The Zusha! road safety campaign is a cost-effective intervention proven to reduce road accidents and save lives. Stickers placed inside of public service vehicles encourage and empower passengers to speak up directly to their drivers against dangerous driving. This successful program is scaling up throughout Kenya and is being tested in other parts of Africa.

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The problem: road accidents

Epidemics are not always disease-related. One of the largest — and growing — epidemics on the global health scene today is traffic accidents. The World Health Organization (WHO) estimates that more than 1.25 million people die in road accidents each year, and another 20–50 million are injured. Road accidents are predicted to be the fifth leading cause of death globally by 2030. [1]

The problem is especially pronounced in low- and middle-income countries. In sub-Saharan Africa, road accidents are the leading cause of death for people ages 15–29 and the second leading cause of death for children ages 5–14. The situation is particularly grim in Kenya, where the annual rate of road deaths, at just over 29 per 100,000 individuals, is the fifteenth highest in the world. Such loss of life and associated injuries have enormous socio-economic impact on families, communities, and the nation at large.

In sub-Saharan Africa, road accidents are the leading cause of death for people ages 15 to 29 and the second leading cause of death for children ages 5 to 14.

Many of the road deaths in Kenya occur in minibuses — “matatus” — the primary mode of transportation in the region. Accidents can occur because of speeding and dangerous overtaking, often motivated by the fact that the faster a driver goes, the more passengers they serve and the more money they make. 

Traditional interventions such as speed governors, complaint hotlines, increased traffic enforcement, road improvements, and new laws can be extremely expensive as well as slow to implement. There’s also no evidence that any of these initiatives work. More importantly, these approaches do not provide passengers real-time control over their own safety when subjected to life-threatening, dangerous driving.

The solution: motivational stickers

As the WHO noted in 2013, “Road traffic injuries have been neglected from the global health agenda for many years, despite being predictable and largely preventable.” Georgetown University’s Drs. James Habyarimana and Billy Jack wanted to identify a way to to reduce the number of casualties at a low cost. Their brainchild proved to be simple, cheap, and highly effective: changing the behavior of passengers as well as drivers by way of motivational stickers.

Pamoja tuokoe maisha!
Together we can save lives – one sticker at a time.

How Zusha! works

In Kenya, the Zusha! road safety campaign is implemented by the Georgetown University Initiative on Innovation, Development, and Evaluation (gui2de), in partnership with Kenyan insurance company Directline Assurance and Kenyan authorities like the National Transport and Safety Authority.

They provide stickers with motivational messages that prompt passengers to “Zusha!” — the Kiswahili word for “protest” or “speak up”– against reckless driving directly to the driver of their matatus or bus. To encourage drivers to place and retain the stickers in their vehicles, the campaign includes a lottery through which they can win a cash prize if they correctly display the stickers.

Woman placing Zusha sticker in bus

What makes Zusha! so effective


Stickers costs less than $US2 each for production and placement, and are viewed by millions of passengers. Zusha!’s cost-effectiveness ratio is estimated to be between US$6.50–$11.70 per DALY (disability-adjusted life year). [2]


In 2015, Zusha! scaled up throughout Kenya, where it has since distributed over 100,000 sets of stickers to 55,000 vehicles. The program has also been tested for impact in Tanzania, Rwanda, and Uganda.


Zusha! assesses the coverage rate of stickers through lottery compliance, bus park checks, and inspections by Kenya’s National Transport and Safety Authority. Coverage rates are estimated to be about 20–50% among targeted vehicles.

Proven impact

Two randomized control trials prove that vehicles with Zusha! stickers have 25–50% fewer insurance accident claims and avoid an estimated 55 deaths each year.

Zusha!’s accountability

gui2de conducts empirical field-based research to assess the impact and effectiveness of their interventions and policies. The program’s initial success helped Zusha!’s creators, Professors William Jack and James Habyarimana of Georgetown University, secure a grant from USAID to scale their intervention nationwide in Kenya, plus initiate research trials in Tanzania, Rwanda, and Uganda.

Recognition for Zusha!

In 2017, Good Ventures made a GiveWell Incubation Grant of US$900,000 to support gui2de’s work on Zusha!.

Frequently Asked Questions

The stickers feature pictures of accidents or injured passengers with messages in either English or Swahili, including:

  • Take action against reckless driving. Speak up to the driver now!
  • Don’t let an over speeding driver end the life of a child. Demand a safe ride!
  • Over speeding + Overlapping = Death. Speak up to avoid accidents.
  • If only one of the passengers had spoken up!
  • Your family needs you, tell the driver not to be careless

To encourage the drivers to place and retain the stickers in their vehicles, the campaign includes a lottery through which drivers can win a cash prize if they correctly display the stickers.

Zusha! will use the funds primarily to ensure they can continue designing, printing, and distributing stickers. To conduct those activities, they will also use funding to support a couple of field staff based in their Nairobi office, who will continue collaboration and outreach with partners such as insurance companies and government agencies. Zusha! plans to use donations from The Live You Can Save donors only for these direct project costs, not for rent, general office overhead, etc.

We recommend Zusha! because they were recognized as a GiveWell standout charity before GiveWell retired that designation.

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All photos and videos courtesy of Georgetown University Initiative on Innovation, Development, and Evaluation

[1] World Health Organization, Global status report on road safety 2013

[2] Journal of Public Economics, Corrigendum to “Heckle and Chide: Results of a randomized road safety intervention in Kenya”