Elsevier

Public Health

Volume 129, Issue 6, June 2015, Pages 818-821
Public Health

Short Communication
Taxi drivers' attitudes toward road safety in Pakistan

https://doi.org/10.1016/j.puhe.2015.03.022Get rights and content

Highlights

  • Taxi drivers represent a vulnerable group of road users, who are at an increased risk of motor vehicle crashes.

  • Most taxi drivers included in this study did not use seatbelts regularly.

  • One-third of taxi drivers were driving illegally, which suggests a lapse in the implementation of road safety regulations.

  • One-fourth of taxi drivers were sleeping for less than 7 h a day, which may increase the risk of motor vehicle crashes.

Introduction

Globally, more than 1.2 million lives are lost as a consequence of road traffic crashes, while, another 10 to 15 million people suffer serious injuries. Without appropriate interventions, this number is expected to increase by 65% in the year 2020 and the anticipated increase for developing countries may be even higher. In Pakistan, the incidence of road traffic crashes was reported at 15.1 per 1000 in 1997 with public transport occupants being the most common victims.1 Another study estimated the injury-to-fatality ratio in Pakistan to be 2.2:1, which was worse than that reported for Uganda, 15:1.2

A substantial amount of evidence has shown that motor vehicle crashes are predictable and preventable events. Human, environmental and vehicle-related factors interact in a dynamic fashion to culminate in such untoward incidents. Taxi drivers are known to be at a very high risk of motor vehicle crashes due to a number of factors including driver fatigue, sleepiness, occupational stress and distractive activities while driving. In Pakistan, taxis and other public transport vehicles have been reported to be the most common striking vehicle in motor vehicle crashes.3 Concrete statistics about the incidence of road traffic crashes among taxi drivers in Karachi—the most populous city of Pakistan—are not readily available. However, based on projections from the national injury survey of 1997, they are likely to be very high.2

Attitudes of taxi drivers toward road safety and their knowledge of traffic regulations are of considerable interest for public health professionals. Data regarding the attitudes of taxi drivers can allow the development and implementation of road safety programs that can influence drivers' attitudes and thereby reduce the incidence of motor vehicle crashes. However, little is known about the attitudes of taxi drivers toward road safety in Karachi and other cities of Pakistan. Therefore, in the present study, the aim was to determine the knowledge and attitudes of taxi drivers in Karachi, Pakistan.

An interview-based, cross-sectional study was performed on a sample of taxi drivers recruited in the city of Karachi, Pakistan. Convenience sampling was used to recruit taxi drivers from the major taxi stands of the city viz. Bahadurabad, North Nazimabad, New Karachi, Railway Station, Sohrab Goth, Malir Cantonment and Jinnah Airport. Sample size calculation was performed using RaoSoft® Sample size calculator (Raosoft, Seattle, WA). With a population size of 10,000, response distribution of 50%, confidence level of 95% and acceptable margin of error of 7%, the required sample size was estimated to be 193. Individuals residing in Karachi and operating a four-wheeled vehicle for hire for the purpose of a non-shared ride with at least 1-year experience were included in this study. The study protocol was approved by the Ethics Review Committee at Aga Khan University and written informed consent was obtained from all participants. Data were gathered using a structured questionnaire, which consisted of questions pertaining to demographics, driver characteristics, taxi characteristics, driver's knowledge about traffic rules and their attitudes toward those rules. For assessing drivers' attitudes, an abbreviated scale was developed using six items derived from the Error subscale of the Driving Behavior Questionnaire. Likewise, for the assessment of their knowledge, they were presented with pictures of some common traffic signs and they were subsequently asked about their meanings (Fig. 1). Statistical Package for Social Sciences (SPSS) version 20.0 (IBM, San Diego, CA) was used for statistical analysis. Frequencies were calculated for qualitative variables and Chi-squared (χ2) test for comparing qualitative variables. A total of 230 taxi drivers, who met the inclusion criteria, were invited to participate in the study. Of these, only 200 (86.9%) agreed to participate in the study and completed the interviews. All taxi drivers included in this study were male—a natural consequence of the male-dominated structure of the local society.

On average, taxi drivers were 40.1 years old with an average monthly income of PKR 11,507/- (Pakistani rupees) equivalent to about $114 USD (using a currency exchange rate of $1 USD equal to Rs. 100.68/- PKR). A decent mix of all major ethnic groups of Karachi were included in the study including Hindko-speaking (n = 73, 36.5%), Pathan (n = 57, 28.5%), Punjabi (n = 42, 21.0%), Sindhi (n = 12, 6.0%) and Baloch (n = 3, 1.5%) drivers. More than one-third of the study subjects admitted to smoking or chewing tobacco (n = 73, 36.5%), while another 30% (n = 60) reported using other addictive substances including Pan and areca-nut. This was in concordance with earlier reports from the region.4

About one-third (n = 65, 32.5%) of taxi drivers had not completed any formal education whatsoever. This may be a reflection of the low overall literacy rate in Pakistan, which has been reported at 53% for the population aged ≥10 years. Moreover, a significant proportion (n = 61, 30.5%) of study subjects were driving illegally (i.e. they did not possess an unexpired driving license issued by the government after passing a driving test). This reflects a lapse in the enforcement of traffic rules and regulation. Here, it should be noted that this study was based on self-reported data and these figures may well be an under-estimate.

