Wilson Odero

Road traffic injuries in Kenya: magnitude, causes and status of intervention

Road traffic crashes exert a huge burden on Kenya’s economy and health care services. Current interventions are sporadic, uncoordinated and ineffective. This report offers a descriptive analysis of secondary data obtained from a variety of published literature and unpublished reports. Over three thousand people are killed annually on Kenyan roads. A fourfold increase in road fatalities has been experienced over the last 30 years. More than 75% of road traffic casualties are economically productive young adults. Pedestrians and passengers are the most vulnerable; they account for 80% of the deaths. Buses and matatus * Matatus are small-scale public transport vehicles in Kenya. These vehicles are important in public transport but they flagrantly violate traffic rules. are the vehicles most frequently involved in fatal crashes. Characteristics of crashes vary considerably between urban and rural settings: pedestrians are more likely to be killed in urban areas, whereas passengers are the majority killed on intercity highways that transverse rural settings. Road safety interventions have not made any measurable impact in reducing the numbers, rates and consequences of road crashes. Despite the marked increase in road crashes in Kenya, little effort has been made to develop and implement effective interventions. Impediments to road traffic injury prevention and control include ineffective coordination, inadequate resources and qualified personnel, and limited capacity to implement and monitor interventions. There is need to improve the collection and availability of accurate data to help in recognising traffic injury as a priority public health problem, raising awareness of policymakers on existing effective countermeasures and mobilizing resources for implementation. Establishment of an effective lead agency and development of stakeholder coalitions to address the problem are desirable.

Pedestrian Safety and the Built Environment : A Review of the Risk Factors

Urban and regional planning has a contribution to make toward improving pedestrian safety, particularly in view of the fact that about 273,000 pedestrians were killed in road traffic crashes in 2010. The road is a built environments that should enhance safety and security for pedestrians, but this ideal is not always the case. This article presents an overview of the evidence on the risks that pedestrians face in the built environment. This article shows that design of the roadway and development of different land uses can either increase or reduce pedestrian road traffic injury. Planners need to design or modify the built environment to minimize risk for pedestrians.

Injuries from interpersonal violence presenting to a rural health center in Western Kenya: characteristics and correlates

Objective: To define the scope of injury due to interpersonal violence in a medium-sized town in Western Kenya. Design: Prospective, cross-sectional data collection and analysis. Setting/subjects: Data were prospectively collected on all injured patients (n = 562) presenting to a health center in Western Kenya, 2002–2004. Age, gender, type, and severity of injury, relationship to assailant, disposition, and clinician’s suspicion of alcohol use were recorded. Main outcome measures: Number of injuries due to interpersonal violence; correlation of gender, alcohol use, relationship to assailant, and type of injury. Results: Interpersonal violence caused 43% of all injuries. Men and women were equally likely to suffer violent injuries (42% vs 45%); however, women were more likely to suffer injury from domestic violence (4.7% vs 7.0%) and sexual assault (0% vs 3.5%). Men and women were equally likely to know their assailant. Women were more likely to be injured by a spouse/partner (19% vs 1.3%), whereas men were more likely to be injured by an acquaintance (29% vs 16%). Alcohol use was more often suspected for victims of violent, as opposed to unintentional, injury (45% vs 16%). Men with violent injuries were more likely than women to be suspected of having used alcohol (51% vs 35%). Conclusions: Interpersonal violence is a leading cause of injury in Western Kenya. Although men and women are equally likely to be assaulted, women are more likely to be injured by a spouse, and men by an acquaintance. Alcohol use is common among those who suffer violent injuries in this population.

Resilience among gay/bisexual young men in Western Kenya: psychosocial and sexual health outcomes.

Objective:To explore associations between intrapersonal and interpersonal factors and both sexual and psychosocial resilient outcomes among young gay, bisexual, and other men who have sex with men (GBMSM) in Western Kenya. Design:Cross-sectional observational study. Methods:Five hundred and eleven GBMSM ages 18–29 were recruited from nine communities in Western Kenya using community-based mobilization strategies. Participants completed an audio computer-assisted self-interview survey in English or Duhluo. We estimated four three-step hierarchical linear regression models to examine associations between predictors (intrapersonal and interpersonal factors) and four resilient outcomes (psychological well-being, self-esteem, condom use, HIV testing). Results:Psychosocial well-being model (modeled conversely as depression/anxiety) was significant (F(13,424) = 106.41, P < 0.001, R2 = 0.765) with loneliness, lesbian/gay/bisexual (LGB) difficult process, LGB identity superiority, and reactions to trauma as predictors. Self-esteem model was significant (F(12,425) = 6.40, P < 0.001, R2 = 0.153) with known HIV-seropositivity, perceived social support, internalized homonegativity, and LGB difficult process as predictors. Condom use model was significant (F(13,379) = 4.30, P < 0.001, R2 = 0.128) with perceived social support, self-esteem, and reactions to trauma as predictors. HIV testing model was significant (F(12,377) = 4.75, P < 0.001, R2 = 0.131) with loneliness, LGB identity uncertainty, LGB difficult process, and LGB identity superiority as predictors. Conclusion:This study demonstrates the variety of ways in which intrapersonal and interpersonal factors are associated with HIV-related resilient outcomes for young GBMSM in Western Kenya. HIV prevention programs for this population should be developed in collaboration with GBMSM and include intervention components that promote resilience.

Driver risk factors of road traffic injuries in an urban setting in Kenya: a case–control study

Introduction Published studies on road traffic injuries in Kenya are all descriptive. There is a dearth of data from controlled studies. The purpose of this study was to determine the contribution of driver risk factors for motor vehicle crashes. Methods This was a case–control study undertaken in Eldoret, Kenya. Cases were drivers of motor vehicles that had crashed and resulted in hospitalisation of the injured; controls were non-accident involved drivers randomly selected through a roadside survey from the driving population. Results 150 case and 327 control drivers were interviewed. They were mostly young (mean age 36.8 years), male (96.7%), married (86%) with post-primary education (60%). The demographic characteristics of cases and controls were similar. The most important personal risk factors were age, not having a driving licence, alcohol use, overspeeding and use of mobile phones. Younger drivers (18–44 years) were twice as likely as older drivers to be involved in a crash [OR=1.84]; unlicensed drivers were 5 times more likely than those licensed to be involved in a crash; drivers who had consumed alcohol were three times more likely to crash [OR=2.94]; and those driving at a speed greater than the posted speed limit were 10 times more likely to crash [OR=10.378]. Conclusions Modifiable driver factors such as licensing, speed, alcohol and use of mobile phones are important risk factors for cashes on urban roads. Enhanced awareness and enforcement of legislation on these factors should be emphasised as part of broader road safety interventions for all road users.