Mandatory helmet legislation and the print media in Viet Nam

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Accident Analysis and Prevention 41 (2009) 789–797

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Mandatory helmet legislation and the print media in Viet Nam

Peter S. Hill a,∗, Anh D. Ngo a, Tuan A. Khuong a, Huong L. Dao c, Hanh T.M. Hoang b,Hang T. Trinh b, Lien T.N. Nguyen b, Phong H. Nguyen b

a School of Population Health, The University of Queensland, Herston Road, Herston 4006, Australiab Health Strategy and Policy Institute, 138 Giang Vo Street, Hanoi, Viet Namc World Bank, Viet Nam Office, 63 Ly Thai To Street, Hanoi, Viet Nam

a r t i c l e i n f o

Article history:Received 25 November 2008Received in revised form 18 March 2009Accepted 14 April 2009

Keywords:Viet NamMotorcyclesHelmetsPrint mediaPolicyPrevention

a b s t r a c t

With motorcycle ownership high and rising in Viet Nam, and motorcycle riders vulnerable to both fataland non-fatal injury, the re-introduction of mandatory helmet legislation in 2007 has been a priority forthe Vietnamese government. The paper uses a qualitative analysis of web-based versions of the eightmost popular newspapers in Viet Nam to track reporting over four phases of the implementation of thelegislation, identifying codes and constructing the dominant themes of the media coverage. The studydocuments the justification and promotion of the legislation, and the mechanisms for preparing for itsimplementation at a national and local level, developing solutions and encouraging the replication ofsuccessful strategies. It records opposition and obstacles to helmet use, and concerns raised around thequality of helmets purchased. In return, the press notes the response of the market in innovative solutionsto these problems. With the successful implementation of the legislation, the functions of the print mediain promulgating and promoting the legislation, together with the reporting of ongoing resistance to theprocess, serve to enable a dialogue between the State and population around expressed concerns. Inhighlighting quality control of helmets as a key issue, the media have identified a potential ongoing rolein monitoring the state’s initiative in reducing the road toll from traumatic brain injury in motorcyclists.

© 2009 Elsevier Ltd. All rights reserved.

1. Introduction

1.1. Road trauma in Viet Nam and motorcycle helmet legislation

Road traffic trauma is the leading cause of fatal and non-fatalinjuries in Viet Nam, with the country’s first National Viet NamMulti-centre Injury Survey (VMIS) in 2001 providing an estimateddeath rate of 26.7 per 100,000 population (DHYTCC, 2003). In 2006,21.2 deaths per 100,000 population were reported as due to trafficinjury (Huyen, 2008). Estimates suggest that 95% of road vehiclesin Viet Nam are motorcycles, with ownership of motorcycles risingrapidly from 104.6/1,000 population in 2001 to 224/1,000 popula-tion in 2007 (Peden et al., 2004). Motorcycle users in Viet Nam arethe most vulnerable to road traffic injuries, with the VMIS show-ing that motorcycle users suffered 51.3% of all non-fatal road trafficinjuries, a rate of 733.5 per 100,000 population (DHYTCC, 2003).

∗ Corresponding author. Tel.: +61 7 33655432; fax: +61 7 33655599.E-mail addresses: [email protected] (P.S. Hill), [email protected] (A.D.

Ngo), [email protected] (T.A. Khuong), [email protected] (H.L. Dao),[email protected] (H.T.M. Hoang), [email protected] (H.T. Trinh),[email protected] (L.T.N. Nguyen), phong the [email protected] (P.H. Nguyen).

Traumatic brain injury from motorcycle collisions has thepotential to impact on whole families, precipitating catastrophicexpenditure and consequent household poverty (Hanh et al., 2008).Internationally, mandatory motorcycle helmet use is regarded asthe single most effective approach for the prevention of head injuryand traumatic brain injury among motorcycle users (Liu et al.,2008). Helmet use reduces the incidence, severity and mortalityrates of traumatic brain injury in motorcycle collisions, with 20–45%reductions reported for fatal and serious head injury (Servadei etal., 2003).

Helmet legislation was first introduced in a Ministry of TransportCircular in 2000 (Ministry of Transport, 2000), making motorcyclehelmet use compulsory on specified road sections, mainly thosedesignated as national roads. In 2001, the government of Viet Namintroduced the National Policy on Accidents and Injury Prevention,which included the target of reducing road traffic deaths from 14 to9 per 100,000 vehicles by 2010 (Hung et al., 2006), and upgraded thehelmet legislation to apply to all roads (Ministry of Transport, 2001).As indicated in Table 3, which summarizes the factors relating tothe failure of implementation of this legislation, enforcement ofthese circulars was irregular, and compliance poor, and media sup-port for the implementation of the policy equivocal. In 2003, a newcircular reduced the requirement for helmets to only those roadssignposted for compulsory helmet wearing (Ministry of Transport,

0001-4575/$ – see front matter © 2009 Elsevier Ltd. All rights reserved.doi:10.1016/j.aap.2009.04.001


790 P.S. Hill et al. / Accident Analysis and Prevention 41 (2009) 789–797

2003). Fines imposed for breaching these regulations were insignif-icant, set at 10,000–20,000 VND (US$0.62–1.241), and there was nofine for wearing helmets that did not meet regulation standards(Hung et al., 2006).

