It’s hard to believe that something as simple—and cheap—as a sticker can save lives. But Zusha! has proven that it can.
Zusha! is a Swahili word that means “speak up, speak out”. It is now a term synonymous with a nationwide road safety campaign in Kenya.
Since 2010, Georgetown University researchers have been working to save lives on Kenya’s dangerous roads through the Zusha! initiative. The program uses stickers that promote action through text and images to empower passengers in public service vehicles (PSVs) to speak out directly to their driver when they are driving recklessly. It may be a simple concept, but it has been proven to deliver big results at a fraction of the cost of other road safety initiatives.
Many of the most high-profile efforts to improve road safety focus on sweeping, systemic changes in infrastructure and laws. These long-term investments are important – but they take time, and money. Zusha! provides an inexpensive complement to these efforts by encouraging a behavioral nudge that can make an immediate impact, and result in lasting change.
Road safety is not necessarily the first thing that comes to mind when thinking of epidemics that affect the lives of people in Sub-Saharan Africa. Yet road accidents are the leading cause of death there for young people between the ages of 15 and 29. And unlike other disease-related epidemics such as malaria and tuberculosis that are on the decline, traffic-related injuries and death are a growing problem.
In Kenya, the annual rate of road deaths is 29.1 per 100,000 people, the 15th highest in the world. Accidents involving buses and mini-buses, known as matatus, frequently result in dozens of injuries and deaths. Such horrific headlines are far too common.
Zusha! is Born
Zusha! began in 2010 as a pilot study run by two professors at Georgetown University, Drs. Billy Jack and James Habyarimana. Dr. Jack had just moved to Nairobi, and was shocked to discover how dangerous it was to drive on the roads. Dr. Habyarimana, a Ugandan native, had first-hand experience of the effects of road accidents in his home country. Recognizing that they could do little in the way of passing laws or building infrastructure, they came up with an idea to reach the passengers of public service vehicles, to give them a voice to demand safer driving and better service. They realized they could directly reach tens of thousands of people by getting inside the vehicles.
Drs. Jack and Habyarimana created a series of stickers that would be placed inside PSVs, in clear view of the passengers. The stickers contained both images and text. The text urged passengers to “Zusha!”—to speak up—directly to the driver if he was driving unsafely. They might tell him to slow down, or stop overlapping, or even to get off his cell phone. The images depicted both the consequences of not speaking up, such as injuries, as well as examples of people using their voice.
Ultimately, Jack and Habyarimana believe the stickers help to overcome a collective action problem: nobody in the crowded bus wants to be the one to complain or say something, and so everyone stays silent – sometimes with tragic consequences. The stickers legitimize passengers’ concerns, and empower them to speak.
It seems too simple, that encouraging people to use their voice could have such an effect on road crashes. But through rigorously implemented randomized control trials, Jack and Habyarimana were able to prove the effectiveness of the Zusha! intervention – twice. Using insurance claims data, they found that vehicles in which the stickers had been placed were up to 50% less likely to have an accident claim than vehicles that did not have stickers. These results were hard to believe – and so they did it again, with more vehicles, and found similar results. The intervention was most effective among the smaller PSV vehicles—the 16-seater matatus—that traveled long distances along regional routes and were thus susceptible to high speed, catastrophic crashes.
The success of these trials led to a Stage III grant from USAID’s Development Innovation Ventures (DIV) in 2014, only the second ever awarded. The grant was used to scale up operations in Kenya countrywide through the Georgetown University Initiative for Innovation, Development, and Evaluation (gui2de) East Africa office in Nairobi. The grant also funded additional studies of similar interventions in Tanzania and Uganda (results pending).
Over the last four years, gui2de has distributed over 100,000 Zusha! stickers to over 55,000 public service vehicles in Kenya. Every year, original images are generated through photo shoots, and focus groups help develop new, effective phrases. The campaign has also used social media, TV commercials, radio ads, and billboards to further encourage road travelers to demand, and speak up for, safe driving.
What’s next for Zusha!?
gui2de works closely with both government and private partners to implement Zusha!. The National Transportation Safety Authority (NTSA) has been an important partner in sticker distribution, monitoring of vehicles for compliance, and general advocacy. We also continue to work with the insurance company Directline Assurance (DLA). DLA distributes Zusha! stickers to their fleet of covered vehicles, which represents about 60% of the PSV market. DLA also runs a Zusha! lottery, through which owners and drivers of vehicles can win a cash prize if they retain their stickers.
In 2018, Zusha! was named a Standout Charity by Give Well. The annual grant from Give Well allows gui2de to maintain a staff presence in Nairobi to continue coordination with DLA and outreach with government agencies and the PSV owners’ organizations.
This summer, gui2de will launch another phase of outreach. We will deliver tens of thousands of stickers to the 16 DLA branches across the country to be distributed to their fleet of PSVs. Previously, we had also distributed stickers at each of the NTSA’s 17 inspection centers; however, because of changes in the NTSA’s mandate due to internal government reorganization, as well as funding constraints, additional distribution will be conducted directly by Zusha! staff in select bus parks across the country. Between the distribution through DLA and our own team, we expect to reach up to 30,000 vehicles by the end of 2019.