Using baseline and formative evaluation data to inform the Uganda Helmet Vaccine Initiative

Abstract

Motorcycles are an important form of transportation in Uganda, and are involved in more road traffic injuries than any other vehicle. The majority of motorcycles in Uganda are used as motorcycle taxis, better known locally as boda bodas. Research shows that a motorcycle helmet is effective at reducing a rider's risk of death and head injury. As part of the Uganda Helmet Vaccine Initiative (UHVI), researchers collected baseline and formative evaluation data on boda boda operators' helmet attitudes, beliefs, and behaviors to inform UHVI activities. Researchers collected data on motorcycle helmet-related attitudes and beliefs through focus group discussions and structured roadside interviews, and researchers conducted roadside observations to collect data on helmet-wearing behaviors. Of the 12,189 motorcycle operators and passengers observed during roadside observations, 30.8% of drivers and <1% of passengers were wearing helmets. The most commonly reported helmet-wearing barriers from the focus group discussions and structured roadside interviews were: (1) 'Helmet is uncomfortable', (2) 'Helmet is too hot', (3) 'Helmet is too expensive', and (4) 'Helmet is of low quality'. Researchers incorporated findings from the formative research into the UHVI campaign to increase motorcycle helmet use. Radio messages addressing helmet comfort and cost were widely aired throughout Kampala, Uganda. In addition, campaign staff held nine boda boda operator workshops, covering approximately 900 operators, in which the facilitator addressed barriers and facilitators to helmet use. Each workshop participant received a high-quality tropical motorcycle helmet. UHVI will continue to use a data-driven approach to future campaign activities.

Boda Bodas and Road Traffic Injuries in Uganda: An Overview of Traffic Safety Trends from 2009 to 2017

“…However, when there are collisions, boda boda drivers are more likely to be involved in 2017 than in 2009. With greater risks already associated with motorcycles and low rates of helmet use, the higher rates of fatal injuries may be the consequence [5,7,8,25,26]. Interestingly, the distribution of RTI causes has remained consistent despite the RTI reduction (Table 2).…”

“…Additionally, as suggested by Kitara, many of these motorcyclists are self-employed as taxi-drivers, so there is a short-term economic incentive for aggressive driving to taxi more passengers [8]. Even safety measures are often unheeded, as evidenced by extremely low rates of required helmet use [25].…”

“…Under Uganda's Traffic and Road Safety (Motorcycles) Regulations, all motorcyclists and their passengers have been required, since 2004, to wear crash helmets while operating the vehicle [34]. However, as multiple studies have shown, adherence to helmet use is far from ideal [5,14,25]. This pattern of nonadherence is especially worrisome, given the increasing involvement of boda bodas in RTIs.…”

“…These efforts were informed by important findings obtained from surveys of boda boda drivers' attitudes towards helmets. From those interviewed, 74% knew of the requirement for helmets, and 71% had access to helmets [25]. The common complaints revolved around the helmet's discomfort, poor quality, and expense.…”

Motorcycle taxi programme increases safe riding behaviours among its drivers in Kampala, Uganda

“…However, it is now a generic term for bicycle and motorcycle taxis in East Africa. In present use, boda-boda increasingly refers to motorcycle taxis), are a major form of transportation because they are relatively affordable, convenient for short distances and efficient for navigating heavy vehicular traffic 1–5. In the city of Kampala alone, there are an estimated 50 000 to 80 000 boda-boda drivers 2.…”