Lessons from implementation of a peer-led training programme on lifejacket wear among occupational boaters on Lake...

While the burden of drowning is reducing in high-income settings, the African region continues to suffer the highest death rate globally. Lakeside boating communities in Uganda remain among the most affected, yet with chronic low lifejacket wear. Following a peer-led training programme to improve lifejacket wear among occupational boaters on Lake Albert, we set out to explore its successes and challenges to inform scale-up.

We took a critical realism position to conduct a qualitative enquiry among occupational boaters on Lake Albert, Uganda. Occupational boaters included fishermen who use boats, water transport operators, boat owners and other boat crew. Leaning on an emic epistemological approach, we conducted seven focus group discussions and seven in-depth interviews with peer trainers and recipients of the intervention at their respective landing sites to explore perspectives on the successes and challenges of the training programme.

The peer-led approach was well received by the boaters due to the trainers' knowledge of the subject, familiarity and collegiality with their community members. The timing of the training, manuals delivered using local languages and community engagement contributed to the programme's success. The perceived programme challenges included limited access to quality lifejackets, expectations of free lifejacket distribution, robberies on the lake enhanced by reflective lifejackets and fluctuating fishing seasons.

The peer-to-peer training approach was considered friendly due to the perceived knowledge of the trainers, their familiarity and collegiality with the trainees. The success of this approach depends on optimal session timing and providing trainers with culturally appropriate training reference materials.