Delivery motorbike crash injuries in South Africa : a scoping review and call for policy reform

Abstract

BACKGROUND : Road crashes continue to cause morbidity and mortality in South Africa, with motorbike accidents causing serious musculoskeletal injuries. The rapid growth of e-hailing delivery services has increased the number of motorbike drivers on congested urban roads, increasing their vulnerability to crashes. AIM : This scoping review examined South African motorbike delivery driver road traffic crashes, injury patterns, economic implications, and related regulatory gaps. SETTING : South African public healthcare and trauma systems. METHODS : A systematic search of PubMed, Scopus, and Web of Science was performed for studies published between 2020 and 2025. The search strategy combined Medical Subject Headings and Emtree terms pertaining to motorbikes, delivery services, and injury-related outcomes. Eligible English-language studies were included, with data extracted using a standardised collection sheet and synthesised descriptively. RESULT : The review comprised three studies with 133 participants with 161 orthopaedic injuries. The studies conducted in Cape Town, Tembisa, and Pretoria consistently reported that delivery motorbike crashes result in high-energy trauma predominantly affecting young, male riders. The predominant injuries consisted of severe long-bone fractures and polytrauma in patients. Across sites, most patients required surgical intervention, and intensive care unit (ICU) admissions were necessary in the most severe cases. The treatment of these patients incurred substantial costs. Expenses were predominantly influenced by surgical procedures, prolonged hospitalisation, ICU treatment, and implants. CONCLUSION : Motorbike delivery drivers in South Africa face disproportionate health risks and financial insecurity because of traffic-related injuries. Contribution: This review highlights important policy and legislative gaps and supports reforms aimed at improving occupational protection and road safety for delivery drivers.