Prevalence and determinants of helmet use among commercial motorcyclists in rural Ghana: Afadzato South district in perspective

Road traffic accidents (RTAs) are a significant cause of morbidity and mortality worldwide, with increasing trends in Sub-Saharan Africa (SSA), highlighting the need for better preventive measures. These underscore the vulnerability of motorcyclists and the critical need to address motorcycle safety to reduce the burden of RTAs. Therefore, this study investigates helmet use among commercial motorcyclists in rural Ghana, analysing the prevalence and predictors of this road safety and health behavior. The study’s theoretical rationalisation came from Icek Ajzen’s Theory of Planned Behavior (TPB), which posits that attitudes, subjective norms, and perceived behavioral control shape behavior. Leveraging a TPB-tailored questionnaire, a cross-sectional survey was conducted with 205 commercial motorcyclists in the Afadzato South District, Volta Region; logistic regression analysis helped establish the determinants of helmet-wearing behavior. Findings revealed that only 39.0 % of motorcyclists consistently wore helmets. Key predictors included gender, age, marital status, education, and perceptual factors. The regression analysis indicated that female motorcyclists and those aged 45+ were significantly more likely to use helmets. Notably, the absence of an additional helmet for passengers significantly decreased usage, whereas discomfort associated with helmet use constitutes a major predictor. Additionally, TPB constructs of beliefs, perceptions, and attitudes towards safety were linked to lower helmet adoption. These results highlight critical areas for intervention, suggesting that targeted safety campaigns should address discomfort through context-appropriate helmets, promote positive beliefs, and ensure helmet provision for passengers. The study also emphasises collaborative efforts among stakeholders to enhance helmet use and improve safety among commercial motorcyclists.