Table 2 Factors noted in Delphi round one to affect the exposure, vulnerability and EMS capacity for victims of RTI in KMA
| Â | Exposure | Vulnerability | Emergency medical service capacity |
|---|---|---|---|
1 | Lack of driving licenses among drivers | Ignorance and low awareness level on road safety | Crash and injury severity |
2 | Inadequate driving training regime | Socio demographic factors | Crash type |
3 | Indiscipline among road users | Driving/or riding incompetency | Number of affected victims |
4 | Inadequate awareness of road safety laws | Carelessness of pedestrians and cyclists | Time/season in order to determine the deployment |
5 | Careless road users | Lack of child accompaniment while on roads | Level of survivability |
6 | Excessive speed | Lack of appropriate driving training | Financial constraints and limited investment in EMS |
7 | Drinking and driving | Blindness without any guidance | Lack of enough and well - equipped ambulances |
8 | Ineffective enforcement of traffic laws | Inappropriate infrastructure for pedestrians and non-motorized road users | Access to referral medical facilities and services |
9 | Low risk perception among road users | Limited interest in road safety sensitization by majority road users | Lack of basic rescue and evacuation skills among lay people |
10 | Unregulated rise of Boda-bodas | Low risk perception among road users | Occurrence of crash in certain locations |
11 | Weather conditions | Alcohol and drug influence | Absence of national EMS policy and post-crash care system |
12 | Poor road engineering design and planning | Poverty leading to unaffordability of safe transport means | Lack of national ambulance network |
13 | Inefficient public transport system | Use of handheld phones by drivers and other road users while on road | Inadequate pre-crash and post-crash data to inform EMS policies |
14 | Driving mechanically dangerous vehicles | Riding/ being transported on Boda-bodas | Limited human capacity trained to handle victims |
15 | Ignoring to use protective safety and visibility gears | Absence of traffic segregation facilities for non-motorized road users | No specialized EMS training courses in medical schools |
16 | Weak road safety policy in KCCA Act | Weak enforcement of existing traffic laws and regulations | Limited training and knowledge in EMS |
17 | Poor and inadequate road furniture | Laxity in using protective gears on roads | Lack of emergency call centers for coordination of EMS activities |
18 | Inadequate pedestrian and cyclist infrastructure | Mixed traffic streams | Unpreparedness among the first responders |
19 | Lack of segregated lanes AND high traffic mix | Road designs and maintenance not considering vulnerable road users | Lack of health insurance by most of the victims |
20 | Overpopulation in Kampala | Lack of formal and informal road safety education among road users | Lack of specialized crash and trauma care sections |
21 | Increased traffic volume and flow | Inadequate regulation of public passenger transport services | In services rotation of EMS staff due to high turn-up of patients |
22 | Affordability and flexibility of 2 wheeler riders | Inadequate public transport system | Inadequate advocacy for establishing formalized EMS systems |
23 | Poor traffic lighting | Poor street lighting | Traffic jams preventing timely emergency response to victims |
24 | Political patronage in road safety enforcement | Â | Â |