In 2007, the Government introduced Resolution number32/2007/NQ-CP (Government of Viet Nam, 2007), a consolidation ofthe previous laws on road traffic safety, requiring the introductionof mandatory motorcycle helmet use on all roads, phased in overa three-month period from 15 September to 15 December 2007.Implementation was overseen by the National Traffic Safety Com-mittee (NTSC). With a seven year history of resistance to helmets,dismissed colloquially as “rice cookers” (Hung et al., 2008; GlobalRoad Safety Partnership, 2008), and indifference to existing leg-islation (Adam Fforde and Associates, 2008), the almost completecompliance astonished even the Minister of Transport and Chair-man of the National Traffic Safety Committee, Mr Ho Nghia Dung(Saigon Giai Phong, 2007a).

The success of the implementation was dependent on a complexof political will, leadership and coordination, the availability of suit-able helmets and the support of international donors for advocacyand mass media promotion and the production of helmets (GlobalRoad Safety Partnership, 2008; Craft et al., 2008; McDonnell et al.,2008). Concerned not to repeat its earlier failures, government useof the media was deliberate and strategic. The policy, legislativeframework and the schedule of penalties were announced over thethree-month period of implementation, and quality control issueswere addressed as these emerged. Local implementation activitieswere modeled, and the population counseled on helmet purchaseand use. But motorcycle ownership in Viet Nam is a symbol of lib-eralization, financial and personal independence (Truitt, 2008) anddespite government ownership, the complex factors that influencethe print media in Viet Nam resulted in coverage was quite mixed,and included surprising levels of resistance to the legislation.

1.2. The media and the state in Viet Nam

Buse et al. (2005) argue that the media – print and electronic –make a significant contribution to policy agenda setting, function-ing as sources of information, propaganda and socialization—givinglegitimacy to government functions, and promoting acceptance ofdominant political and economic frameworks. The actual mech-anisms for achieving change are less clearly understood (Otten,1992), with the media acting to both shape policy agendas, and theircoverage in turn shaped by them. Much has been made of the impor-tance of media advocacy in identifying health issues, framing themand maintaining focus (Wallack, 1994). However, the predictabilityof outcomes is not always clear (Paalman, 1997), and the impor-tance of health issues may not be reflected in their media coverage(Chapman, 1998). In turn, column inches of reporting do not nec-essarily correspond with the impact of coverage (Harrabin et al.,2003).

The media in Viet Nam however, have an unusual positioningin relation to the implementation of public policy that arises fromtheir financial dependence on advertising and popular demand, atthe same time as being fully owned by State agencies (Marr, 1998).The organizational structure of the media in Viet Nam ensures thatall lines of control can be traced to the Communist Party, throughgovernment ministries, provincial and municipal governments andmass organizations. With legislation reliant on a hierarchy of imple-mentation through these same Party and government structures,reporting in the news media reinforces its use as a vehicle of the

1 Currency conversion rates are set at US$1.00 = 16,208.5 VND, as at 15December 2007 (OANDA.com The Currency Site. Accessed 9 Jan 2009 at:http://www.oanda.com/convert/classic).

state to “inform and educate citizens but also to inundate themwith official positions. . .and to mobilize people to do what gov-ernment, party, and mass organization leaders require” (Kerkvliet,2001). Consequently, in Viet Nam, analysis of the media providesa reliable means of tracking policy pronouncements, with printmedia linked directly to government sources of legislation andregulation (see Table 1). Paradoxically, this complex “network ofcriss-crossing horizontal and vertical lines of control” between theparty and the various government agencies and mass organiza-tions responsible for the media, allows considerable diversity ofpositions and perspectives (Heng, 2001; Kerkvliet, 2001). Rapidsocio-economic change has contributed further to this. The 1986

economic liberalization policy of Ð�oi Moi (‘renovation’) with itsdismantling of collective agriculture, introduction of banking andcurrency reforms, growth of the private sector and engagementwith international financial markets and the international media,has substantially increased social awareness (Witter, 1996). Despite

state control, the implications of Ð�oi Moi, and the vigorous inter-nal political dynamics, the decentralization of authority, social andcultural diversity ensure that a spectrum of political positions findexpression, including overt opposition (Heng, 2001).

This paper uses content analysis of the print media coverageof the 2007 re-introduction of mandatory motorcycle helmet leg-islation to undertake three tasks. Firstly, to identify and examinethe key themes of the news coverage identified through the con-tent analysis; secondly to present these in a structure that reflectsthe reported ‘narrative’ of implementation; and finally, to exam-ine the functions of the print media in the broader context of thissuccessful campaign, by triangulating news coverage with our ownobservation and available policy analyses.

2. Methodology

Researchers selected the eight highest circulation daily newspa-pers in Viet Nam for analysis. The newspapers are published by theViet Nam Communist Party and various government authorities,including the Ministries of Police, Information and Communica-tion, and Science and Technology, and represent both national andprovincial interests, as well as addressing differing demograph-ics, including youth through the Communist Youth Union and theYouth Association of Ho Chi Minh (Table 1). All newspapers pro-vide electronic editions, with Vietnamnet and VNexpress exclusivelyweb-based.

