Background Road traffic accidents are a leading cause of death and disability in the Republic of Botswana. Fatality rates increased by 383% (per 10 000 vehicles) from 1975–1998, with recent estimates indicating a 50% higher fatality rate per population than the global average. Few studies have systematically examined the characteristics of crashes in Botswana with a view of guiding road safety policy.

Aims To document the characteristics and severity of crashes in Botswana so as to inform road safety priorities.

Methods A retrospective analysis of the National Traffic Police Data of Botswana for the period 1994–2008 inclusive was performed.

Results During the 14-year study period, there were 235 456 recorded crashes and over the period, the number of crashes increased 116%. The increase in fatality crashes and serious injury crashes was, however, 18% and 0.9%. Overall 2.3% of crashes involved a fatality crashes, 6% were serious injury crashes, and 16.8% were minor injury crashes; the majority were property damage only crashes (74.8%). Of the fatality crashes, 31.8% involved a pedestrian (25%≤9 years), followed by run-off-road crashes into a fixed object (29%) and rollover crashes (11.5%). Passengers account for approximately 40% of all persons killed.

Significance The results highlight the need for road safety countermeasures aimed at addressing the high level of pedestrian crashes, particularly young children. Analysis of crash types also indicates a need for improved seat-belt use and speed enforcement. The high number of rollover crashes and run-off-road crashes highlights a key role for infrastructure investment in policy development.