Kennedy Muni, MPH, PhDc
Nominated From: University of Washington
Research Site: Uganda
Research Area: Emergency Medicine, Surgery, and Trauma
Primary Mentor: Charlie Mock
Motorcycle taxis and road safety in Kampala: comparing health outcomes in SafeBoda and regular motorcycle taxi drivers
In 2015, there were 18,495 reported road traffic collisions (RTCs) in Uganda, of which 60% were either fatal or serious (10). Boda-boda, or motorcycle taxis, are most frequently used adolescents and young adults, and account for a significant number of RTCs in Uganda. For example, in 2009, 27% of fatal RTCs involved boda-boda (9). In 2015, 23.5% of road accident victims were boda-boda-related (10). One study in Mulago Hospital found that among those hospitalized with RTIs, 75% were due to crashes involving boda-boda (11). Boda-boda injuries account for 50% of all surgeries and 62.5% of the annual surgery budget at Mulago Hospital (6, 11). Several factors may account for this high injury burden. Many boda-boda drivers engage in risky behaviors (e.g. wrongful passing, driving between lanes, and driving in the wrong direction) and are unwilling to spend more than 50 US dollars on a helmet and reflective jacket (2, 4, 8). Although evidence shows that helmet use reduces a motorcycle rider’s risk of death by 42% and risk of head injury by 69%, helmet use among boda-boda and their passengers in Uganda is low (1, 12). A roadside observation study of 12,189 boda-boda and passengers reported helmet use of 30.8% and <1% among boda-boda and passengers respectively (1). Boda-boda identified several barriers to helmet use, including that helmets are hot, uncomfortable, and expensive.
Despite the high number of RTCs and road traffic injuries (RTIs) associated with boda-boda, government attempts to regulate this industry have largely failed partly due to politics and limited police capacity (2, 4). SafeBoda, a private sector Uber-like motorcycle taxi service, was launched in 2014 to provide a safe transportation experience using boda-boda. It is currently available only in Kampala, Uganda’s capital and largest city. The program consists of professionally trained boda-boda who wear an orange reflective jacket with the SafeBoda logo. SafeBoda boda-boda are provided with helmets for both themselves and their passenger (13). They also undergo a 3-week training conducted by the Ugandan Police and the Red Cross society on defensive riding, traffic laws, and first aid. Since its launch, there have been no published studies assessing the program’s impact on RTCs, RTIs, and helmet use among boda-boda. The goal of my dissertation is to provide these data. If found effective, our findings will help guide future policy decisions regarding these forms of innovative programs in Uganda and the east African region.
Motorcycle taxis, known locally in Uganda as boda-boda, are a major form of transportation (1-3). In the city of Kampala alone, there are between 50,000 and 80,000 boda-boda (2). A large proportion of the boda-boda in Uganda are adolescents and young adults who are at the prime of their lives (2-4). Boda-boda have a reputation of not following traffic laws, excessive risk taking, and low helmet use – factors associated with increased risk of road traffic crash and injury (5, 6). In Uganda, boda-boda are involved in more road traffic crashes (RTCs) than any other vehicle (1). They account for 41% of total road traffic injuries (RTIs) and at least 27% of fatal RTIs (1, 7-9). Mulago, the main national public hospital in Uganda, receives between 10 and 20 victims of boda-boda related RTCs daily, and spends approximately 63% of its annual surgery budget on trauma cases from these crashes (2, 7). SafeBoda, an Uber-like motorcycle taxi service, was launched in 2014 to provide safe transportation using boda-boda. My dissertation will assess the effect of the SafeBoda program on various outcomes including incidence of RTCs, RTIs, and helmet use in this young high-risk group in Kampala.
Traffic accidents are one of the leading cause of morbidity and mortality in all countries, but is especially high in countries where preventive measures, such as helmets, may not be frequently used. Examining the factors associated with safer driving of motorcycle taxis in Uganda may identify factors that would lead to adoptionof safer behaviors in Uganda as well as in States within the United States where helmet laws have not yet been adopted or where adherence is suboptimal.
1) characterize the SafeBoda program to understand its reach, membership, and training program
2) compare helmet use, attitudes towards helmet use, and knowledge of Uganda’s traffic laws between SafeBoda and non-SafeBoda boda-boda; 3a) compare self-reported incidents of RTCs, police citations, and injuries between SafeBoda and non-SafeBoda boda-boda; and 3b) compare driving patterns, including miles driven and frequency of speeding, in a subset of SafeBoda and non-SafeBoda boda-boda.
- Dr. Charlie Mock, Department of Global Health, Epidemiology, and Surgery, University of Washington
- Dr. Olive Kobusingye, Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota