The rapid expansion of motor vehicle use in developing countries resulted in a sharp rise in road traffic–related deaths and injuries. The UN General Assembly recognized road deaths and injuries as a global epidemic since 2003. More than 90% of the 1.2 million people who die each year in traffic related crashes are from the developing countries in which more than 51% are vulnerable road users.

The Kurdistan region in Iraq has been chosen for this study where the number of registered vehicles has increased exponentially in the last decade, and the official number of fatalities in 2013 was 1,114. This number, however, is highly underreported;​ the actual figure of fatalities is estimated to be 100% more than the reported number according to World Health Organization. Pedestrians in the region are not separated from vehicles even on high speed roads, in front of schools, bus stops, parks and commercial areas. In addition, driving education and risk assessment is poor among drivers. A pre-study showed that only 5% of the current drivers in the largest city in Kurdistan, Erbil, know how to use a roundabout. Moreover, 0%, 1% and 12% could read and were knowledgeable about the signs of “One-way”, ”Give-Away” and“ No-Entrance” respectively. The driving test and training systems are inadequate and inconsistent in the cities of Kurdistan. The test are performed in an isolated and controlled environment separate and far away from the everyday traffic. Moreover, the road network is non-standard and is lacking alignment and signs.

This study evaluates current traffic safety conditions in Kurdistan, and then proposes a new strategy to change the current driving license test system to a more realistic and educational test that is fair and promotes safe traffic flow. The new approach, in this study, is based on a new standard driving test and training system based on the 4 E’s model which stands for:​ Engineering, Education, Enforcement, and Encouragement. The new proposed tests will be conducted on a limited, predefined, standardized and heavily monitored route within existing traffic environment.

This new testing system will focus on educating large groups of university students how to operate their vehicles more efficiently and safely. Moreover, the route within the existing road infrastructure that will be upgraded to standard and heavily monitored also allows licensed drivers, optionally or through an enforcement program, to retrain and experience driving on standard routes gradually leading to an improvement in drivers’ awareness. The standard route can also be used as a model and starting point to successively standardize the current road network and when constructing new roads.