A longitudinal analysis of road traffic fatalities in Ghana, 2000–2022: trends, characteristics and associated factors

Background Road crashes remain a major public health issue, with low- and middle-income countries bearing a disproportionate burden. WHO road fatality rate estimate for Ghana is ranked among the top 15 countries worldwide. While studies using police-crash data have provided valuable insights into the burden of road fatalities, they rely on crude estimates. Age-standardised rates and their temporal changes over time are limited or lacking. This study estimates age-standardised road fatality rates and examines significant trends, characteristics, and associated factors in Ghana. Methods Data were obtained from the national crash database and annual crash reports. Age-standardised fatality rates (ASFR) were estimated per 100,000 population and case fatality rates per 1,000 casualties. The Joinpoint regression model was used to identify significant changes in trends, and the modified mixed-effects Poisson regression was used to identify associated factors. Results A total of 45,565 fatalities were recorded, with an average ASFR of 7.88 per 100,000 population. ASFR increased (AAPC = 0.52%), with three distinct periods observed: a rise from 2000 to 2011, a decline from 2011 to 2015, and a rise from 2015 to 2022. ASFR was higher among males (ASFR = 13.27) than among females (ASFR = 3.91). While pedestrian fatalities declined (AAPC = − 1.53%), motorcycle fatalities increased (AAPC = 13.13%). The risk of fatality was higher among males, pedestrians (RR = 2.91), older adults (RR = 1.40), rural residents (RR = 1.71), evening (RR = 0.25), night (RR = 1.55), weekend (RR = 0.04), and when 2 or more vehicles are involved in the crash. Conclusion ASFR increased overall, with a notable rise in motorcycle fatalities. Interventions such as enhanced enforcement of helmet use, improved rural infrastructure, and the adoption of safe-system approaches are urgently needed to reduce road fatalities in Ghana. Trial registration Not applicable.