Background Drowning is a major cause of unintentional injury death worldwide. The toll is greatest in low and middle-income countries. Over 95% of people who drowned while boating in Uganda were not wearing a lifejacket. We explored the determinants of lifejacket use among boaters on Lake Albert, Uganda.
Methods We conducted a qualitative enquiry with a hermeneutic phenomenological undertone leaning on relativism ontology and emic subjectivism epistemology. Focus group discussions (FGDs) and in-depth interviews (IDIs) were held with boaters in 10 landing sites. We explored experiences and perspectives on lifejacket use. We used thematic analysis technique to analyse data and report results according to the Consolidated Criteria for Reporting Qualitative Research.
Results We recruited 88 boaters in 10 FGDs and 11 to take part in the IDIs. We identified three themes: motivators and opportunities for lifejacket use, barriers and threats to lifejacket use, and strategies to improve lifejacket use. Many boaters attributed their lifejacket use to prior experience or witness of a drowning. Perceived high costs of lifejackets, limited knowledge, reluctance to use lifejackets because of distrust in their effectiveness, and the belief that it is women who should wear lifejackets were among the barriers and threats. Participants mentioned the need for mandatory enforcement together with community sensitisations as strategies to improve lifejacket use.
Conclusion Determinants of lifejacket use among boaters include experience or witness of drowning, limited knowledge about lifejackets and distrust in the effectiveness of the available lifejackets. Mandatory lifejacket wearing alongside educational interventions might improve lifejacket use.
- qualitative research
- risk perception
Data availability statement
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Contributors All authors made significant contributions to merit coauthorship. FO conceptualised the study, led the writing of the proposal, obtained ethical clearance, supervised the data collection process, oversaw the analysis and led the writing of the manuscript. SPSK and JJ provided technical guidance on the best qualitative approach for the study, and played a supervisory role in the entire process. FN advised on data collection process and participated in the interpretation of findings. FEM, KT and JBI participated in the review of the manuscript to ensure intellectual integrity. TM and LRN participated in the data analysis, while OK provided expert advice as the senior in the field of drowning prevention. All authors reviewed and approved the final manuscript. However, FO takes full responsibility for the conduct of the study and final manuscript as the guarantor; he had full access to the data, and controlled the decision to publish.
Funding This study was partly supported by Bloomberg Philanthropies (51606) through the CDC Foundation and the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Centre and the University of the Witwatersrand; and funded by the Carnegie Corporation of New York (grant no: B 8606.R02), Sida (grant no: 54100029), the DELTAS Africa Initiative (grant no: 107768/Z/15/Z). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences' (AAS) Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa’s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK) and the UK government.
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Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
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