Chitetezo: Improving adolescent road safety and reducing road traffic collisions.

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Up to 1.4 million people are killed each year as a result of road traffic collisions. Over 90% of these collisions happen in low and middle-income countries. Between 20 to 50 million people are injured but survive, often with life-changing disabilities. Young people are particularly vulnerable road users. In fact, young people are more likely to die from a road collision in Africa than any other single cause. Within Africa, Malawi has one of the highest rates of road traffic collision in the region.Current approaches to dealing with road traffic safety are not working. To date, almost no research has been undertaken looking at community-based ways of reducing road traffic collision with young people in low and middle-income countries.We have been working to improve road safety in Malawi. In this study we will assess whether an intervention called Chitetezo (a Malawian phrase meaning "Protected") improves young people's road safety and reduces the number of road traffic collisions. We co-developed Chitetezo in collaboration with two young Malawian artists and the school management of one school in Blantyre, Malawi. Chitetezo involves young leaders working with other young people to improve understanding about road safety and their human right to live in a safe environment. The young people create large picture murals as part of this process: one which depicts the current road environment in their local community and its dangers; and another mural that shows the personal and environmental changes they would like to occur and believe would lead to reductions in road traffic collisions. The young people then host an exhibition to which they invite members of the local community and local government. During the exhibition, the young people present their murals and lead the adults in a discussion of the problems they have observed, as well as some potential solutions. The idea is that the discussions between young people and adults will lead to decisions being made to improve their local road safety infrastructure. We tested Chitetezo in one school in Blantyre, and found that young people enjoyed taking part and found it fully acceptable. Furthermore, there is some evidence that road safety infrastructural changes to improve road safety occurred 3 months later, as a direct result of the intervention being delivered.This study Chitetezo will be run in 10 other schools around Blantyre. We will collect data to measure whether or not it makes a difference to the road safety behaviour of young people and the local road safety infrastructure. We will speak to young people about their experience of taking part in the intervention, or learning about it happening in their school. We will work together with young people collecting information on the environmental impact of the road infrastructure and young people's road safety behavior, both before and after the intervention takes place. We will also carry out an analysis of all the data on road collisions that are routinely collected by the Malawian Road Traffic Safety Service. This data will help us understand whether or not the intervention has made a difference to the number of road traffic collision over time.