Disparity of motorcycle helmet use in Nepal:Weak law enforcement or riders' reluctance?

Like many low- and middle-income countries, Nepal is experiencing a massive motorization, predominantly from increased use of motorcycles which is driving a surge in road-related injuries and fatalities. Motorcycles and their riders have been identified as a focal point for road traffic injury prevention measures. While helmet use is mandatory for both motorcycle drivers and passengers, fines for helmet non-use are only levied on drivers, not on passengers, and it is unclear how this unequal enforcement translates to helmet use rates in Nepal. Hence, a video-based observation on motorcyclists’ helmet use was conducted alongside a questionnaire survey on fatalism, perceived police enforcement, risk-taking personality, and perceived usefulness of helmets. For the observation and questionnaire survey, seven rural and urban sites were selected from all seven provinces of Nepal, representing varied populations, road environments, and elevations. The observation of the helmet use behavior of 2548 motorcycle riders revealed an alarming picture of helmet use in Nepal. While more than 98% of observed motorcycle drivers in Nepal used a motorcycle helmet, less than 1% of observed passengers did so. Interviews of 220 riders show that the absence of a fine for helmet non-use by passengers is accompanied by an unawareness of the traffic law, where only 11.8% of respondents knew about the mandatory helmet use law for passengers. Unhelmeted riders had a significantly higher attribution of road related crashes to fate, compared with riders that used a helmet. Results of this study can serve as an evidence base for revisions of Nepal's Vehicle and Transportation Management Act in regard to traffic rule enforcement and fines. They further show the global importance of comprehensive regulation on safety related behaviors of road users. The feasibility of more comprehensive enforcement is discussed against the background of helmet availability for passengers.