As the introduction of the policy was phased incrementally from15 September (when mandatory helmet use was applied to stateemployees, and national roads) to 15 December 2007 (when hel-mets were required for all riders, on all roads), four one-monthperiods were selected to examine trends in reporting during theprocess of implementation: pre-implementation (15 August–14September, 2007); early implementation (15 September–14 Octo-ber, 2007); late implementation (15 November–14 December,2007); post-implementation (15 December, 2007–14 January,2008). The patterns of reporting frequency are included in Table 1.

Newspaper web-site search engines were used to identify allarticles using the term mu ba�o hi�em (helmet) in all editions overthese periods. These include editorials, news reports, opinion andinformation, together with government news releases, but do notinclude advertisements or letters to the editor. A total of 721 newsreports was identified for analysis, using a content analysis pro-cess informed by Chapman (1998) and Paalman (1997). Followingan initial overview of the articles, the research team met to discussbroad themes, and to discuss trends in reporting over the four one-month periods (Table 1). Two researchers (LNN and PHN) enteredeach article into the Atlas.ti Qualitative Analysis Software program(AQDAS, 2008), independently coding content for primary codes,


P.S. Hill et al. / Accident Analysis and Prevention 41 (2009) 789–797 791

Table 1Print media articles pre-, during and post-implementation of mandatory helmet legislation, Viet Nam.

Newspaper Source Distribution Pre-implementation Early implementation Late implementation Post-implementation

Cong An Nhan Dan Ministry of Police National Not available Not available 11 20Lao Dong Viet Nam Labor Federation National 45 27 32 32Nhan Dan Communist Party National 23 26 11 8Saigon Giai Phong People’s Committee of HCMC Ho Chi Minh

City48 25 29 25

Thanh Nien Communist Youth Union National 10 16 13 15Tuoi Tre Youth Association of Ho Chi Minh National 38 32 26 25Vietnamnet Ministry of Information and

CommunicationInternet 37 30 17 12

VNexpress Ministry of Science and Technology Internet 18 18 19 33

Totals 219 174 158 170

with multiple codes possible per articles, depending on content. Anopen approach to coding was adopted. Their preliminary findingswere presented to the research team and following discussion, thecodes were clustered into themes, adding themes that had emergedduring coding. A consensus was reached by the research team onthe themes, and coding standardized. Earlier codes were re-codedwhere necessary to reflect the agreed themes. Following furtheranalysis and discussion, a final thematic analysis was developed.Key themes have been combined where appropriate for the pur-poses of this paper, and the linkages between headings, themesand codes shown in Table 2. Quotations that illustrate the key the-matic issues and the titles of referenced newspaper reports weretranslated into English for the convenience and understanding ofEnglish speaking readers.

News coverage does not present independent, objective data(Chapman, 1998) though it does provide important insights intohow events are represented publicly. In order to locate the mediaanalysis in the broader context of this recent and previous failedlegislation, the content analysis of the print media has been tri-angulated with a policy analysis of evaluations by independent

(McDonnell et al., 2008) and other stakeholder sources (Asia InjuryPrevention Foundation, 2008; Craft et al., 2008; Global Road SafetyPartnership, 2008), together with the authors’ observation andanalysis. The findings have been integrated into the discussion andare summarized in Table 3.

3. Findings

The following section represents the findings of the con-tent analysis of all relevant print media articles published inthe eight selected newspapers, during the three-month incre-mental implementation of the mandatory helmet legislation inViet Nam. The frequency and pattern of reporting between thepapers varied over the period of implementation, as shown inTable 1. The pre-implementation period showed the greatest fre-quency of publication as newspapers met their obligations toannounce the legislation and its implementation details, and asconcerns were immediately raised regarding issues of helmetquality and the opportunistic promotion of helmets that did not

Table 2Section headings and qualitative analysis themes and codes, with frequency of codes by phase of implementation.

Section headings Themes Codes Implementation phase

Pre- Early Late Post-

Section 3.1.1 Political directives Central policy pronouncements 48 17 20 12Local application of policy 46 17 29 19

Promotion and persuasion Helmet promotion 33 38 18 214Communication/education 10 3 25Practical guidance on choosing, wearing 13 16 2 0

Section 3.1.2 Implementation Barriers to implementation 4 1 18 18Punishment for infringements 10 12 10 23Incorrect wearing of helmets 0 0 0 20Solutions proposed/reported for implementation 42 15 2 2

Section 3.1.3 Resistance to legislation Non-compliant behaviors/resistance 16 22 0 27Questioning of evidence for implementation 1 2 2 5

Attitudes to legislation Supportive of legislation 14 8 28 22Neutral 0 0 2 0Resistant to legislation 19 29 17 33

Section 3.1.4 Helmet quality Counterfeit 49 10 6 1Smuggling/illegal import 7 0 0 5Approved helmet brands 42 6 1 1Unmet quality standards 58 12 7 9Helmets for children 0 0 4 8

Quality control measures Descriptions of current quality control 74 36 35 5Proposals for quality control 10 4 5 3Quality control difficulties 10 5 0 0

Section 3.1.5 Market response to legislation Supply/demand of helmets 69 13 14 8Cost/affordability of helmets 32 4 19 5Services: Lockers, safe-keeping, decoration 43 15 9 13

Section3.1.6

Benefits of the legislation Reported outcomes of legislation 1 2 3 21Estimated benefits of legislation 6 8 9 25

Other Assorted codes 13 0 0 0



Table 3Factors influencing implementation of mandatory helmet legislation in Viet Nam, 2001 and 2007 (Sources: Hung et al., 2006; Adam Fforde and Associates, 2008; Craft et al.,2008; Global Road Safety Partnership, 2008; McDonnell et al., 2008).

