Pedestrians’ adherence to road traffic regulations on the N1 Highway in Accra, Ghana

INTRODUCTION Pedestrian behavior and adherence to road traffic regulation is vital in the prevention and control of road traffic accidents (RTA) especially on highways in Ghana. We assessed pedestrians' adherence to road crossing regulations on the George Walker Bush (N1) Highway in Accra. METHODS We conducted a cross sectional study of pedestrians crossing the N1 highway from both sides of the road between 7:00 am and 11:00am. We observed all pedestrians using a checklist and interviewed 413 using a structured questionnaire. We collected data on basic demographics, and pedestrians' knowledge on road crossing (exposures). Data was, cleaned and analyzed using Epi-info version 3.5.4. Pearson Chi-square was used to assess differences in proportions for categorical variables. Binary logistic regression was used to test for association between pedestrian choice of route and exposures. RESULTS We observed (n = 1856) pedestrians crossing the road during the study period; 1155 (62.2%) males, 461 (24.8%) did not use the approved route(s). Majority 317(76.8%) were adults between the ages of 20-49, mostly males 265 (56.4%). Most people (92.7%) had at least basic education. AOR for sex (male) was 1.7(1.1-2.6), and regular use of Highway (always) was 0.4(0.2-0.8) at 95% CI. CONCLUSION One out of every 4pedestrians using the N1 Highway used an unapproved route. Majority of pedestrians who regularly cross the Highway at unapproved routes were males. We recommend vigorous public education and addition of more footbridges.