Pattern of road traffic accidents in Nepal: A cross-sectional record review.

BACKGROUND: Road traffic accidents (RTAs) are a leading cause of mortality and disability in Nepal. Despite the scale of the problem, comprehensive province-level analyses covering recent years remain limited. This study describes the pattern of RTAs across all seven provinces of Nepal over four fiscal years. DESIGN AND METHODS: A cross-sectional record review was conducted using RTA records obtained from Nepal Traffic Police departments across all provinces. Records spanning fiscal years 2020/21-2023/24 AD were analysed. Variables extracted included province and year of incident, urban/rural classification, driver age group, and vehicle type. Descriptive statistics were computed using SPSS version 20. Data for 2023/24 cover only the first five months of the fiscal year and should be interpreted with caution. RESULTS: A total of 74,929 RTAs were recorded over the study period. Annual totals increased from 20,640 in 2020/21 to a peak of 24,537 in 2021/22, before declining modestly to 23,597 in 2022/23. The Kathmandu Valley consistently recorded the highest accident burden (10,733 in 2021/22; 10,675 in 2022/23). Drivers aged 25-40 years accounted for the largest proportion of recorded driver involvements with known age (58,614; 50.2%), followed by those aged 16-25 years (34,886; 29.9%). Motorcycles and scooters were the most commonly involved vehicle type. Urban areas accounted for 30,401 accidents (59.0% of accidents with known location), though rural predominance was observed in Madhesh and Koshi provinces. CONCLUSIONS: RTAs in Nepal are concentrated among young and middle-aged adult drivers, predominantly involve two-wheeled vehicles, and exhibit marked urban-rural variation across provinces. These findings support age-targeted safety interventions, strengthened motorcycle helmet enforcement, and geographically differentiated road safety strategies.