Cultural factors and context-specific interventions for aberrant driving behaviours in LMICs: a systematic review

Despite growing recognition that aberrant driving behaviours contribute significantly to road traffic accidents in Low to Middle-Income Countries (LMICs), most interventions are adapted from developed nations without adequate consideration of cultural context. This systematic review examines how cultural factors influence aberrant driving behaviours and their incorporation into intervention design and effectiveness. Following PRISMA guidelines, 161 studies (2,367,804 participants) from 47 developing countries (2020–2025) were reviewed using narrative synthesis. Social norms (43.5%), risk perception (30.4%), and occupational culture (9.9%) were the primary cultural determinants. Asian studies more frequently addressed occupational culture and optimism bias, while African studies emphasised enforcement perceptions and fatalistic risk orientations. Cultural and behavioural approaches were the most common intervention type (25.47%), followed by policy strategies (14.91%). Only 28 studies (17.4%) provided quantitative effectiveness data, with community-based interventions reporting speeding reductions of 15–30% and seatbelt use increases of 20–40%. Evidence comparing culturally adapted versus non-adapted interventions remained sparse. Professional drivers (33.54%) and young drivers (8.07%) exhibited distinct cultural patterns requiring tailored approaches. Evidence quality was low to moderate, driven by cross-sectional designs, self-reported measures, and limited quantitative outcomes. Combining cultural adaptation with policy, enforcement, and community co-design offers the most promising approach to reducing aberrant driving in LMICs.