Introduction Driver distraction is increasingly recognized as a significant predictor of road traffic crashes today. Uganda experienced over 18 000 crashes in 2014 and 61.7% were either fatal or regarded as serious. Driver distraction as a factor in motor vehicle crashes is currently under reported in Uganda because data on crashes is collected from driver self-reports and witness accounts. This reporting method therefore may be undermining the role driver distraction plays in road traffic crashes. The prevalence o seatbelt use is also poorly documented.

Objective To determine the prevalence and forms of driver distraction and seatbelt in Kampala.

Methods A cross sectional study design was used. 12 244 drivers were observed over a 7 day period at 3 randomly selected sites by specially trained data collectors. Seatbelt use and common forms of driver distractions ranging from use of mobile phones and talking to another car occupant among others were observed. Associations are reported using Odds ratios and p-values.

Data analysis Data was analyzed using R software.

Results The observed prevalence of any form of distraction was 50.2% (6146/12244) while seatbelt use stood at 36.3%. Seatbelt use was higher among private drivers 51.1% compared to public drivers 14.8%. Overall private drivers were more likely to be distracted than public drivers for all forms of distraction except for looking outside the car (OR=0.73, CI=0.63–0.84). Male drivers were more likely to be distracted than female drivers except talking to a passenger (OR=0.73, CI=0.63–0.84). All associations were statistically significant at bivariate level except for variation of phone use among female and male drivers where the p-value was greater than 0.05 but only type of vehicle, sex of driver and time of the day were at multivariate level.

Conclusion Priority needs to be given to addressing all forms of driver distraction among drivers.