In this study, 14.5% (n = 29) of taxi drivers were involved in self-reported accidents. Of these, five (2.5%) drivers reported more than one motor vehicle crash in the past year. Increased incidence of motor vehicle crashes has been reported in high-vehicle load areas where traffic rules are not observed strictly.5 Additionally, study subjects reported an average daily sleep of 7.6 h with 28.0% (n = 56) of respondents sleeping for less than 7 h a day. Driver sleepiness is a well-known risk factor for motor vehicle crashes and consequently, subjects who were sleeping for less than 7 h daily reported more motor vehicle crashes during the past year as compared to others (χ2 test, P = 0.03).

Most taxi drivers drove self-owned taxis (n = 105, 52.5%), while the rest drove either rented (n = 73, 36.5%) or company-owned (n = 22, 11.0%) taxis. A significant proportion of taxis (n = 91, 45.5%) were manufactured before the year 1984 and nearly half of the vehicles (n = 98, 49.0%) were not fitted with seatbelts. Vehicle crashworthiness is an important factor in the outcome of motor vehicle crashes. Blows et al. reported that vehicles constructed before the year 1984 had three times the chance of being involved in accidents.6 Moreover, most study participants (n = 183, 91.5%) were not using seatbelts regularly, which may have rendered them vulnerable to serious motor vehicle crashes.

Knowledge of taxi drivers in this study was assessed on the basis of correct identification of commonly used traffic signs (Fig. 1). Although most taxi drivers (n = 163, 81.5%) were able to identify most of these signs, younger drivers were found to have poorer knowledge (P = 0.001). Conversely, a higher educational status was predictive of better knowledge (P = 0.002). Although knowledge of vehicle drivers and road users does not directly influence the outcome of road traffic injuries, deficiencies in such knowledge are an indirect reflection of the enforcement of traffic regulations. Deficiencies in drivers' knowledge often result from the ability to bypass driving tests and the proper procedure for obtaining a valid license.

Attitudes of drivers were assessed by self-reported responses on a few selected items of the Driving Behavior Questionnaire. In general, a mixed response to these items was noted among study participants; however, it should be noted that drivers are known to produce ‘socially desirable’ responses in self-reported studies. Study participants reported that on average, they had 4 encounters with the traffic police every month. Moreover, almost two-thirds of participants (n = 120, 60%) reported that they had been issued tickets by the traffic police during the past year. Average number of tickets issued to these drivers during the past year was 3. All these findings suggest undesirable attitudes among taxi drivers. Self-reported risky driving behaviors and traffic rule violations have been associated with an increased risk for road traffic injuries.7

Knowledge and attitudes of taxi drivers regarding road safety that the authors report from Karachi, Pakistan, are similar to those reported from other parts of the world. Peltzer and Renner reported a high degree of risk-taking behavior among taxi drivers in South Africa.8 Similarly, in a sample of 3-wheeler taxi drivers from Sri Lanka, Akalanka et al. observed that young and less educated taxi drivers were more likely to be involved in high-risk driving behaviors.9 In their study, drivers with less than high school education were 3.5 times more likely to drive aggressively and high-school completers were 4 times more likely to bribe a policeman when caught violating traffic rules. In another study, risky driving behavior among taxi drivers was linked to workplace hazards, aggression and drivers' perceptions of management's commitment to health and safety.10 It can thus be deduced that the results of this study are comparable to those of most previous studies reported from developing countries.

Section snippets

Implications

In this cross-sectional study, the authors assessed the knowledge and attitudes of taxi drivers in Karachi, Pakistan. Karachi, being the most populous city of Pakistan, houses people of different ethnicities and racial backgrounds from all over the country. Being the world's tenth largest urban agglomeration, this city served as an ideal setting for conducting this study on taxi drivers. Although this study was conducted on a small sample of taxi drivers, it provides a reasonably good

Acknowledgments

The authors would like to acknowledge Dr Zafar Fatmi—Assistant Professor and Head of the Division of Environmental Health Sciences, Department of Community Health Sciences at the Aga Khan University—for his invaluable comments and critical appraisal of the study.

Ethical approval

The study was approved by the Ethics Review Committee at Aga Khan University, Karachi, Pakistan.

Funding

None declared.

Competing interests

The authors have no conflict of interests to disclose.

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