Background Rural Uganda is an especially hazardous environment for children with limited parental supervision, open fires, speeding traffic, sharp farm tools, and flowing rivers. Effective safety education has the potential to reduce injury risk among this vulnerable population. Although safety instruction is a required component of the national curriculum, schools face challenges of overcrowding, understaffing, lack of resources and teacher training, and absenteeism which may inhibit student learning of safety behaviours. Given this context, there is need to investigate the content, quality and effectiveness of the safety units as currently taught in Ugandan schools.

Objective Qualitatively assess primary teacher perceptions of 1) childhood injury risks in a rural Ugandan community, and 2) the current state of safety instruction.

Results 21 teachers in grades 1–6 from 5 schools in rural eastern Uganda completed surveys on child injuries and safety instruction. Falls, cuts, and burns are considered the most common injuries among children. Children are frequently left without adult supervision, beginning between ages 3–7. Children are especially likely to be alone when either the child or parent is busy farming, fetching water, or at market. Safety units are most commonly taught in grades 1, 2, 4 and 6. The most common topics are safety around roads/transport and safety at home. The most common instructional strategies include providing information/safety rules, safety demonstrations, and first aid training. All teachers report their students adopt safer behaviours after instruction. Only one teacher reports ever receiving training in safety instruction.

Conclusions Injury risk is high in rural Uganda but children often receive inadequate supervision. Teachers are motivated to teach safety skills but lack supportive training and resources. Explicit training and materials developed for Ugandan teachers has the potential to reduce childhood injury risk in rural Uganda.