Prevalence and determinants of occupational Injuries among welders in small scale metal workshops in Wakiso District, Uganda

Background: Injuries are a public health concern accounting for 2.78 million fatalities globally. Welders are exposed to a broad range of injuries (e.g. cuts, burns, eye injuries, skin irritations, and musculoskeletal disorders) and yet, there is paucity of information on context specific determinants to inform injury prevention and control. This study determined the factors associated with occupational injuries among welders in Uganda.Methods: A cross-sectional study was conducted among welders in Wakiso District, Uganda. Pretested and translated questionnaires were used to collect data from 327 randomly selected respondents using face to face interviews. 2 parishes were purposively selected, and 20 metal workshops were systematically selected in each parish. Descriptive statistics and adjusted odds ratios were computedResults: A high prevalence 287 (87.8%) of self-reported occupational injuries was found among welding workers with cuts/burns 242 (84.3%) and eye injuries 180 (62.7%) reported as the most sustained injuries. Occupational injuries were associated with being a causal labourer with informal training (AOR 4.70 (2.03-10.84)) and working for longer hours (AOR 2.63 (1.26-5.51)). Those with more work  experience were less likely to be involved in occupational injuries (AOR 0.30 (0.11-0.84)).Conclusions: The prevalence of occupational injuries among small-scale welding workers was high and this was associated with learning their trade at work and working for longer hours. Mitigation measures that focus on safety at workplace, advocating for capacity training, and enforcement of workplace regulations should be instituted

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

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

Driver yield and safe child pedestrian crossing behavior promotion by a school traffic warden program at primary school crossings: A cluster-randomized trial

To determine the effect of a school traffic warden program on increasing driver yield and safe child pedestrian crossing behavior in Kampala, Uganda. We designed and implemented a school traffic warden program in specific school zones in Kampala, Uganda. We randomly assigned 34 primary schools in Kampala, in a 1:1 ratio, using a computer-generated randomization sequence, to control or intervention arms in a cluster randomized trial. Each school in the intervention group received one trained adult traffic warden stationed at roads adjacent to schools to help young children safely cross. The control schools continued with the standard of care. We extracted and coded outcome data from video recordings on driver yield and child crossing behavior (defined as waiting at the curb, looking both ways for oncoming vehicles, not running while crossing, and avoiding illegal crossing between vehicles) at baseline and after 6 months. Using a mixed effect modified Poisson regression model, we estimated the prevalence ratio to assess whether being in a school traffic warden program was associated with increased driver yield and safe crossing behavior. A higher proportion of drivers yielded to child pedestrians at crossings with a school traffic warden (aPR 7.2; 95% CI 4.42–11.82). Children were 70% more likely to demonstrate safe crossing behavior in the intervention clusters than in control clusters (aPR 1.7; 95% CI 1.04–2.85). A higher prevalence was recorded for walking while crossing (aPR 1.2; 95% CI 1.08–1.25) in the intervention clusters. The school traffic warden program is associated with increased driver yield and safe child pedestrian crossing behavior, i.e., stopping at the curb, walking while crossing, and not crossing between vehicles. Therefore, the school traffic warden program could be promoted to supplement other road safety measures, such as pedestrian safety road infrastructure, legislation, and enforcement that specifically protects children in school zones.</p

Status of Household Solid Waste Management and Associated Factors in a Slum Community in Kampala, Uganda

Background. Only a third of the total waste generated in slum communities in Kampala is collected and disposed of to the landfill every month. This study assessed the status of household solid waste management and associated factors in a slum community in Kampala, Uganda. Methods. We conducted a community-based cross-sectional study involving 395 households using a semistructured questionnaire and an observational checklist. Proper solid waste management was determined based on possession of waste collection and storage receptacle; collection receptacle ability to minimise nuisances (covered); segregation of waste; presence of flies and other vectors; and collection receptacle fill status. Prevalence rate ratios and their 95% confidence intervals were used as a measure of association. Results. Only, 41.3% (163/395) of the households exhibited proper waste management practices. The majority of the households 85.8% (339/395) owned solid waste storage receptacles, most of which were sacs 61.7% (209/339) and would minimise nuisances 72.9% (245/339). The main type of waste collected was biodegradable materials 56.7% (224/395). The majority of the households 78.7% (311/395) did not segregate their waste. Solid waste was mainly transported to the collection point by pulling the collecting sac 54.4% (215/395). The city authority 73.9% (292/395) and private companies 12.9% (51/395) were the major entities collecting waste. Factors associated with proper waste management were collecting waste in plastic containers (adjusted PR = 1.27, 95% CI (1.04–1.55)), polythene bags (adjusted PR = 0.26, 95% CI (0.14–0.47)), and paper bags or metallic bins (adjusted PR = 0.13, 95% CI (0.03–0.44)) as well as awareness of solid waste management laws (adjusted PR = 1.49, 95% CI (1.20–1.85)) and the dangers of improper solid waste management (adjusted PR = 2.15, 95% CI (1.51–3.06)). Conclusion. Solid waste management was generally poor. As such, a cascade of interventions that address knowledge, physical, and behavioural aspects of solid waste management is required to improve its management in slum communities

What could go wrong with cooking? Exploring vulnerability at the water, energy and food Nexus in Kampala through a social practices lens.

