Radiation protection knowledge, attitudes, and practices among radiology managers in Kampala Central Division: A cross-sectional study.

Background: Medical applications account for nearly all human-made sources of ionizing radiation exposure, making radiation protection (RP) essential for safeguarding patients and healthcare workers (HCWs). Radiology managers are central to ensuring compliance with safety standards, promoting a positive safety culture, and overseeing RP resources. However, their knowledge, attitudes, and practices (KAP) regarding radiation safety are insufficiently documented in Uganda. Objective: To assess the RP KAP of radiology managers in medical facilities within Kampala Central Division and generate evidence to strengthen radiation safety systems. Methods: A cross-sectional quantitative study was conducted among radiology managers from all 19 Atomic Energy Council licensed facilities in Kampala Central Division. Data were collected using a structured, self-administered questionnaire adapted from validated tools. Descriptive statistics summarized demographic characteristics and KAP levels. Knowledge was categorized using Bloom’s cut-off points, and attitudes were assessed using a 5-point Likert scale. Associations between demographic characteristics and knowledge levels were examined using the Chi-square test. Results: Nineteen managers participated (73.68% male; mean age 26 years). Knowledge levels were mostly low (47.37%) or moderate (47.37%), with only one participant achieving a high score. Level of education (p = 0.038) and hospital type (p = 0.002) were significantly associated with knowledge. Attitudes toward RP were highly positive, with mean scores above 4.8 on key items. RP practices were generally adequate, including universal availability of AEC regulations and high encouragement of PPE use, although gaps such as inconsistent dosimeter monitoring were noted. Conclusion: Although radiology managers expressed strong attitudes toward RP, their knowledge levels were suboptimal. Strengthening training, promoting continuous professional development, and reinforcing institutional RP systems are essential to improving radiation safety for HCWs and patients. Recommendation: Facilities should implement targeted and continuous training programs, especially through CMEs, for radiology managers to strengthen their knowledge of radiation safety principles.