Background characteristics of study participants
We conducted a total of 12 key informant interviews with participants who were over 18 years and 6 focus group discussions which comprised 35 participants, most of them either road safety experts, teachers, or parents. The focus group discussions had somewhat equal numbers of females and males. Almost all 97.1% (34/35) the FGD participants indicated engaging in some form of employment. Participant duration of involvement in road safety activities varied with 31.4% (11/35) having 1-5 years and 42.9% (15/35) having more than 5 years’ experience. Details of FGD participants are shown in table 1.
Table 1: Socio Demographic characteristics of FGD participants
|
Frequency (N=35)
|
Percentages
|
Sex
|
|
|
Male
|
18
|
51.4
|
Female
|
17
|
48.6
|
Age
|
|
|
18-34
|
13
|
37.1
|
35-44
|
15
|
42.9
|
45 and above
|
7
|
20.0
|
Highest level of education
|
|
|
Primary
|
2
|
5.7
|
Secondary
|
8
|
22.9
|
Tertiary (Diploma/University)
|
25
|
71.4
|
Occupation
|
|
|
Working
|
34
|
97.1
|
Not working
|
1
|
2.9
|
Involvement in road safety activities
|
|
|
Not involved
|
9
|
25.7
|
1-5 years
|
11
|
31.4
|
5+ years
|
15
|
42.9
|
The results are presented below in three broad themes that include road safety risk factors, opportunities and barriers. The risk factors were related to behaviour of the driver (e.g. speeding and driver distraction); pedestrian behaviour (e.g. risk taking); traffic (e.g. complex traffic mix and obstruction of pedestrian walkways); the road environment (e.g. unsafe school location); the road infrastructure (e.g. inadequate pedestrian facilities and narrow roads); and vehicle (e.g. technical defects). Pedestrian safety opportunities included road side traffic police enforcement and assistance by school traffic wardens. Barriers to pedestrian safety included road safety legislative gaps, limited political commitment, inadequate funding and inadequate enforcement. These themes are explored further and verbatim quotes are provided (figure 1).
RISK FACTORS FOR CHILD PEDESTRIAN ROAD TRAFFIC INJURIES
In this study, we identified six categories of risk factors for child pedestrian injury and these included: driver behaviour, child related, traffic, environment, infrastructure and vehicle factors.
Driver behaviour factors: The participants identified speeding, driving under the influence of alcohol, driver distraction, and insufficient driver skills as the major driver related factors to pedestrian crashes. From across the KIIs and FGDs, the majority of crashes were reported to be due to reckless driving and speeding during peak hours. According to a key informant, managing speed remained a challenge around school zones because of the infrastructural deficits to protect vulnerable road users.
Of course one of the biggest challenges we have is speed. Uhh our people don’t follow the speed limits. Even where it is clearly indicated using road signs. (Key informant, traffic police)
Majority of the key informant and focus group participants indicated driving under the influence of alcohol as a threat and was linked to reckless driving, car crashes, and road deaths. Driver intoxication occurred mainly during the early morning hours and the night, the time when child pedestrians travel according to the FGDs with parents and teachers.
A vehicle knocked down a girl from the school where my child goes. But the vehicle was over speeding, others say the driver was drunk. The driver was arrested. So, these drivers sometimes they’re not sober because they’re under the influence of alcohol. (FGD, parents)
Operating a cell phone or conversing on one while driving as a risk factor to child pedestrian crashes was alluded to by a number of males and females in the focus group discussions. They further mentioned that the driver is distracted as they operate the cell phones. A focus group discussion participant had this to say.
There is also this habit of communicating on phone while driving. Very many of the accidents you find that a person is on phone while driving or riding (FGD, teachers)
More than half of the key informants reported lack of experience and limited knowledge of the
Traffic and Road Safety Regulations among some drivers. In some instances there were drivers who lacked driving licenses which was an indication of not having attended driving school.
We drive these cars but not all of us have driving experience. For instance I’m still young and I have driven for a short time compared to others who are more experienced than me. Not everybody who uses a vehicle, the motorcycle or maybe a car knows how to drive, they don’t even have driving license; they don’t know the road rules. (Key informant, taxi driver)
Child related factors: Other factors were identified with respect to child pedestrians which included child risk taking behaviour, the lack of child supervision, and crossing at unsafe points. The road traffic injury risk was further increased by the exposure of child pedestrians to unsafe roads through specific risk-taking behaviour e.g. road dart out and playing on the road. This was reported by most focus group discussions as demonstrated by one of the participants below.
Children are young, they don’t mind when they’re walking along the road. You’ll see them even playing on the road and forget that vehicles are oncoming (FGD, parents)
Traffic related factors: the key risk factors identified included complex traffic mix and obstruction of pedestrian walkways. The focus groups with parents and half of the key informants revealed that in many instances, the pedestrian footpaths were obstructed by parked cars, motorcyclists, informal businesses prompting children to go onto the road. Crashes were reported to occur when children attempted to cross at parked and stopped vehicles which obstruct visibility between pedestrians crossing the road way and approaching vehicles. This is illustrated below by one of the group discussions.
I found a child who had got involved in an accident, the girl was crossing behind an offloading taxi that was obstructing her. The driver thought, there was no person crossing behind the parked car, he knocked the girl down. (FGD, Parents)
Infrastructure factors: Factors related to infrastructure included inadequate lighting, narrow roads and inadequate safe pedestrian crossings or walkways. Many of the key informant and focus group participants indicated inadequate safe walking and crossing pedestrian facilities for children. Most key informants attributed some crashes to the narrow roads and the complex traffic mix (i.e. a combination of huge trucks, buses, small vehicles, motorcycles, and bicycles all sharing the same space) with pedestrians competing for the limited space.
