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Failure to use seatbelts is a major contributing factor to road fatalities. The use of seatbelts has been one of the most effective road safety measures ever implemented, saving more lives than any other intervention. The effectiveness of seatbelts depends upon the type and severity of the crash and the seating position of the passenger. Use of seatbelts can reduce the risk of death in a road crash by up to 50% for front seat and 25% for rear seat passengers. Seatbelts prevent being catapulted into the vehicle structure or ejected from the car. Passengers ejected from the car die in 75% of cases.

In low and middle-income countries, seatbelt usage rates are generally very low - especially on rear seats where seatbelts might not even be fitted. The use of child restraints in motor vehicles varies considerably between countries and is mainly confined to use in high-income countries.

Seatbelt legislation is an effective way to increase restraint use and reduce injuries. The mandatory use of seatbelts is also highly cost effective. Legislation on the use of safety restraints must be accompanied by strict enforcement in order to be effective.

Effective seatbelt programmes were identified by the World report on road traffic injury prevention as a proven and effective measure to reduce death and injury on the road. The road safety manual on seatbelts and child restraints was published in 2009 by the FIA, WHO, GRSP and World Bank. It provides advice and examples that lead to increased use of seatbelts and child restraints as safety devices at a national level. It is aimed at policy-makers and road safety practitioners and draws on experience from countries that have succeeded in achieving and sustaining high levels of restraint use. It includes recommendations for developing and implementing technical standards and legislation as well as advice on how to monitor and evaluate progress, and suggestions regarding other multidisciplinary measures.

The key principles and practical steps that the following manual presents can easily be adapted and made relevant to different contexts around the world. The modular structure of the manual means it can be read and easily adapted to suit the problems and needs of individual countries; it includes:

  • The need for seatbelts and child restraints
  • How to assess the situation in a particular country
  • How to plan and manage a seatbelt campaign
  • How to develop and implement interventions
  • How to evaluate the programme