Factors influencing implementation 2001 2007

Political support Limited political support Prime Minister and Party strongly supportiveLack of clear policy leadership Minister of Transport policy championNTSC recently formed Strong, active NTSCFragmented support from government, provinces and massorganizations

Unified government and mass agency support

Uncoordinated, early international support Critical mass of international agency support

Legislative program Lack of comprehensive evidence for legislation Strong evidence justifying legislationIncremental, uncoordinated regulation Comprehensive, coordinated legislation and regulationUnclear, contradictory messages Single consistent messageQuality standards limited Quality control infrastructure developed

Quality standards revised and extended to “tropical”designs

Enforcement issues Enforcement dependent on local authorities Universal commitment to enforcementFines insignificant Fines higher than helmet pricesLimited police coverage Mobilization of police and civil inspectors for enforcementInsufficient instruction to comply Clear instruction to complyWhole legislation package introduced once withoutsufficient preparation (e.g. helmet supply, publiceducation, human resources)

Enforcement increased incrementally through severalsequential steps

Proper preparation for implementation (e.g. helmet supply,public education, human resources)

Poorly coordinated and weak media education campaign Intense media education campaign, using public rolemodels and celebrities

Anticipated barriers not identified for effective solutions Anticipated barriers identified, followed by effectivesolutions

Helmet promotion and facilitation ofhelmet use

Limited or no promotional activities for helmets Intense promotional activities for helmets: e.g. freehelmets for the needy, children, helmet advertisements byhelmet manufacturers.

No subsidy for helmets Subsidized helmets for government employeesStorage issues not available Market, employers mobilized to solve storage issuesAesthetic issues not considered Rates reducedLimited appropriate helmet designs available Designs introduced suitable for tropical climate and

aesthetic preferencePersonalization encouraged

meet standards. Most key issues were covered over all peri-ods, including justifications for helmet use and promotion of thelegislation, resistance to the legislation, problems during imple-mentation, the response of the market and negotiating solutions.The post-implementation period saw an understandable surgein coverage of the success of the intervention and its predictedbenefits.

3.1. Key themes in the media coverage

Over the course of implementation of the legislation several keythemes emerged and were developed in the print media coverage.The themes are presented in a sequence that broadly follows theimplementation ‘narrative’, though specific themes may have beenreferred to during different phases of implementation. They reflectthe early promotion of the law and its implementation, but withrecord resistance to the legislation reported throughout the fourperiods. Early concerns around the theme of helmet quality werefollowed by state quality control responses. The market joined gov-ernment agencies in ensuring the availability of helmets, but alsopersonalizing them. The final theme reflects the completed imple-mentation, with the benefits of the legislation reported or projected(Table 2). Coding for thirteen articles did not fit with any identifiedtheme.

All the content presented in these findings is sourced from theprint media reports, and needs to be read as reports of evidenceand events, subject to the biases of the media, rather than inde-pendently verified data. As the media are state owned, however,data presented coincides closely with state authorized sources ofstatistics and other information.

3.1.1. Justification and promotion for the legislationThe pre-implementation month saw the highest volume of arti-

cles justifying the proposed legislation, as the various ministriesand state agencies met their obligations to inform the population ofthe policy. Press reports from government and international author-ities, copied often verbatim in differing newspapers, were bluntaround the exponential growth in motorcycle ownership and theescalating cost of motorcycle related trauma to Viet Nam: “In VietNam, traffic accidents kill an average of 35 people and injure 60others every day” (Nhan Dan, 2007a); “Every year traffic accidentskill more than 12,000 people” (Tuoi Tre, 2007a). International com-parisons and statistics (Vietnamnet, 2007a) were invoked by theNTSC to challenge current perceptions: “Wearing helmets is a nor-mal practice in a developed society, where people value their lives”(VNexpress, 2007a). Political leaders – the Prime Minister, DeputyPrime Minister and Minister of Transport (also chair of the NTSC) –were prominent in reports progressively updating the legislation,as were representatives of mass organizations such as the YouthUnion. The Asian Injuries Prevention Foundation (AIPF) president,Mr. Greig Craft, impressed journalists by wearing a helmet to hispress conference (Saigon Giai Phong, 2007b).

While the heaviest coverage came from papers associated withthe Viet Nam Communist Party and the Ministry of Informationand Communication, all papers communicated the clear politi-cal commitment to change. With both government and the Partynow endorsing the legislation, the policy arguments were framedconsistently in three ways: firstly, as personal protection: “Whenan accident happens, only the helmet will be broken, instead ofyour head” (Tuoi Tre, 2007b,c); secondly, as social action: “Wear-ing a helmet helps reduce social loss and burden, protect happiness



for thousands of families, save thousands of lives, and contributeto economic growth” (Saigon Giai Phong, 2007c); and thirdly, associal obligation, with fines now raised to 100,000–200,000VND(US$6.17–12.34), equivalent in cost to an approved helmet, andschools, government departments and offices instructed to enforcenecessary change:

“Besides, schools have also coordinated with parents not to givechildren motorbike driving licenses, and worked closely withthe districts to check and strictly punish those who violatethe regulations. In addition, the schools also have to educatepupils about the traffic law. . . The Hanoi Culture and Informa-tion Department has been assigned to increase communicationcampaigns on the street about safety helmet wearing and installpanels with information about punishment. This must be com-pleted before October 21” (VNexpress, 2007b).

