Motorcycle helmet quality and associated factors in Ghana: a cross-sectional study from Tamale Metropolitan area

OBJECTIVE: Helmets reduce serious and fatal injuries in motorcycle crashes; however, poor-quality helmets diminish protection. Ghana mandates the use of prescribed helmets, yet the country's law fails to specify what constitutes such a helmet. This study assessed helmet quality and the factors associated with owning a good-quality helmet. METHODS: A helmet assessment study was conducted in the Tamale Metropolis to evaluate the quality of motorcycle helmets. Motorcyclists who had helmets were recruited from public places, and their helmets were evaluated. Helmets were deemed to be of good quality if all assessment criteria were met, including a hard outer shell, an energy-absorbing layer, a comfort liner, a chinstrap, and at least one element of labeling. Data were summarized descriptively, and logistic regression was used to identify factors associated with owning a good-quality helmet. RESULTS: 607 helmeted motorcyclists were recruited for the study. Most (87%) helmets assessed were open-face. All helmets had hard outer shells; 95.9% had an energy-absorbing layer, 93.1% had a comfort liner, and 85.5% had a retention system. 41.9% had at least one of the four labeling components. The proportion of good-quality helmets was estimated at 34.7% (95% CI: 31.0-38.5%). A higher proportion of good-quality helmets were secondhand than those purchased new. Age, occupation, and place of helmet purchase were significantly associated with owning a good-quality helmet. Helmets purchased from general shopping centers (aOR = 2.61, 95% CI: 1.39-5.84), street vendors (aOR = 1.92, 95% CI: 1.03 to 3.66), and friends or colleagues (aOR = 3.34, 95% CI: 1.14 to 6.79) had higher odds of being a good quality than those supplied with the motorcycle purchase. Helmets given as gifts had lower odds of being a good quality than those supplied with the motorcycle. CONCLUSIONS: There is a high prevalence of poor-quality helmets, despite quality being the most frequently self-reported consideration in helmet purchase decisions. These findings suggest important gaps in both helmet regulation and motorcyclists' ability to identify helmets with adequate protective features. Developing national helmet standards and strengthening import controls, together with public education on helmet quality, proper use and fit, is essential to improve the protective value of helmet use in Ghana.