Curriculum-Based Road Safety Education as a Cost-Effective Strategy to Reduce Pedestrian Traffic Injuries in Bangladesh
1
Institute of Epidemiology Disease Control and Research, Dhaka, Bangladesh
2
Management Information System, Directorate General of Health Services, Dhaka, Bangladesh
3
CDC Foundation, Atlanta, GA 30308, United States
Popul. Med. 2026;8(Supplement Supplement 1):A1276
ABSTRACT
BACKGROUND:
Road traffic injuries (RTIs) are the 8th leading cause of death globally and the primary cause among youth aged 5–29 years. Bangladesh reports 18.6 deaths per 100,000 population, exceeding the global average. In 2024, 8,543 deaths and 12,608 injuries due to road traffic incidents generated USD $1.71 billion in economic losses (0.38% of GDP). Pedestrians account for up to two-thirds of road traffic fatalities. While road infrastructure and driving culture change is needed, education for pedestrians may reduce mortality in the interim.
OBJECTIVES:
To identify the most cost-effective policy intervention to reduce pedestrian road traffic injuries and deaths in Bangladesh.
METHODS:
We conducted decision tree cost-utility analysis with 10-year time horizon comparing two interventions against status quo: (1) curriculum-based road safety education for grades 1–10, and (2) quarterly police-based awareness programs in 21 high-risk sub-districts. Data from Bangladesh Road Transport Authority informed model parameters. Outcomes were measured in disability-adjusted life years (DALYs), with baseline 334,180 DALYs annually. Costs and DALYs were discounted at 5% annually. Incremental cost-effectiveness ratios (ICERs) were calculated with sensitivity analyses.
RESULTS:
Curriculum-based education was the dominant strategy, reducing DALYs from 5.77 to 0.95 per person (4.82 DALYs averted, 83.5% reduction) at incremental cost of USD $0.06 per person, yielding a negative ICER of -1.45 (cost-saving with superior effectiveness). Police-based awareness showed moderate benefits (DALYs reduced to 3.81) but was strongly associated with higher costs of USD$.09 and ICER of 3.78. Sensitivity analyses confirmed robustness.
CONCLUSIONS:
Integrating road safety education into national curriculum represents the most cost-effective, scalable strategy for reducing pedestrian RTIs in Bangladesh. This intervention aligns with Sustainable Development Goal 3.6 and offers a replicable model for low- and middle-income countries. Findings support an immediate, phased implementation through curriculum revisions, teacher training and classroom instruction, beginning in high-burden urban districts.
Road traffic injuries (RTIs) are the 8th leading cause of death globally and the primary cause among youth aged 5–29 years. Bangladesh reports 18.6 deaths per 100,000 population, exceeding the global average. In 2024, 8,543 deaths and 12,608 injuries due to road traffic incidents generated USD $1.71 billion in economic losses (0.38% of GDP). Pedestrians account for up to two-thirds of road traffic fatalities. While road infrastructure and driving culture change is needed, education for pedestrians may reduce mortality in the interim.
OBJECTIVES:
To identify the most cost-effective policy intervention to reduce pedestrian road traffic injuries and deaths in Bangladesh.
METHODS:
We conducted decision tree cost-utility analysis with 10-year time horizon comparing two interventions against status quo: (1) curriculum-based road safety education for grades 1–10, and (2) quarterly police-based awareness programs in 21 high-risk sub-districts. Data from Bangladesh Road Transport Authority informed model parameters. Outcomes were measured in disability-adjusted life years (DALYs), with baseline 334,180 DALYs annually. Costs and DALYs were discounted at 5% annually. Incremental cost-effectiveness ratios (ICERs) were calculated with sensitivity analyses.
RESULTS:
Curriculum-based education was the dominant strategy, reducing DALYs from 5.77 to 0.95 per person (4.82 DALYs averted, 83.5% reduction) at incremental cost of USD $0.06 per person, yielding a negative ICER of -1.45 (cost-saving with superior effectiveness). Police-based awareness showed moderate benefits (DALYs reduced to 3.81) but was strongly associated with higher costs of USD$.09 and ICER of 3.78. Sensitivity analyses confirmed robustness.
CONCLUSIONS:
Integrating road safety education into national curriculum represents the most cost-effective, scalable strategy for reducing pedestrian RTIs in Bangladesh. This intervention aligns with Sustainable Development Goal 3.6 and offers a replicable model for low- and middle-income countries. Findings support an immediate, phased implementation through curriculum revisions, teacher training and classroom instruction, beginning in high-burden urban districts.
| eISSN: | 2654-1459 |
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