This prescriptive approach was tempered by more persuasivecoverage, with articles assisting motorcyclists to understand spe-cific requirements of the legislation, for example, helmets forchildren or pillion passengers. Particularly in the initial phases ofthe campaign, articles provided information on appropriate choiceof helmets and preferred brands, showing how to identify the offi-cial hologram and certification number, how to select helmetsthat fit their head size and correctly wear their helmet (Tuoi Tre,2007b,c; Nhan Dan, 2007b).

Reporters used “human interest” narratives to underline the pro-tection to families offered by helmets, as in the case of a Dong Anhegg vendor who transports her eggs over 20 kilometers of highwayto downtown Hanoi. Her concern was for her dependent school agechildren and farmer husband: “I wear a safety helmet to ensuresafety so that I can do my business not only for myself, but also formy husband and children” (Nhan Dan, 2007c). The cost of ignoringhelmet advice was echoed in the anguish of one grieving mother:“This morning before he left, I told him to wear his safety helmet buthe refused. He said that traffic police will only check that tomorrow,don’t worry. . .” (Vietnamnet, 2007b).

3.1.2. Preparation for implementationFor legislation in Viet Nam to be effectively implemented,

it requires support for regulation, promotion and enforcementfrom the Party structure, government ministries, provincial andmunicipal authorities and the ‘mass organizations’. Preparationfor implementation across all levels of the political system wasreported, with newspapers highlighting the activities of their spon-sors. The Communist Party Nhan Dan announced that politicalcommitment to the legislation was strong, with the Prime Ministerpublically charging the two responsible ministers (Police, Trans-portation), the general directors of media agencies, and Chairmenof the Provincial People’s Committees to intensify communicationand educational activities, promising strict enforcement of the hel-met legislation from December 15 (Nhan Dan, 2007d). Reportingrecognized the collaborative NTSC as the primary vice for govern-ment action, generating solidarity of commitment between keyministries, and coordinating the resources of the ministries andsupportive international agencies. With the legislative process inViet Nam requiring tiers of regulation implemented at each levelin order to operationalize government legislation, the reporting ofinitiatives by popular papers such as the Viet Nam Labor Federa-tion’s Lao Dong or the Youth Association’s Tuoi Tre was intendedboth to profile the extent and diversity of helmet promotion activi-ties, and to provide examples for other agencies to copy (Lao Dong,2007a):

“In HCM City, Danang and Hanoi cities, helmet wearing festi-vals were organized with some games where the players wouldwin gifts if they performed well. The games included painting,

sketching, assembling transport safety models, song contests,etc. The key objective of the games was to raise awarenessof wearing helmets for parents and their children” (Tuoi Tre,2007d).

People’s Committees launched initiatives, and at festivals inmajor urban centre, free helmets were distributed to “disadvan-taged students who have excelled in their studies” (Tuoi Tre, 2007d;Lao Dong, 2007b). University students were mobilized to make hel-mets more attractive:

“For just about 40,000 - 50,000 VND more, you’ll have a nicelooking helmet. Decorating helmets with colorful pattern hasbecome a trend for many young people. Seizing this opportunity,many students at the Hanoi Architecture University and ArtsUniversity have offered services to decorate helmets” (Tuoi Tre,2007e).

The reporting of more regulatory approaches provided a coun-terbalance: papers reported government cadres instructed to wearhelmets (Nhan Dan, 2007e), and security guards in some officesrecording the names of those not wearing safety helmets and refus-ing them entry (Tuoi Tre, 2007f). In major cities such as Hanoi, DaNang, and Ho Chi Minh City, the press confirmed that monitor-ing cameras were installed at some check-points, underlining thepolice commitment to enforcement. Just prior to final implemen-tation, the government slogan “From December 15, not wearing ahelmet: immediate fine, no more reminders” appeared on majornewspapers (Cong An Nhan Dan, 2007a).

The issues of enforcement were prominent in the print media,with traffic police mobilized to “remind” riders to wear helmets(Lao Dong, 2007c), and themselves put under pressure to set a con-stant example (Tuoi Tre, 2007g). Reports editorialized, or expressedthe concerns of unnamed “citizens” at the incapacity of the policeto enforce the legislation. Significant non-compliance was expectedduring implementation, even with all police forces mobilized (NhanDan, 2007f,g) and civil inspectors authorized to fine offenders(Thanh Nien, 2007a). The VNexpress speculated: “maybe the policewill be deployed at T-junctions or intersections, but each one hasto manage thousands of motorbikes. How could they handle all theoffenders?” (VNexpress, 2007c). Compounding this were reportsquestioning the complex procedure required for the payment offines, requiring offenders to present at the State Treasury duringlimited office hours—with predictions that the lengthy queues wait-ing to pay fines would overwhelm processing capacity (Thanh Nien,2007b).

