A ‘safe systems’ approach for enabling traffic injury prevention in Nepal (SAFETrIP Nepal) This programme of research aims to improve collaboration between health and other agencies to reduce road traffic deaths and injuries in Nepal.

It is being conducted through a collaboration between the University of the West of England, Bristol UK and Kathmandu Medical College, Kathmandu, Nepal, together with; Safe and Sustainable Travel Nepal (a charity advocating for safer travel in Nepal), MIRA (a non-governmental organisation in Nepal that supports research), emergency care experts in Nepal and colleagues at Imperial College London.

This research is important because road traffic injuries are the 12th most common cause of death globally, and the leading cause of death in 5-29 year olds. Approximately 1.3 million people die and over 50 million people are injured in road traffic crashes each year, with over 90% of victims being from low- and middle-income countries. Nepal, a low-income country, has recently had a big road-building programme and there has been a large increase in vehicle ownership. However, without good road safety leadership, coordination and funding, the number of road traffic injuries have increased and there is no national ambulance service to provide prehospital care to those injured. Road traffic injuries are one of the most preventable causes of death, injury and disability. A ‘Safe Systems’ approach, in which all agencies work together to create an environment which keeps road users safe, has been shown to lead to significant reductions in rates of road traffic injuries.

Between 01/11/2022 and 31/10/2026 we will conduct three work packages that will support the development of a safe road system in Nepal and will map to two of the United Nations Sustainable Development Goals; 3.6 (halve global road traffic deaths and injuries) and 11.2 (provide access to safe, affordable, accessible and sustainable transport systems for all, and improving road safety). The work packages focus on: (1) Supporting leadership and action for road safety at local and provincial government levels; (2) Strengthening public transport safety (specifically bus travel); and (3) Improving the care of those with injuries following a traffic crash. A fourth work package will improve researcher’s awareness of how to keep research data safe whilst still maximising its use. The objectives of our four work packages are:

Work Package 1:
• To identify existing policies and programmes at local, provincial and national levels of government in Nepal that can be linked to evidence-based recommendations for safer road systems
• To understand the current reach and implementation of these policies and programmes
• To identify the barriers and enablers to further implementation of these policies and programmes
• To develop a toolkit for those working at local and provincial government level to help them improve road safety

Work Package 2:
• To identify the factors that influence how bus transport is currently provided in Nepal, and how those factors affect bus safety
• To establish how these factors affect the current provision of bus transport and which factors can best be used as levers towards safer buses and bus services
• To identify which established, cost-effective, interventions are needed to shift current practice and policy
• To generate agreement across sectors on recommendations to make bus travel safer

Work Package 3:
• To determine the health, social and economic impacts of being injured in a road traffic crash in Nepal.
• To understand the facilitators and barriers to optimal handover of road traffic injured patients from prehospital carers to hospital emergency department staff
• To establish stakeholder agreement on a best practice care pathway for road traffic injured patients to be used in hospital emergency departments

Work Package 4:
• To deliver five, seven-week online good data governance courses between 2023 and 2026
• To develop and make available training materials that enable the safe collection, use and storage of research data
• To strengthen the capacity for peer-to-peer learning on good data governance within and between low and middle-income countries.