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

Abstract

Introduction: Road traffic injuries (RTIs) are an important contributor to the morbidity and mortality of developing countries. In Uganda, motorcycle taxis, known as boda bodas, are responsible for a growing proportion of RTIs. This study seeks to evaluate and comment on traffic safety trends from the past decade. Methods: Traffic reports from the Ugandan police force (2009 to 2017) were analyzed for RTI characteristics. Furthermore, one month of casualty ward data in 2015 and 2018 was collected from the Mulago National Referral Hospital and reviewed for casualty demographics and trauma type. Results: RTI motorcycle contribution rose steadily from 2009 to 2017 (24.5% to 33.9%). While the total number of crashes dropped from 22,461 to 13,244 between 2010 and 2017, the proportion of fatal RTIs increased from 14.7% to 22.2%. In the casualty ward, RTIs accounted for a greater proportion of patients and traumas in 2018 compared to 2015 (10%/41% and 36%/64%, respectively). Conclusions: Although RTIs have seen a gross reduction in Uganda, they have become more deadly, with greater motorcycle involvement. Hospital data demonstrate a rising need for trauma and neurosurgical care to manage greater RTI patient burden. Combining RTI prevention and care pathway improvements may mitigate current RTI trends.

Characteristics and Injury Patterns of Road Traffic Injuries in Urban and Rural Uganda—A Retrospective Medical Record Review Study in Two Hospitals

“…For two-thirds of the RTC, the counterparts in the rural setting were riding motorcycles while the same share accounts for cars in Urban Hospital 1 ( p < 0.001). Some differences could be explainable by infrastructural differences such as paving and sidewalks as well as traffic density, vehicles and (especially in rural areas) speeding [ 10 ]. Consistent with previous research findings, this study identified both motorcyclists and pedestrians as the most vulnerable groups.…”

“…In regards of gender, males dominated those affected by injuries obtained during crashes in all modes of transport: men account for 94% of bicycle injuries and 75% of motorcycle injuries and showed equal risk for RTI regardless of an active or passive traffic role (pedestrian, driver or passenger). Females are almost at the same risk of being injured as a pedestrian and as a motorcycle-passenger, which is a vehicle they almost never actively drive [ 10 ].…”

“…Continuous public traffic education, particularly for school children and commercial motorcyclists, has also demonstrated to raise the awareness for better safety behaviour among younglings and their caregivers. Initiatives by local shareholder, such as the ‘SafeBoda’ project which aims at educating and equipping commercial motorcyclists that represent a large share of private-hire transportation in Uganda, presented a particularly promising approach [ 10 ]. In the same context, precise observation of injury characteristics indicated other starting points for prevention in the crash-phase: Comprehensive helmet use for drivers and passengers is long known to reduce head injuries and strict enforcement of helmet laws already in place could decrease the number and severity of most common RTI in both rural and urban Uganda [ 41 ].…”

“…Uganda, which is a sub-Saharan low-income country in East Africa with a population of 44 million in 2019, an annual Gross Domestic Product growth of 2,9% in 2020 and a life expectancy of 63 years in 2018 [ 9 ], registers up to 50 road traffic crashes each day with total of 18,426 affected according to statistics by the World Bank [ 9 ]. Of those affected by RTC, 17.5% die and 74.5% are injured so severely that they subsequently require inpatient treatment [ 10 ]. According to official accounts of the Uganda Bureau of Statistics, the number of people killed per 100 crashes recorded in the Accident Severity Index (ASI) amounted to 18 in 2015 with a total number of 3224 road deaths in that year [ 11 ].…”

Epidemiology of injured patients in rural Uganda: A prospective trauma registry’s first 1000 days

“…Nearly 15% of incidents were suspected or confirmed to involve substance intoxication. The substantial rates of injury associated with boda bodas in Uganda are well-documented, due in part to the country’s poorly enforced speed limits and traffic safety laws [ 15 ]. Only 15% of patients injured on the road in Soroti were pedestrians–a stark contrast from other studies in Uganda and neighboring countries, perhaps attributable to the rural nature of the hospital’s catchment area [ 16 , 17 ].…”