3.1.3. Resistance to the legislationDespite the concerted government campaign, and the print

media’s instrumental role in presenting the legislation, reportingthe initiatives and mobilizing community responses, dissatisfac-tion and resistance were reported throughout the implementationperiod. Reports presented as personal commentary were common:nine percent of all articles quoted “local citizens” – frequentlynamed – as either supporting or opposing the legislation. Earlyreports re-voiced the common aesthetic objections to helmets:“Wearing a helmet is unfashionable. With young females, nobodycan see the beauty of their made-up face and stylish hair”(VNexpress, 2007c; Vietnamnet, 2007c). Helmets “looked stupid”(VNexpress, 2007c). They were hot and heavy, restricted vision andhearing, were inconvenient, difficult to store and likely to be stolen(Tuoi Tre, 2007h). Cost was described as an issue, but overlaid onthe cost was uncertainty around quality. Motorcyclists reportedtheir preferences for uncertified helmets at 40,000–80,000 VND(US$2.47–4.94), aware that good quality helmets would be morethan 150,000 VND (US$9.25) (Tuoi Tre, 2007i). Even an expen-sive motorcycle did not justify an expensive helmet, suggested one



owner, unconvinced that quality could be guaranteed, regardless ofprice (Thanh Nien, 2007c).

The very high compliance rate following the final implemen-tation date 15 December 2007 was reported as driven by a desireto avoid fines, rather than for the protection helmets offered: “Iwear a helmet only to avoid police stopping and fining me” (ThanhNien, 2007c). Incorrect helmet wearing was conspicuous – a fourday study in Hanoi estimated 90% of helmets were not correctlyworn (Tuoi Tre, 2007j). Reporting of inappropriate helmet use wasfrequently ambiguous, with a sense of being “cool” implicit in theinfringement. Riders were observed carrying their helmets untilthey encountered a police check point, failing to buckle the chin-strap, or leaving the strap too loose, wearing caps under theirhelmets or wearing their helmets the wrong way round (Saigon GiaiPhong, 2007d). In response, the press reported fines for incorrectwearing of helmets raised to match fines for not having a helmet atall (Thanh Nien, 2008).

3.1.4. The question of helmet qualityThe initial announcement of the proposed legislation was imme-

diately countered by reports of concerns regarding quality, with 156articles on quality equaling the 150 promoting the legislation inthe pre-implementation month (Table 2). Coverage focused on theavailability of counterfeit helmets, often smuggled from China, withquestions around which brands met standards, and concerns onquality control. While motorcycle riders were represented as largelycomplying with the requirement to purchase helmets, equivoca-tion around the quality of helmets undermined the value of helmetwearing: “One of my friends was killed in an accident riding amotorbike. Though he wore a helmet, it failed to protect his head,as the helmet broke and one fragment pierced his forehead. Maybethe helmet was of low quality” (Tuoi Tre, 2007k). Early reportingfrom Hanoi’s premier trauma hospital, VietDuc, raised concernsaround the ineffectiveness of poor quality helmets, despite overallreductions in head injuries (Vietnamnet, 2007b):

“on average 20 head injury patients were admitted daily. Thisnumber is not lower than in the mid year when fewer peoplewore a helmet. Importantly, many people who wore a helmetstill got head injuries” (VNexpress, 2007e).

From pre-implementation, legitimate question lines continuedto develop around quality: imports of sub-standard helmets, coun-terfeits of popular brand-names, the use of inappropriate materials(Tuoi Tre, 2007l; Nhan Dan, 2007h). Reports in the Saigon pressconfirmed inspections by the Department of Science and Tech-nology in Ho Chi Minh City that found 78% of checked samplesdid not meet Vietnamese standards (Saigon Giai Phong, 2007f).Availability of helmets for children was limited, and reported com-ments from clinicians surprisingly questioned the value of helmetsin children under 14 (currently exempt from the legislation), theheadlines declaring they were “dangerous in children under 3 yearsold” (VNexpress, 2007f). Response from the government was swiftand widely communicated in the media: an Inter-sectoral SteeringCommittee for Helmet Quality Control was established under theauspices of the Ministry of Science and Technology; certificationdetails were disseminated (Tuoi Tre, 2007b,c); lists of manufactur-ers meeting or not meeting standards were published (Tuoi Tre,2007m; Saigon Giai Phong, 2007f); escalating prices controlled andinspection and legal interventions increased (Thanh Nien, 2007d).Reputable brands offered complimentary injury insurance up to100 million VND (US$61.70) per case with their helmets (Tuoi Tre,2007n).