There are inadequate facilities for children to walk safely and cross. It is actually true that our road infrastructure itself does not protect the school going child pedestrians. (Key Informant, Safe Way Right Way)
From the interviews with most key informants, child pedestrian crashes occurred during the night and early in the morning when the lighting levels were low due to reduced visibility. Majority of the school going children lacked reflective gear which further worsened their visibility and a key informant had this to say.
The children go as early as 5:00am to schools, and when you look at the lighting it is poor. Sometimes you may not see them because of their height. They are not visible, they don’t have the visibility materials. They are sharing roads with vehicles. (Key informant, Uganda Red Cross Society)
Environment factor: The key risk factor related to the environment was the unsafe location of schools. From a few KIIs and FGDs with parents, participants mentioned inadequate planning in the location of some schools along unsafe busy roads and highways which made it unsafe for child pedestrians. Many schools were located around busy roads, close to business centres and industries that had complex traffic mix that young children couldn’t cope with.
Most of the schools are established near busy road corridors without consideration for children. Land use and planning is actually is a challenge in Kampala. You have industries, commercial centers, residential, schools, hotels that creates high volumes of traffic and high moving traffic for the pedestrians. (FGD, Parents)
Vehicle related factors: Majority of the key informant and focus group participants implicated vehicles with poor mechanical condition to cause pedestrian motor vehicle collisions following failures in braking. Another contributory factor to powered two wheeler crashes is the failure of child pedestrians to detect the motorcyclist’s presence (conspicuity) because of the motorcycle size.
The vehicles we have are too old. When I was coming, the vehicle I got, the gentleman (driver) wanted to brake, it wasn’t braking; so we are seated in a faulty vehicle and those are the vehicles which knock our children. (FGD, Teachers)
OPPORTUNITIES FOR CHILD PEDESTRIAN SAFETY
Pedestrian safety opportunities identified included road side police enforcement, road safety campaigns, walking children to school, presence of school traffic warden and care for an injured child pedestrian. These were informed primarily by the road safety experts, teachers or parents following key informant interviews and focus group discussions.
Roadside police enforcement: A few key informants revealed that police enforcement of traffic regulation on the road influenced motorists’ behaviour. Police perform random checks or enforcement using speed radars and this seems to serve as a deterrent to speeding.
In the morning around the time when children go to school we drive when we are a little bit careful. Because we expect that around that time the traffic officers are always there on the road. So, we are always very careful. (Key informant, driver)
Implementation of road safety campaigns and school road safety programme: During the group discussions with parents and teachers, participants highlighted the implementation of road safety campaigns and education programme in the curriculum. The focus groups revealed that road safety messages were informative and provided learners with appropriate knowledge and expertise to make them safe and responsible road users.
We're doing enhanced sensitization to the school-going children in the class rooms. There are also messages in the compound about how to cross the road. (FGD, Teachers)
Presence of school traffic wardens and walking children: Almost all focus groups and key informant participants mentioned the presence of school traffic wardens and walking children by some parents. They noted that the school children could not deal with the complex traffic mix without assistance.
We've seen wardens increasing at school areas to help the children cross the road, they are wearing reflective jackets and so, the safety at schools, might be increasing. (Key informant, Ministry of Works and Transport)
Presence of engineering measures at some school designated crossings: Majority of the focus group and key informant participants mentioned presence of pedestrian infrastructure and traffic calming measures e.g. speed humps in some sections of school zones and zebra crossings.
In some areas where they know children cross from, there is a zebra crossing and they have also gone ahead to put walkways and humps to reduce the speed of vehicles. (FGD, Teachers)
However, there were divergent views regarding the safety of some measures like zebra crossings that are violated by drivers making it unsafe for the child pedestrians. One of the key informants had this to say.
Yeah. The zebra-crossing where there are no traffic controls or school traffic wardens, is still a danger. But when the school traffic warden is there, because they blow the whistle and stop vehicles for children to cross. That one has been a bit safe. (Key informant, traffic police)
Care for the injured child pedestrian: Teachers or health personnel were reported to make the initial interventions necessary in the event of an RTI involving school children according to some of the participants in the focus group discussions with parents and teacher. Teachers or bystanders are the first people to help a pupil in the event of a road traffic or injury in school by giving first aid and evacuating the pupil to the nearest health facility.
Usually schools try to make sure the child is taken to the nearest point for care following a road traffic crash injury. And in some cases some people attempt to give first aid. So they stop bleedings and refer to the hospital. (Key Informant, Safe Way Right Way)
BARRIERS TO CHILD PEDESTRIAN SAFETY
The key barriers were related to policy and programmatic aspects and these included, insufficient funding, limited political commitment, inadequate enforcement and unsafe school locations. Accounts from majority of the key informants suggested that implementation and coordination of road safety activities was hindered by inadequate funds. Moreover, according to a few key informant experts, the traffic and road safety legislation had gaps, for example, speed limits on urban roads and school zones were high.
The other obstacle we face for us, especially in government is funding. We do not as yet have a strict, school zone regulation protecting children, nor enforcing a specific speed limit. (Key informant, Ministry of Works and Transport)
From a few key informants, political commitment and action was inadequate to advocate for the needs of vulnerable school going children in road systems. There was inadequate uptake of some road safety interventions and interference with the enforcement of road safety regulations according to the participants.
The other obstacle is political interference. When it comes to road safety, it's not yet at that priority level politically. (Key informant, Ministry of Works and Transport)