Sub-Saharan African cities like Kampala face challenges with rapid urbanization and impacts of climate change. These challenges have exacerbated the struggle to provide adequate infrastructural and socio-ecological services to Kampala's growing poor. Based on a social practices perspective, this paper presents a study of emergent vulnerabilities at the urban Nexus of water, energy and food (WEF) in the informal settlements of Bwaise and Kanyogoga. We employ methods of observation, interviews, focus group discussions and a vision-building workshop to explore the growing vulnerabilities of poor households as they daily navigate deteriorating water quality, rising energy prices and food insecurity. Results indicate that most household-level vulnerabilities relate to energy poverty. Households scale back on water treatment practices such as boiling and the cooking of highly-nutritious yet energy-demanding foods such as beans in efforts to conserve charcoal. Emergent practices of everyday resilience-building include the use of biomass briquettes as an alternative to solid charcoal as well as social networks and capital which allow households to borrow food and energy. We suggest the notion of ‘precarious consumption’ as a tool for understanding emergent everyday vulnerabilities in relation to the urban WEF Nexus service provision and resilience policy-making in cities of the Global South.</p

Opportunities and barriers to effective operation and maintenance of public toilets in informal settlements: perspectives from toilet operators in Kampala

Although classified by the Joint Monitoring Programme (JMP) as unimproved sanitation facilities, public toilets still play a critical role in eliminating open defecation in informal settlements. We explored perspectives of toilet operators on opportunities and barriers to operation and maintenance (O&M) of public toilets in informal settlements. A cross-sectional study design was used. Up to 20 in-depth interviews were used to obtain data on the experiences of public toilet operators. Thematic content analysis was used. Ressults show that opportunities for improving O&M include; operation of public toilets is a source of livelihood; operators are knowledgeable on occupational risks, and the community is involvedin sanitation activities. Barriers to effective O&M include; high operation costs, failure to break even and a lack of investments in occupational health Therefore, there is need to recognise the significance of public toilets as a viable alternative to open defecation in areas where ownership of private sanitation facilities is difficult. Failure to observe the health and safety of toilet operators may further compromise O&M

Developing, implementing, and monitoring tailored strategies for integrated knowledge translation in five sub-Saharan African countries

Abstract Background Integrated knowledge translation (IKT) through strategic, continuous engagement with decision-makers represents an approach to bridge research, policy and practice. The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA +), comprising research institutions in Ethiopia, Malawi, Rwanda, South Africa, Uganda and Germany, developed and implemented tailored IKT strategies as part of its multifaceted research on prevention and care of non-communicable diseases and road traffic injuries. The objective of this article is to describe the CEBHA + IKT approach and report on the development, implementation and monitoring of site-specific IKT strategies. Methods We draw on findings derived from the mixed method IKT evaluation (conducted in 2020–2021), and undertook document analyses and a reflective survey among IKT implementers. Quantitative data were analysed descriptively and qualitative data were analysed using content analysis. The authors used the TIDieR checklist to report results in a structured manner. Results Preliminary IKT evaluation data (33 interviews with researchers and stakeholders from policy and practice, and 31 survey responses), 49 documents, and eight responses to the reflective survey informed this article. In each of the five African CEBHA + countries, a site-specific IKT strategy guided IKT implementation, tailored to the respective national context, engagement aims, research tasks, and individuals involved. IKT implementers undertook a variety of IKT activities at varying levels of engagement that targeted a broad range of decision-makers and other stakeholders, particularly during project planning, data interpretation, and output dissemination. Throughout the project, the IKT teams continued to tailor IKT strategies informally and modified the IKT approach by responding to ad hoc engagements and involving non-governmental organisations, universities, and communities. Challenges to using systematic, formalised IKT strategies arose in particular with respect to the demand on time and resources, leading to the modification of monitoring processes. Conclusion Tailoring of the CEBHA + IKT approach led to the inclusion of some atypical IKT partners and to greater responsiveness to unexpected opportunities for decision-maker engagement. Benefits of using systematic IKT strategies included clarity on engagement aims, balancing of existing and new strategic partnerships, and an enhanced understanding of research context, including site-specific structures for evidence-informed decision-making