3.1.5. The market responds to facilitate helmet useWhile the early phase of implementation focused on political

press releases and advice through government agencies, newspa-

pers also highlighted the broader need for services to facilitatehelmet use. The lack of public storage facilities left motorcycliststhe unenviable choice of high charges or risking theft, leading toconflict in motorcycle parking areas: “There is no space for the hel-met in schools, markets, shopping centers, or offices. Many are veryangry when motorcycle keeping services refuse to keep helmets orcharge a very high price” (Cong An Nhan Dan, 2008). In the finalstages of implementation an accommodation was reached, withmotorcycle parking attendants reported to be directing clients howbest to secure their helmets to their bikes, and reducing holding feesfrom 2,000 VND (US$0.12) to 500 VND (US$0.03) or, in some cases,

no charge. In the spirit of Ð�oi Moi, helmet locks and boxes werequickly made available at reasonable costs to prevent theft. Sev-eral news outlets reported helmet containers imported from Chinaor Taiwan, but noted that the high cost, 300,000–600,000 VND(US$18.51–37.02) – up to four times the price of a certified helmet –was a deterrent (VNexpress, 2007d; Lao Dong, 2007d). The marketwas reported as responding to complaints around the unattractive-ness of helmets by diversifying its choice of helmets, and offeringto decorate them: “high quality, fashionable and personalized”(Saigon Giai Phong, 2007e). While winter hat sales dropped, facemasks and cloth caps for wearing under helmets responded toincreased demand (Saigon Giai Phong, 2007c).

3.1.6. Celebrating the benefits of the legislationDespite the significant persisting cloud around the quality of

available helmets, the reports of almost complete compliance withthe legislation, in urban and rural communities, suggested anovernight transformation. “The percentage of people wearing hel-mets was nearly 100%,” one Hanoi traffic policeman was quoted asexclaiming, “I would not have thought the people would implementthe law so well. The first day was so perfect!” (Thanh Nien, 2007e).

The Minister of Transport was “jubilant” when interviewed(Saigon Giai Phong, 2007a). Motorcycle fatalities and injuries werereported by the Ministry of Health to have fallen (Thanh Nien,2008), and the Wonderpark tourism and recreational centre wascelebrating with a 20 m Christmas tree – decorated with motorcy-cle helmets – with “Christmas God Father” himself also wearinga helmet! (Thanh Nien, 2007f; Cong An Nhan Dan, 2007b). Themedia reflected on the unprecedented outcomes of the campaign,highlighting the commitment of all levels in the political hierar-chy, and their own role: “This success would be largely due tointense and comprehensive education and communication activ-ities involving all levels of the political system. The contributionof media would also be significant” (Thanh Nien, 2007g). An edi-torial in Tuoi Tre (2007o) noted the importance of a central policymessage that was simple, direct, and comprehensible: “Wearinghelmets is mandatory when riding motorcycles”. It argued that theintense communication campaign, with the print media an activecontributor, had shown the importance of the intervention and thegovernment’s determination. Strong leadership and positive rolemodeling in the media had shown political commitment to helmetsat the highest level—and determination to enforce the legislation(Tuoi Tre, 2007o).

4. Discussion

This paper has presented an account of the 2007 mandatoryhelmet legislation in Viet Nam, as published in the print media,analyzing the key themes reported over the implementation period.Over one year later, it is clear that the campaign has been success-ful in terms of helmet compliance. To what extent that success isdependent on the contribution of the print media is less clear, and isa task arguably beyond the ambit of this paper, though the analysisdoes provide insight into the functions of the media in this process.



For neighboring developing countries considering the implementa-tion of mandatory helmet legislation, it is useful to locate this printmedia coverage in the broader context of the successful campaign,while acknowledging the limitations of available sources.

4.1. Lessons from the 2007 implementation process

The success of the 2007 mandatory helmet legislation, as pre-sented by the print media, can triangulated from a number ofcorroborating sources. The NTSC itself has confirmed estimatesof 99% compliance for helmet wearing and a reduction in trafficfatalities of 14.27% in the first quarter of 2008 (which includesthe Tet Vietnamese New Year festivities) compared with the pre-vious year (Thai, 2008). Academics from Viet Duc Hospital, thekey trauma hospital for the northern region of Viet Nam, havereported a decrease in both traffic trauma and deaths from trau-matic brain injury (Chinh et al., 2008). Independent analyses havebeen commissioned (McDonnell et al., 2008) and the key interna-tional stakeholder organizations have published commentary (AsiaInjury Prevention Foundation, 2008; Craft et al., 2008; Global RoadSafety Partnership, 2008). Combining these sources with our ownobservations, and discussions with involved colleagues, we havesummarized the key reasons identified for the overall success ofthis campaign, compared to the failed 2001 legislation (Table 3).

National legislation in Viet Nam requires extensive collaborativeregulation through relevant ministries, provincial governments andmunicipalities for effective implementation (Conway, 2004). In thecase of the 2001 mandatory helmet law, this was largely ignored(Craft et al., 2008; Adam Fforde and Associates, 2008), with sub-sequent legislation focusing on national highways and specifiedroutes undermined by irregular signage, inadequate fines, incon-sistent enforcement and easy circumvention of the requirements(Hung et al., 2006; McDonnell et al., 2008) (Table 3).

Key international advocates for road safety argue that a com-bination of high level government and Party endorsement, policyleadership and coordination from the NTSC were critical to thelegislation’s success. International stakeholders supported withadvocacy, mass media promotion and the production and distri-bution of helmets (Global Road Safety Partnership, 2008; Craft etal., 2008). The fragmentation of the 2001 legislation was avoidedby the simultaneous completion of the necessary legislative pack-age – including quality standards – implementation regulation andorganizational directives, realistic fines and an adequate enforce-ment capacity. The consistent, unqualified requirement for all ridersto have helmets on all roads was effectively communicated in themedia, and supported by celebrity role models. The simultaneous,universal change to helmet-wearing dispelled much of the anxietyaround being “different” (Asia Injury Prevention Foundation, 2008).Public-private partnerships to produce attractive tropical helmetdesigns contributed, as did the mobilization of the market to solvelocal problems of storage, and “value-add” with decoration (Craftet al., 2008). Free distribution of helmets to the needy, and subsi-dization in the workplace eased the economic burden of purchasinghelmets, and increased fines provided a necessary counterbalance(Khanh et al., 2008).

