Thanks are given to the British Council for funding visits to Nigeria, to Dr Bill Brieger, without whom this paper would not have been possible, Mr Emmanual Adams for his help in Nigeria, Professor Keith Tones for comments on earlier versions of this paper and to my colleague Sally Foster. Many of the `answers' to road safety were present in theory at the training workshop on `Accidents and Safety Control of Mass Transit Operations in Nigeria' held in 1990 in Benin City (Bolade and Ogunsanaya, 1991). It is hoped that will education, girls will be allowed to remain in school until the age of 18. Lack of resources and of a co-ordinated response to the problem has been blamed for lack of progress in preventing road accidents in other African countries (Bezzaoucha et al., 1988). [Oladepo and Brieger (Oladepo and Brieger, 1986) have shown that professional drivers are 5 times more likely to have an accident than are drivers who do not drive for a living.]. Students will be able to describe the Road accidents have been recognized as a major public health problem in Nigeria for some time (Asogwa, 1978). (ed.) Bathing in boiling water results in many women being burned or disfigured; gishiri cut has resulted in vesicovaginal fistula in many young girls. Green, J. _Hill's Criteria of Causation This type of analysis has led to the production of the idea that health promotion is involved in a battle for the hearts and minds of the population, a struggle between a modern belief in lifestyle and an atavistic culture of `fatalism'. There are many gaps in knowledge that need to be filled through...research'. The choice of one's ori, or head/destiny, however, is perhaps not as fixed as this. Bastian, p. 216 (Bastian, 1992), notes that `witchcraft themes dominate popular discourse of all sorts' in Nigeria. It is impossible to estimate what percentage of deaths and injuries appear in the `official' statistics above for Igbo-Ora. Washing one's ori/head was an important ritual and potions were available also to rub onto one's ori. Basically, the causation approach is advocated by people who believe that the environment is largely predictable and that research, analysis and planning lead to rational decision processes and optimal outcomes. Causation is the "causal relationship between the defendant's conduct and end result". The influence of cultural perception of causation, complications, and severity of childhood malaria on determinants of treatment and preventive pathways. (1979) Yoruba Beliefs and Sacrificial Rites. In epidemiology the accepted model of disease causation requires the precise interaction of factors, mostly natural and behavioral, and conditions before a disease will occur [ 21 ]. Twenty informal interviews were carried out with local people at their homes; this was a purposive sample and all the respondents were women, as data were also being collected on reproductive health. However, `fatalism' may be a rational perspective in the social and economic circumstances, and who can judge whether there are gods or a God who predetermine people's fate? Data were collected opportunistically. Longman, London. It is frequently stated in the literature that many developing countries have insufficient data on accidents (Jacobs and Sayer, 1983; Mohan, 1997). Different cosmologies exist outside this culture, often described as `fatalist' by Western commentators and as obstructing change. In Ademuwagun, A., et al. Admission to three health care facilities for unintentional injuries. These postulates enabled the germ theory of disease to achieve dominance in medicine over other theories, such as humors and miasma. Igodan (Igodan, 1991) and Iyang (Iyang, 1991), including proper breaks for coach drivers and attention to shift patterns. These fundamental theories are likely to have a strong influence on the health behaviors of many patients/families served by CCHAP practices. Author information: (1)University of Ibadan. It is felt that these data under-represent accidents. INTRODUCTIONDisease is a dynamic process and it is just opposite tothe health. As seen above, the descriptions given for causes of accidents are not too helpful for health promotion purposes. In addition to different worldviews, the different levels of development also mean that solutions formulated in richer countries do not suit poorer countries. Bastian has written of the complexity of ideas about roads and pathways in colonial times as well as today, and of the Nigerian fascination with the evils on the road; `Most of the people I knew agreed that night-time travel in Nigeria was tantamount to suicide because of all the dangerous forces, material and otherwise, that made their way along the darkened roads' [see Bastian, p. 102 (Bastian, 1992)]. Data taken from admissions records to the hospital and private clinics (the three facilities which treat accidents) show a similar dominance of RTAs. (1989) The IMF, the World Bank and the African Debt: 2. Levels of accidents from available records are noted and people's ideas about accident prevention are discussed. Unintentional injury rates in developing countries have increased to become a significant cause of premature death and morbidity (Bradley et al., 1992; Zwi, 1993; Murray and Lopez, 1994). Changing these cosmologies or worldviews may not fit with the ethic of paying due respect to the cultural traditions of the `target group'.  |  Tones, K., Tilford, S. and Robinson, Y. Of researchers, but it is just opposite tothe health ) Debates and Dilemmas in health. And beliefs of traditional healers and sometimes villagers go to the concept of predestination, which may `! Had had accidents during their training ( Osinubi et al., 1985 ) l, Katz, J. Brieger! 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