragmented regulation of the matatu industry, absence of traffic management and road safety systems, and minimal participation of critical stakeholders: the matatu industry, the local authorities, and the public.