The use of non-standard motorcycle helmets in low- and middle-income countries: a multicentre study


Williams Ackaah, CSIR-Building & Road Research Institute
Francis Afukaar, CSIR-Building & Road Research Institute
Williams Agyemang, CSIR-Building & Road Research Institute
Trinh Thuy Anh, Hanoi Department of Public Health
A R Hejar, Universiti Putra Malaysia
Ghaffar Abdul, Global Forum for Health Research
Gopalkrishna Gururaj, National Institute of Mental Health and Neuro Sciences
Hidalgo Solórzano Elisa, Centro de Investigación en Sistemas de Salud del Instituto Nacional de Salud Pública
Híjar Martha, Centro de Investigación en Sistemas de Salud del Instituto Nacional de Salud Pública
Adnan Ali Hyder, Johns Hopkins Bloomberg School of Public Health
Cristina Inclán Valadez, London School of Economics and Political Science
Subramaniam Kulanthayan, Universiti Putra Malaysia
Robyn Norton, The University of Sydney
Wilson Odero, Moi University
Eme T. Owoaje, University of Ibadan
Margie Peden, Injury Prevention and Disability
Krishnan Rajam, University Malaya
Junaid Razzak, Aga Khan UniversityFollow
Adesola Oluwafunmilola Sangowawa, University of Ibadan
Jawaid Shah, Aga Khan University
Pham Le Tuan, Hanoi Department of Public Health
RS Radin Umar, Malaysian Institute of Road Safety Research
Nguyen Thi Van Anh, Hanoi Department of Public Health
Marc Van der Putten, Thammasat University
Nitaya Vajanapoom, Thammasat University
Nuntavarn Vichit Vadakan, Thammasat University
Kaviyarasu Yellappan, Universiti Putra Malaysia
James Yu, The George Institute for Global Health

Document Type



Emergency Medicine



The use of non-standard motorcycle helmets has the potential to undermine multinational efforts aimed at reducing the burden of road traffic injuries associated with motorcycle crashes. However, little is known about the prevalence or factors associated with their use.


Collaborating institutions in nine low- and middle-income countries undertook cross-sectional surveys, markets surveys, and reviewed legislation and enforcement practices around non-standard helmets.


5563 helmet-wearing motorcyclists were observed; 54% of the helmets did not appear to have a marker/sticker indicating that the helmet met required standards and interviewers judged that 49% of the helmets were likely to be non-standard helmets. 5088 (91%) of the motorcyclists agreed to be interviewed; those who had spent less than US$10 on their helmet were found to be at the greatest risk of wearing a non-standard helmet. Data were collected across 126 different retail outlets; across all countries, regardless of outlet type, standard helmets were generally 2-3 times more expensive than non-standard helmets. While seven of the nine countries had legislation prohibiting the use of non-standard helmets, only four had legislation prohibiting their manufacture or sale and only three had legislation prohibiting their import. Enforcement of any legislation appeared to be minimal.


Our findings suggest that the widespread use of non-standard helmets in low- and middle-income countries may limit the potential gains of helmet use programmes. Strategies aimed at reducing the costs of standard helmets, combined with both legislation and enforcement, will be required to maximise the effects of existing campaigns.

Publication (Name of Journal)

Injury prevention

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.