State of pedestrian road safety in Uganda: a qualitative study of existing interventions

Child pedestrian crossing behaviour and associated risk factors in school zones: a video-based observational study in Kampala, Uganda

BACKGROUND

Pedestrian crashes, often occurring while road crossing and associated with crossing behaviour, make up 34.8% of road casualties in Uganda. This study determined crossing behaviour and associated factors among child pedestrians around primary schools in Kampala, Uganda.

METHODS

We conducted a cross-sectional study in 2022 among 2100 primary school children. Data on their crossing behaviour were collected using video recordings from cameras staged at the crossing points of 21 schools. We estimated prevalence ratios (PR) with their corresponding 95% CIs using a modified Poisson regression model for the association between unsafe behaviour and the predictors.

RESULTS

The prevalence for each of 5 unsafe child pedestrian behaviour was 206 (25.8%) for crossing outside the crosswalk, 415 (19.8%) for failing to wait at the kerb, 238 (11.3%) for failing to look for vehicles, 361 (17.2%) for running and 235 (13%) for crossing between vehicles. There was a higher likelihood of crossing outside the crosswalk when an obstacle was present (adjusted PR (aPR) 1.8; 95% CI 1.40 to 2.27) and when children crossed alone (aPR 1.5; 95% CI 1.13 to 2.06). Children who crossed without a traffic warden (aPR 2; 95% CI 1.40 to 2.37) had a significantly higher prevalence of failing to wait at a kerb.

CONCLUSION

These findings reveal the interaction between child pedestrians, vehicles and the environment at crossings. Some factors associated with unsafe child pedestrian behaviour were the presence of an obstacle, crossing alone and the absence of a traffic warden. These findings can help researchers and practitioners understand child pedestrian crossing behaviour, highlighting the need to prioritise targeted safety measures.

Driver yield and safe child pedestrian crossing behavior promotion by a school traffic warden program at primary school crossings: A cluster-randomized trial

OBJECTIVE

To determine the effect of a school traffic warden program on increasing driver yield and safe child pedestrian crossing behavior in Kampala, Uganda.

METHODS

We designed and implemented a school traffic warden program in specific school zones in Kampala, Uganda. We randomly assigned 34 primary schools in Kampala, in a 1:1 ratio, using a computer-generated randomization sequence, to control or intervention arms in a cluster randomized trial. Each school in the intervention group received one trained adult traffic warden stationed at roads adjacent to schools to help young children safely cross. The control schools continued with the standard of care. We extracted and coded outcome data from video recordings on driver yield and child crossing behavior (defined as waiting at the curb, looking both ways for oncoming vehicles, not running while crossing, and avoiding illegal crossing between vehicles) at baseline and after 6 months. Using a mixed effect modified Poisson regression model, we estimated the prevalence ratio to assess whether being in a school traffic warden program was associated with increased driver yield and safe crossing behavior.

RESULTS

A higher proportion of drivers yielded to child pedestrians at crossings with a school traffic warden (aPR 7.2; 95% CI 4.42-11.82). Children were 70% more likely to demonstrate safe crossing behavior in the intervention clusters than in control clusters (aPR 1.7; 95% CI 1.04-2.85). A higher prevalence was recorded for walking while crossing (aPR 1.2; 95% CI 1.08-1.25) in the intervention clusters.

CONCLUSION

The school traffic warden program is associated with increased driver yield and safe child pedestrian crossing behavior, i.e., stopping at the curb, walking while crossing, and not crossing between vehicles. Therefore, the school traffic warden program could be promoted to supplement other road safety measures, such as pedestrian safety road infrastructure, legislation, and enforcement that specifically protects children in school zones.

Integrated Knowledge Translation for Non-Communicable Diseases: Stories from Sub-Saharan Africa

Integrated Knowledge Translation (IKT) is a key strategy for contextualising, tailoring, and communicating research for policy and practice. In this viewpoint, we provide examples of how partners from five countries in sub-Saharan Africa used IKT to advance interventions for curbing non-communicable diseases in their contexts and how these strategies were magnified during the COVID-19 pandemic in some cases. The stories highlight the importance of deliberate and reinforced capacity building, authentic relationship enhancement, adaptable and user-informed stakeholder engagement, and agile multi-sectoral involvement.

