Road safety stakeholders’ perspectives of risk factors, opportunities and barriers for child pedestrians in Uganda: A qualitative study

Abstract

Abstract Background The health and socio-economic burden of road traffic injuries on children and their caretaker is extremely high in Uganda where 33% (1,384/4,159) of road traffic fatalities were among child pedestrians in 2021. We explored the road safety situation in Kampala, Uganda to understand the child pedestrian risk factors associated to road traffic injuries (RTIs), opportunities and underlying barriers to child pedestrian safety. Methods We conducted a qualitative study in 2021 using two primary methods of Key informant interviews and focus group discussions. Overall, we conducted 12 key informant interviews with stakeholders involved in road safety and 6 focus group discussions which comprised 18 teachers and 17 parents. Data was analyzed using thematic analysis technique. ATLAS ti. 9 was applied for data management and during analysis, three themes were developed. Results Child pedestrian RTIs were related to the behaviour of the driver (e.g. speeding, driver distraction) and pedestrian (e.g. risk taking); traffic (e.g. complex traffic mix); the road infrastructure (e.g. inadequate pedestrian facilities); and the vehicle (e.g. technical defects). Pedestrian safety opportunities identified included roadside police enforcement and assistance of children to cross by a school traffic warden. The key barriers to pedestrian safety included limited political commitment, inadequate funding, and inadequate enforcement. Conclusion This paper has presented evidence that pedestrian road traffic crashes occur due to an interplay of multiple risk factors and yet low priority is placed on road safety. The findings highlight the key risks faced by children in low-income settings like Uganda and recommend prioritizing holistic measures that include enforcement, school traffic control measures and pedestrian road safety infrastructure.