Background In Vietnam, from 15th December 2007, the Government mandated all motorcycle riders and passengers to wear a helmet when travelling on a motorcycle. Helmet wearing among adults has been maintained at more than 90% since then, however in children, compliance has been a much greater challenge.

Methods Roadside observations at 16 randomly selected primary and secondary schools in 4 provinces were conducted in December 2009 and December 2010. Observations conducted on one weekday and one weekend day, not consecutively. Four time frames were used for observations being: 7:00–9:00, 10:00–12:00, 16:00–18:00 and 19:00–21:00.

Results 13 200 and 14 050 children 6–15 years of age were observed in 2009 and 2010 respectively. Majority of school children (64.2% and 68.9% in 2009 and 2010 respectively) did not wear a helmet when travelling to and from school. Lowest wearing was in Hanoi (16.9%) with Can Tho Province recording the highest (43.7%). Compared with 2009, compliance rate in HaNoi, Da Nang and Can Tho decreased. Only Yen Bai saw an improvement from 18.9% to 30.9% (p=0.000). Overall, wearing decreased significantly from 35.8% in 2009 to 31.1% in 2010 (p=0.000).

Policy Implications Despite the existence of helmet law for children, compliance has worsened. Public education for adults on the legal requirement to put a helmet on their child, as well as penalties for failure to comply, coupled with intensive enforcement by traffic police and schools is urgently required.