Injury patterns in patients with severe traumatic brain injuries from motor crashes admitted to Mulago hospital accidents & emergency unit

Background

The global burden of Road Traffic Crashes (RTC) is increasing. Uganda has one of the highest rates of RTCs in Sub-Sahara. Victims of RTCs sustain varying degrees of injuries depending on factors including the velocity at time of impact, protective gear; and if it was a motorcycle-motorcycle or motorcycle-vehicle crash. High speed collisions can result in severe forms of injuries and polytrauma. Some injuries are undetected.

Methods

A cross sectional study was carried at Mulago Hospital Accidents & Emergency Unit, between November 2021 and February 2022; on all adult patients (≥18 years) with severe head injury from motor road traffic crashes. The study looked at injury patterns and assessed the relationship of polytrauma in patients with severe head injury to the mechanism of injury (motorcycles versus vehicles). Data were extracted from patient charts using a validated data abstraction tool and complete head to toe physical examination was carried out and injuries recorded. Data were analysed to determine the relationship of polytrauma in patients with severe head injury to the mechanism of injury.

Results

The participants were predominantly males with a population median age of 32 (25-39). The commonest modes of transportation of patients to the hospital were Police Pickup trucks (40%) and ambulance (36.1%). Among motorcycle RTCs, (19.2%) wore helmets; 21.2% had protective gear; with injury identified mainly in; the limbs (84.8%), neck (76.8%), chest (39.4%), and abdomen (26.3%). Patients from vehicle RTCs were 19% more likely to have polytrauma compared to patients from motorcycle RTCs.

Conclusions

This study showed that patients who sustain severe traumatic brain injuries from vehicle crashes have an increased likelihood of having multiple injuries, compared to patients from motorcycle RTCs. For motorcycle users, injuries mostly affect the limbs. At particular risk are motorcyclists who do not wear helmets and protective coveralls.

Interventions to Improve Pedestrian and Cyclist Safety in Latin America: a Systematic Review and Metasummary

Road user fatalities account for a leading cause of preventable death in Latin America with pedestrians and bicyclists at higher risk for more extensive injuries as compared to other road users. Despite these vulnerable road user (VRU) risks, encouraging individuals to walk and cycle is an important public health strategy for addressing the region's obesity epidemic through promoting physical activity via active transportation (AT). However, in order to promote AT as a viable source of physical activity, safety of the VRU must be considered. The purpose of this systematic review and metasummary is to describe the effectiveness of interventions that have been implemented in Latin America to improve pedestrian and bicyclist safety. A systematic search of public health, policy, and engineering databases was completed using terms generated through the PICO method. The PRISMA framework was used for article screening. Eight articles detailing nine interventions across four countries were included for final synthesis and organized according to the Three E's Model of Injury Prevention, including three education-based interventions, two engineering, three enforcements, and one utilizing all Three E's. VRU outcomes assessed ranged from attitudes and behaviors to fatal injuries, with only enforcement-based interventions reporting on the latter. No interventions reported on non-fatal injury outcomes. Interventions rooted in each arm of the Three E's demonstrated limited ability to improve VRU outcomes, with enforcement-based interventions providing the strongest body of evidence. Findings demonstrate the limited research on VRU safety in Latin America, and further efforts should be of urgent public health priority.

Assessing the management student's entrepreneurial intentions: Role of entrepreneurship education and technology transfer

Entrepreneurship education is considered as an important way to influence the competitiveness of any country or industry. Therefore, entrepreneurship education provides opportunities to progress to a more competitive educational environment. This paper examines the impact of students' entrepreneurship education in China on their entrepreneurial intentions. Perceived entrepreneurial capacity, education in entrepreneurship, and attitudes toward entrepreneurship are all factors in the model developed to predict entrepreneurial intention. Structured equation modeling (SEM) is being used to test 98 management students from various universities in China. The findings show that there is statistically significant and positive relationship among entrepreneurship learning, entrepreneurial attitude, entrepreneurship education, and management students' entrepreneurial intention. Perceived behavioral control and perceive social rule significantly improve management students' entrepreneurial intention. Moreover, technology transfer correlates statistically with students' entrepreneurial intentions. Thus, universities are being encouraged to offer entrepreneurial training modules to increase their students' entrepreneurial intent.