Helmet use among motorcyclists in Tamale, Ghana: prevalence and associated factors.

Motorcycle use has become crucial in Ghana, as it is the predominant mode of transportation in some parts of the country. Ensuring their safety is crucial in reducing the exponential increase in related fatalities. This study assessed helmet-wearing rates among motorcyclists (riders and pillion riders), non-standard helmet use and improper helmet use, and identified demographic, spatial and behavioural factors influencing helmet wearing in Tamale, Ghana. We conducted an observational study among 10,127 motorcyclists (7,147 riders and 2,980 pillion riders) in Tamale. Motorcyclists were observed at intersections, traffic lights, and sections of the road where they usually slow down. The prevalence of helmet use was estimated as proportions and 95% confidence intervals. Log-binomial regression was used to identify factors associated with helmet use. The prevalence of helmet use was 24.4% (95% CI: 23.6% to 25.2%). Among riders, the prevalence was 31.7%; among pillions, 6.9%. The prevalence further declines to 15.0% (95% CI: 14.3% to 15.7%) when improper use and non-standard helmets are considered. Helmet use was higher among males, older motorcyclists, weekday commuters, those in the central business district, and on highways. Riders with pillion passengers were less likely to wear helmets, and helmet use among pillion riders declined as their number increased. Findings underscore the need for regulatory action on helmet standards, targeted enforcement and pillion safety.