A systematic PRISMA review of traffic crashes, risk factors, determinants of risk behaviors, and interventions among motorcycle taxi riders

Abstract

Motorcycle taxi riders (MTRs) are a disproportionately high-risk occupational group for road traffic crashes (RTCs) and injuries (RTIs), raising significant public health, social, and economic concerns in low- and middle-income countries (LMICs). This review is the first PRISMA-compliant synthesis focused exclusively on MTRs, distinguishing them from commuters or delivery riders. It synthesizes evidence on reported crashes, risk factors, behavioral determinants of risky riding, and safety interventions. A PRISMA-compliant search across four databases yielded 651 articles, of which 56 met the inclusion criteria. Reported crash rates varied between 25.8 % and 78.6 %, with common injuries including fractures, head trauma, and soft-tissue damage. The main risk factors were speeding, alcohol and substance use, mobile phone distractions, and non-use of helmets, often exacerbated by demographic pressures such as youth, low income, and limited education. While most included studies were conducted in Africa, research from South Asia (Pakistan, India, Bangladesh, Vietnam) highlights risky motorcycling. However, it rarely isolates MTRs, underscoring a persistent geographic and occupational gap. Effective interventions included a Nigerian health education program that raised safety awareness from 21 % to 82 % and Uganda’s SafeBoda initiative, which reduced crashes by 39 %. The evidence underscores the urgent need for tailored interventions that combine rider education, behavior change strategies, protective gear, enforcement, and policies addressing income insecurity and informality. These efforts are crucial not only for reducing morbidity and mortality but also for limiting wider socioeconomic costs in LMICs.