Helmet use and associated factors among motorcyclists in the Association of Southeast Asian Nations: prevalence and effect of interventions

The Association of Southeast Asian Nations (ASEAN) is a collaborative group of 10 countries (Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand, Vietnam) located in South-East Asia. In most ASEAN countries, the majority of road users are motorcyclists. Globally, among the 20 countries with the greatest rate of motorcycle deaths per 100,000 population, six ASEAN countries are included. A review found that across ASEAN countries, a significant proportion of motorcycle drivers did not wear a helmet; this ranged from 11-20% in Indonesia, 35-66% in Cambodia, 25-97% in Laos, 24.2-67.2% in Malaysia, 44.2%-56.3% in Thailand, and 10-70.1% in Vietnam, while rates of non-use of helmets were higher in motorcycle passengers, ranging from 25% in Vietnam, 38.1% in Malaysia, 48-80% in Indonesia, 72-81% in Thailand, and 91% in Cambodia. The effect of the introduction of helmet use legislation for drivers and passengers was evaluated in Thailand and Vietnam, and in both evaluations, significant increases in helmet use were found compared to prior the legislation in both countries. Multisectoral or community intervention programmes in localised areas and schools in Laos and Thailand also lead to significant increases in motorcycle helmet use. The effectiveness of the enforcement of helmet laws in ASEAN countries was rated an average of 7.2 (on a scale of 0 to 10, where 0 is not effective at all and 10 is highly effective), with the lowest (5) in Malaysia and the highest (10) in Brunei, Dar es Salaam. Stricter enforcement of mandatory helmet laws for two-wheeler riders (both drivers and pillion-riders) are needed.