Targeted Interventions for Dangerous Driving in Low-Middle Income Countries: A Systematic Review

Abstract

Road traffic injuries are a leading cause of death in low and middle-income countries (LMICs), with over 90% of road fatalities occurring in these settings. Crash statistics are documented, but evidence on which demographics engage in dangerous driving remains fragmented, limiting interventions. This systematic review synthesised evidence on demographic patterns associated with dangerous driving in LMICs and assessed intervention effectiveness. PubMed, Google Scholar, TRID, and OECD iLibrary identified studies published between January 2021 and October 2025 examining dangerous driving and demographic characteristics. Screening followed PRISMA guidelines with narrative synthesis. Twenty-one studies from eighteen countries in South Asia and Sub-Saharan Africa were reviewed. Young adults (18-25 years) were most examined (57.1%), followed by adolescents (<18 years, 19.1%) and adults (26-45 years, 14.2%). Male and middle-income drivers, particularly young adults (18-25 years), were the highest-risk demographics. Aggressive, distracted, speeding, alcohol-impaired, and unlicensed driving were most prevalent. Intervention evidence was scarce: only six >studies (28.6%) reported interventions, while fifteen (71.4%) reported none. Interventions included multi-component programs (n=2), policy/legislative approaches (n=1), technology-based solutions (n=1), education and training (n=1), and context-specific measures (n=1). However, geographic concentration and socioeconomic underreporting prevent definitive conclusions, leaving policymakers with insufficient evidence for targeted strategies.