Background and objective:
Road traffic injuries (RTIs) and deaths constitute a serious preventable global public health problem. Our objective is to analyze time trends of age-standardized mortality rates and disability-adjusted life years (DALYs) due to RTIs in 23 Middle East and North Africa (MENA) countries; and to assess the correlation between countries’ implementation of best practices for road safety recommended by the World Health Organization, their income-level, and RTI burden.

Methods:
Time trend analysis over 17 years (2000–2016) was conducted using Joinpoint regression. An overall score was computed for each country to assess the implementation of best practices for road safety.

Results:
Mortality significantly decreased (p-values<0.05) in Qatar, Oman, Kuwait, Morocco, Iran, Lebanon, Tunisia, and Jordan. In most MENA countries, DALYs increased; however, they significantly decreased in Iran. Overall, the computed score varied widely among the MENA countries. In 2016, no correlation was identified between the computed overall score and mortality and DALYs. Furthermore, the country-income level was not associated with RTI mortality or the computed overall score.

Conclusion:
Countries in the MENA region are at varying levels of success in reducing the burden of RTIs. During this Decade of Action for Road Safety 2021–2030, MENA countries can achieve optimal road safety by implementing road safety measures that are customized for the local context such as law enforcement and public education. Other focus areas for improving road safety in the region are building capacity in sustainable safety management and leadership, improving vehicle standards, and addressing gaps in areas such as child restraint use.