4.2. The media and policy change

Media advocacy for public health has an established position,particularly in tobacco control, but also in gun control, traffic injury,alcohol and substance abuse and more recently, childhood obesity(Chapman and Lupton, 1994; Shelov, 1995; Wilson, 2007). In traf-fic injury prevention, mass media campaigns have been evaluatedfor theory-based approaches to speeding reduction (Stead et al.,2005); tested for drinking and driving message recognition in targetaudiences (National Highway Traffic Safety Administration, 2004);

and systematically reviewed for their effectiveness in reducingalcohol-related crashes (Elder et al., 2004). Media coverage has beenanalyzed for the ways in which arguments for and against restric-tions for young drivers are framed (Blows et al., 2005), and the roleof the media in supporting voluntary local council recommenda-tions for bicycle helmet use in Sweden has been documented (Nolénand Lindqvist, 2002). However, no previous academic publica-tions tracing the implementation of mandatory helmet legislationthrough the print media have been identified.

4.3. The print media and mandatory helmet legislation in VietNam

The focus of this paper has been the print media coverage of theimplementation of the 2007 mandatory helmet legislation in VietNam. While the content analysis is able to examine the key issuesreported by the press to the population of Viet Nam, it does notprovide a basis from which the contribution of the print media canbe objectively evaluated. However, the data provided in this studydoes enable us to identify the key functions provided by the pressmedia as part of the implementation process, and to examine these.

The first of these functions is characteristic of government-owned media in a socialist state: the promulgation of governmentpolicy, commencing with the announcement of the legislation andits implementation schedule. With legislation in Viet Nam requiringa coordinated cascade of circulars, regulations and organizationaldirectives (Conway, 2004), this political function of the press isassumed—but as shown by previous experience, not sufficient toguarantee successful implementation. What was conspicuous inthis study was the evidence of the iterative communication of polit-ical resolve, and a united commitment at all levels of Party andgovernment to implementation.

The second function has been the promotion and interpretationof the legislation, offering advice and guidance, and reporting localresponses to the legislation, showcasing innovations and success-ful applications of directives that in turn stimulate imitation andcompetition. With the endorsement of the Party and mass organiza-tions, the media has played a key role in reporting local solutions toshared problems—subsidizing costs, identifying quality standards,selecting appropriate designs, decorating and personalizing, resolv-ing storage issues.

The third function, the reporting of resistance to the legisla-tion, reflects the emergent liberalization of the media in Viet Nam,a product of decentralization and diversity within state owner-ship (Heng, 2001). Despite the 2001 experience of an unsupportivemedia, the reporting opposition to the legislation was well estab-lished in the pre-implementation phase and has been allowed topersist throughout. The relief expressed by Ho Nghia Dung, Minis-ter of Transport and Chair of the NTSC reflected genuine uncertaintythat the government’s concerted efforts would succeed:

“The result was a nice surprise to many people. Before Decem-ber 15, Ho Nghia Dung, Minister of Transport and Chairman ofthe National Traffic Safety Committee was very worried aboutthe implementation level of the Government’s Decision 32 onmandatory helmet wearing. He said ‘The awareness of a cer-tain group of the population about the benefits, importance andstrictness of the Decree 32 was low. Among them, some evendisagreed with the government’s decision and refused to imple-ment it.’ But after the first day, the high percentage of peoplewearing the helmet made the minister happy. ‘A new cultureis being formed!’ said Minister Ho Nghia Dung.” (Saigon GiaiPhong, 2007a)

The sustained reporting of resistance may have contributed tothe government’s awareness that it could not assume compliance,consolidating support and motivating constant reinforcement of



strategies. But it also appears to have opened up spaces throughthe media where the state could dialogue with the population,and where the concerns of the citizen could be acknowledged.Arguably, a “new culture” has been formed. Questions over qualityresulted in the publishing of approved brands and quality controlreviews; skepticism over the capacity of police to enforce fines wasanswered by the recruitment of civil officers to assist; ill-informedprofessional commentary on helmets for children was rebuffed;complaints around the aesthetics of helmets or the cost of storageprompted reports of solutions.

As a result, the media now has a claim to a continuing role inthe policy dialogue, monitoring government responses to the mostcritical issue of this campaign: the high proportion of substandardhelmets purchased and currently worn. This is an issue that requiresongoing surveillance and vigilance, and the newsprint is now wellplaced to provide a public surveillance function, publicly collatingand recording reported deaths from motorcycle related trauma, andplacing pressure on the government to maintain enforcement ofthe legislation, and address the ongoing issues of quality control,correct helmet use, and the provision of appropriate helmets forchildren.

Acknowledgements

The authors wish to acknowledge The Atlantic Philanthropieswho funded the research as part of the Evidence for Health PolicyProject (VINE), Viet Nam.

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Mandatory helmet legislation and the print media in Viet Nam

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