Seatbelt and child restraint use substantially reduce road traffic injuries and fatalities, yet their utilisation remains poorly documented in Uganda. This study assessed the prevalence and factors associated with seatbelt and child restraint use in Kampala.
Between March and April 2021, observations were conducted at 16 randomly selected sites in Kampala using Kobo Collect. Two data collectors observed each site on two weekdays and one weekend day from 07:30 to 16:45. One observer dictated while the other recorded observations on tablets. Prevalence ratios with 95% CIs were estimated using modified Poisson regression in R to examine associations between seatbelt use and predictors such as gender, vehicle type and age.
A total of 56 441 occupants in 36 473 vehicles were observed. Overall seatbelt use was 41%, with significantly higher compliance among drivers (53%) than passengers (19%) (p<0.001). Child restraint use was <2%. Gender disparities were evident: female drivers had higher use (74%) compared with males (50%). Seatbelt use was more common in sedans/Sport Utility Vehicles (Adjusted Prevalence Ratio 3.12; CI 2.93 to 3.32) and when traffic police were present (Adjusted Prevalence Ratio 1.29; CI 1.25 to 1.34).
This study provides novel evidence on seatbelt and child restraint use in Kampala. Less than half of the occupants used seatbelts, and nearly all children were unrestrained. Gender, vehicle type and police presence significantly influenced compliance. Strengthened enforcement, public awareness and integration of child restraint promotion into policy are critical for reducing the burden of road traffic injuries in Uganda.