Injury prevalence and safety habits of boda boda drivers in Moshi, Tanzania: A mixed methods study

Nguyen, TuanDat; Vissoci, João Ricardo Nickenig; Joelson, Treasure; Pesambili, Msafiri; Haglund, Michael M.; Gerardo, Charles J.; Mvungi, Mark; Staton, Catherine A. · 2018 · OpenAlex-citations

DOI: 10.1371/journal.pone.0207570

archive: archived pipeline: cataloged verified

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Summary

This mixed-methods study addresses the high burden of road traffic injuries (RTIs) among motorcycle taxi (*boda boda*) drivers in low- and middle-income countries, specifically focusing on Moshi, Tanzania. Motivated by the disproportionate vulnerability of motorcyclists due to limited protective equipment and the rapid increase in traffic fatalities in Tanzania, the research aimed to characterize injury prevalence, assess safety habits, and identify potential interventions to improve road safety. The study employed a cross-sectional design conducted between March and April 2014, involving 300 *boda boda* drivers recruited via convenience sampling from registered and unregistered stands in urban Moshi. The methodology combined quantitative surveys with qualitative interviews. The quantitative component utilized a computerized survey to collect data on demographics, crash history, injury details, and safety practices, including helmet usage and condition. Logistic regression models were used to evaluate associations between safety habits and crash outcomes, controlling for age, work hours, and experience. The qualitative component involved open-ended interviews regarding suggestions for improving traffic safety, analyzed through thematic content analysis by a multidisciplinary team. Key findings revealed a high prevalence of trauma: 49.3% of drivers had experienced a crash, and 38.0% had sustained at least one road traffic injury, with head and extremity injuries being most common. Despite 95.0% of participants agreeing that helmets reduce injury severity, only 73.3% reported consistent helmet use, and 82.5% of observed helmets were damaged or improperly fitted. Statistical analysis indicated that owning a helmet with a proper fit was significantly associated with a reduced risk of traffic crashes (OR = 0.06) and RTIs (OR = 0.07). Conversely, having a cracked helmet was associated with a higher risk of crash involvement. Qualitative analysis identified four primary areas for intervention: roadway infrastructure and traffic regulation, road user attitudes and safe driving behaviors, education and training, and law enforcement. The study concludes that while *boda boda* drivers possess knowledge regarding safety measures, adherence to safety habits remains low, and equipment quality is poor. The significant protective effect of properly fitted helmets highlights a critical gap between awareness and practice. The authors emphasize that successful improvement in road safety requires multi-sectoral interventions targeting infrastructure, enforcement, and education, rather than relying solely on individual behavior change. This research provides specific epidemiological data and actionable insights for developing targeted safety strategies in East Africa.

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Topics

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• helmet protective
• cyclist safety
• incidence prevalence

Information type

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• Empirical Findings: observational prevalence, crash risk outcomes