Browsing by Author "Balugaba, Bonny E"

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Interventions to Reduce Pedestrian Road Traffic Injuries: A Systematic Review of Randomized Controlled Trials, Cluster Randomized Controlled Trials, Interrupted Time-series, and Controlled Before-after Studies
(Public Library Science, 1160 Battery Street, Ste 100, San Francisco, Usa, Ca, 94111, 2022) Namatovu, Stellah; Balugaba, Bonny E; Muni, Kennedy; Ningwa, Albert; Nsabagwa, Linda; Oporia, Fredrick; Kiconco, Arthur; Kyamanywa, Patrick; Mutto, Milton; Osuret, Jimmy; Rehfuess, Evan A; Burns, Jacob; Kobusingye, Olive
Background Road traffic injuries are among the top ten causes of death globally, with the highest burden in low and middle-income countries, where over a third of deaths occur among pedestrians and cyclists. Several interventions to mitigate the burden among pedestrians have been widely implemented, however, the effectiveness has not been systematically examined. Objectives To assess the effectiveness of interventions to reduce road traffic crashes, injuries, hospitalizations and deaths among pedestrians. Methods We considered studies that evaluated interventions to reduce road traffic crashes, injuries, hospitalizations and/or deaths among pedestrians. We considered randomized controlled trials, interrupted time-series studies, and controlled before-after studies. We searched MEDLINE, EMBASE, Web of Science, WHO Global Health Index, Health Evidence, Transport Research International Documentation and ClinicalTrials.gov through 31 August 2020, and the reference lists of all included studies. Two reviewers independently screened titles and abstracts and full texts, extracted data and assessed the risk of bias. We summarized findings narratively with text and tables. Results A total of 69123 unique records were identified through the searches, with 26 of these meeting our eligibility criteria. All except two of these were conducted in high-income countries and most were from urban settings. The majority of studies observed either a clear effect favoring the intervention or an unclear effect potentially favoring the intervention and these included: changes to the road environment (19/27); changes to legislation and enforcement (12/12); and road user behavior/education combined with either changes to the road environment (3/3) or with legislation and enforcement (1/1). A small number of studies observed either a null effect or an effect favoring the control. Conclusions Although the highest burden of road traffic injuries exists in LMICs, very few studies have examined the effectiveness of available interventions in these settings. Studies indicate that road environment, legislation and enforcement interventions alone produce positive effects on pedestrian safety. In combination with or with road user behavior/education interventions they are particularly effective in improving pedestrian safety.
State of Pedestrian Road Safety in Uganda: A Qualitative Study of Existing Interventions
(Makerere Univ, Coll Health Sciences,Sch Med , Po Box 7072, Kampala, Uganda, 00000, 2021) Osuret, Jimmy; Namatovu, Stellah; Biribawa, Claire; Balugaba, Bonny E; Zziwa, Esther Bayiga; Muni, Kennedy; Ningwa, Albert; Oporia, Fredrick; Mutto, Milton; Kyamanywa, Patrick; Guwatudde, David; Kobusingye, Olive
Background: Pedestrians in Uganda account for 40% of road traffic fatalities and 25% of serious injuries annually. We explored the current pedestrian road traffic injury interventions in Uganda to understand why pedestrian injuries and deaths continue despite the presence of interventions. Methods: We conducted a qualitative study that involved a desk review of road safety policy, regulatory documents, and reports. We supplemented the document review with 14 key informant interviews and 4 focus group discussions with par- ticipants involved in road safety. Qualitative thematic content analysis was done using ATLAS. ti 7 software. Results: Five thematic topics emerged. Specifically, Uganda had a Non-Motorized Transport Policy whose implementation revealed several gaps. The needs of pedestrians and contextual evidence were ignored in road systems. The key program- matic challenges in pedestrian road safety management included inadequate funding, lack of political support, and lack of stakeholder collaboration. There was no evidence of plans for monitoring and evaluation of the various pedestrian road safety interventions. Conclusion: The research revealed low prioritization of pedestrian needs in the design, implementation, and evaluation of pedestrian road safety interventions. Addressing Uganda’s pedestrian needs requires concerted efforts to coordinate all road safety activities, political commitment, and budgetary support at all levels.
State of pedestrian road safety in Uganda: are interventions failing or absent?
(2019) Osuret, Jimmy; Namatovu, Stellah; Biribawa, Claire; Balugaba, Bonny E; Zziwa, Esther Bayiga; Muni, Kennedy; Ningwa, Albert; Oporia, Frederick; Mutto, Milton; Kyamanywa, Patrick; Guwatudde, David; Kobusingye, Olive
Background In Uganda, pedestrians are the most frequently injured category of road users, accounting for 40% of road traffic fatalities and 25% of serious injuries every year. There is paucity of information on existing pedestrian interventions and challenges that affect their implementation in Uganda. In this paper, we ascertain the state of pedestrian road safety interventions in Uganda and explore the challenges in the process of design, implementation, monitoring and evaluation of existing interventions. Methods We conducted a qualitative study that started with a desk review of existing policy documents, police statistics, media reports, non-governmental organization reports, and published research. We supplemented the review with 14 key informant interviews and 4 focus group discussions. Participants were drawn from various agencies and stakeholders responsible for road safety. In total, we collected and synthesized data on the design, implementation, and evaluation of pedestrian safety interventions from 25 documents. Data were analyzed using qualitative thematic content analysis. Results The National Road Safety Council within the Ministry of Works and Transport is the lead agency tasked with coordinating all road safety efforts, while the Uganda Police is largely engaged in enforcing pedestrian safety. We identified several existing policies and regulations for pedestrian safety like the Non-Motorized Transport policy whose implementation has been inadequate. Implementation is constrained by weak institutional capacity and limited resources. Moreover, road safety stakeholders operated in silos and this hindered efforts to coordinate pedestrian safety activities. Interventions like road designs were implemented with limited reference to any supporting data and therefore did not cater for pedestrian needs. Conclusion There are interventions targeting pedestrian safety in Uganda, but effective implementation is lacking or failing due to constraints related to weak institutional capacity. This necessitates strategies to mobilize resources to strengthen the capacity of the lead agency to effectively coordinate road safety interventions.