Predictors of Road Safety behaviors among Boda-Boda Operators and their passengers in Kampala: A Mixed-Methods Study

Technical Summary: Predictors of Road Safety Behaviors Among Boda-Boda Operators and Passengers in Kampala

Problem Statement
Despite existing road safety regulations, "Boda Boda" (motorcycle taxi) riders in Uganda continue to experience frequent road traffic injuries (RTIs) due to unsafe riding behaviors, resulting in high morbidity and mortality for both riders and passengers. While global RTI fatality rates have declined, the burden remains disproportionately high in low- and middle-income countries, particularly in sub-Saharan Africa where head injuries are a leading cause of mortality. In Uganda, motorcycle involvement in crashes has risen significantly, accounting for over 40% of road traffic fatalities in 2019. Previous research has largely focused on general road safety or specific interventions like "Safe-Boda," but there is a critical gap in evidence regarding the specific predisposing, reinforcing, and enabling factors that influence safety behaviors for both riders and passengers within the unique occupational context of the boda-boda sector.

Methodology
The study employed a cross-sectional, convergent parallel mixed-methods design guided by the PRECEDE Model (Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation). The study was conducted in Kampala Central Division.

• Quantitative Component: A structured survey was administered to 424 boda-boda riders (aged ≥18 with ≥6 months of experience). Data collection occurred between February 5 and February 28, 2026. The instrument assessed socio-demographics, predisposing factors (knowledge, attitudes, perceptions), reinforcing factors (family, peers, unions), and enabling factors (infrastructure, training). The outcome variable, "riding behavior," was derived from 11 items and dichotomized into "safe" and "unsafe" categories based on a median split. Data were analyzed using descriptive statistics, chi-square tests, and binary logistic regression to determine predictors (p < 0.05).
• Qualitative Component: Simultaneously, in-depth semi-structured interviews were conducted with 10 passengers (6 female, 4 male) selected via purposive sampling until data saturation. Interviews focused on barriers to safety, helmet use, and regulatory gaps. Thematic analysis was used to identify recurring patterns.
• Integration: Quantitative and qualitative strands were analyzed independently and then triangulated to provide a comprehensive understanding of safety determinants.

Key Results

• Prevalence of Unsafe Behavior: Among the 424 riders, 65.1% exhibited unsafe riding behaviors.
• Quantitative Predictors:
  • Education: Contrary to some global findings, riders with secondary (AOR=0.50) and post-secondary education (AOR=0.57) had lower odds of safe riding behaviors compared to those with no/primary education.
  • Marital Status: Married riders were less likely to exhibit safe behaviors (AOR=0.56) compared to unmarried riders.
  • Religion: Identifying as Christian was a strong predictor of safe behavior (AOR=2.98).
  • Attitudes: Willingness to obey traffic regulations was significantly associated with safe behavior (AOR=0.41 for those who agreed, indicating a protective effect when compared to the reference group who disagreed).
  • Reinforcing Factors: Perception that boda-boda unions advocate for safety (AOR=1.76) was a significant positive predictor.
  • Enabling Factors: Riders who perceived roads as well-maintained were more likely to ride safely (AOR=1.65).
• Qualitative Findings: Five themes emerged: safety concerns, helmet use, passenger responsibility, road infrastructure conditions, and regulation gaps. Passengers reported low safety ratings (often 4/10 to 7/10), citing over-speeding and reckless maneuvers. A major barrier was the lack of helmet provision or poor helmet quality. Passengers acknowledged their own limited ability to enforce safety, noting that riders often prioritized speed and income over safety. Infrastructure issues (potholes, poor drainage) and weak enforcement of existing laws were also highlighted.

Key Contributions
This study contributes context-specific evidence by applying the PRECEDE model to the boda-boda sector in Kampala, distinguishing between rider and passenger perspectives. It identifies that safety behaviors are not solely determined by knowledge (which was high, with 98% knowing helmets are important) but are heavily influenced by attitudinal, social, and structural factors. The study highlights the counter-intuitive finding that higher education levels did not correlate with safer behaviors in this specific context, suggesting that formal education does not automatically translate to occupational safety compliance. Furthermore, it underscores the critical role of union advocacy and infrastructure quality as enabling factors.

Significance and Claims
The paper claims that rider and passenger safety in Kampala is interdependent and influenced by a complex mix of behavioral, social, and infrastructural determinants rather than just demographic characteristics. The authors assert that while knowledge of safety rules is high, the translation of this knowledge into practice is hindered by weak enforcement, poor infrastructure, and inconsistent social reinforcement.

The study concludes that sustainable improvements require integrated interventions that go beyond education alone. Specifically, the authors advocate for:

1. Strengthening the role of boda-boda unions in safety advocacy and peer monitoring.
2. Enhancing family and community support for safety norms.
3. Improving road infrastructure maintenance.
4. Stricter enforcement of traffic regulations, including helmet mandates.
5. Recognizing boda-boda transport as an occupational health priority.

The authors note limitations, including reliance on self-reported data (potential for social desirability bias) and the restriction of the sample to Kampala Central Division, which may limit generalizability to peri-urban or rural settings. However, they maintain that the findings provide a necessary evidence base for designing targeted, sustainable interventions to reduce RTIs in Uganda's informal transport sector.