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Evaluating the Decade of Action for Road Safety:
Some emerging results
1
Margie Peden, Senior Research Fellow, Head Global Injury Programme, TGI
And
Adnan A. Hyder, Senior Associate Dean for Research and Professor of Global
Health, Milken Institute School of Public Health, the George Washington
University
29 October, 2019
Research team
• The George Institute
• Margie Peden & Prasanthi Attwood
• George Washington Milken Institute School of Public Health
• Adnan Hyder & Nino Paichadze
• Imran Bari and Hyunjae Cho
• WHO
• Melecki Khayesi
• Sean Flannigan
• MAPFRE Foundation*
• Jesus Monclus Gonzalez
• Belen Campillo Garcia
* Funded by MAPFRE Foundation
Methods used
Mixed methods
1. Analysis of Global Status Reports
2. Online survey
3. In-depth interviews
4. Review of literature
5. Analysis of SG reports
Both qualitative and quantitative approaches
Global Status Report on Road Safety
Preliminary results
Methodology
Year
Number of
Participating
Countries
Number of Countries
Dropped
2010 182 21
2013 180 19
2016 175 14
Number of countries included in the analysis: 161
Road traffic deaths/100,000 by income level
8.5
17.6
20.6
15.7
11.7
16.8
22.1
16.4
7.8
17.0
26.7
16.4
0
5
10
15
20
25
30
High-income Middle-income Low-income Total
DE
AT
HS
P
ER
10
0,0
00
2010 2013 2016
Percentage change in road traffic deaths (2010- 2016)
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Increase
Decrease
No Data
Countries consistently ranked among the top 10,
2010-2016
Countries with highest death rates Countries with lowest death rates
Country 2010 2013 2016
Thailand Rank 2
(38.1)
Rank 1
(36.2)
Rank 8
(32.7)
Liberia -Rank 3
(33.7)
Rank 1
(35.9)
Guinea-
Bissau
Rank 8
(31.2)-
Rank 9
(31.7)
Malawi -Rank 2
(35.0)
Rank 10
(31.0)
Country 2010 2013 2016
SwedenRank 4
(3.0)
Rank 2
(2.8)
Rank 5
(2.8)
United
Kingdom
Rank 6
(3.7)
Rank 3
(2.9)
Rank 7
(3.1)
NetherlandsRank 8
(3.9)
Rank 7
(3.4)
Rank 8
(3.8)
Number of countries which have a lead agency for road safety
34
72
22
128
45
80
25
150
44
82
22
148
0
20
40
60
80
100
120
140
160
High-income Middle-income Low-income Total
Co
un
ts
2010 2013 2016
Pro
mo
te u
rban
tra
nsp
ort
Promote walking
2010 2013 2016
Yes No Yes No Yes No
Yes 59 36 Yes 75 30 Yes 85 36
No 8 58 No 10 46 No 12 28
Countries that promote walking and urban
transport
Number of countries with blood alcohol concentration limits (for general
population) less than or equal to 0.05 g/dl
31
45
7
83
4135
3
79
3945
4
88
0
10
20
30
40
50
60
70
80
90
100
High-income Middle-income Low-income Total
2010 2014 2017
Number of countries that have urban speed limit =< 50 km/h
33
49
19
101
3438
12
84
3640
12
88
0
20
40
60
80
100
120
High-income Middle-income Low-income Total
2010 2014 2017
Online Survey
Preliminary results
• Aim: to understand perceptions of the overall success and
impact of the Decade of Action globally, nationally and on an
organizational level
• Specifically, the survey sought to answer the following
questions:
– Was the Decade a success?
– Why was the Decade useful? (e.g. funding, capacity development,
strategy alignment)
– What challenges were encountered?
– Should there be another Decade?
Aim of the survey
• The link to the survey was shared with the members of the
following organizations
– UNRSC
– GRSP
– RTIRN
– Global Alliance of NGOs for Road Safety
– GRSLC (Facebook page only)
Survey participants
• Total responses: 115
• Country of residence of the respondents
– 48 different countries
• Organizations of 50 (44%) respondents are UNRSC members
Preliminary results
Respondents’ country of residence
Type of the organization
Geographic focus of organization’s road safety work
Number of years organization has worked in road safety
Other injury topics that organizations work on
In general, how would you describe the Decade of Action?
What contributed the most to the success of the Decade of Action?
Globally In your country In your organization
Increased Fund 65
(49.6%)
23
(17.6%)
29
(22.1%)
Increased
awareness
86
(43.7%)
50
(25.4%)
60
(30.5%)
Buy-in from
government
47
(40.9%)
40
(34.8%)
17
(14.8%)
Increased
capacity
53
(38.1%)
36
(25.9%)
40
(28.8%)
Better data 0
(0.0%)
42
(41.6%)
47
(46.5%)
What hindered the success of the Decade of Action the most?
Globally In your country In your organization
Lack of funding 56
(33.1%)
59
(34.9%)
47
(27.8%)
Lack of awareness 27
(28.1%)
39
(40.6%)
17
(17.7%)
Buy-in from
government
34
(29.8%)
46
(40.4%)
20
(17.5%)
Lack of capacity 39
(32.0%)
48
(39.3%)
27
(22.1%)
Lack of data 45
(33.1%)
50
(36.8%)
30
(22.1%)
Others 10
(27.0%)
12
(32.4%)
8
(21.6%)
Given the progress of the Decade of Action, is there a need for another (similar)
initiative after 2020?
Qualitative data
In-depth interviews
• 14 people approached
• 12 agreed
• To date interviewed 9 (7
English + 2 Spanish)
• Mixture of international,
country, youth, NGO,
academics, traumatologist,
non-RS person, etc
• 18 questions in following
themes: organizational, inputs,
output/ outcomes, opinions
Draft analysis on these questions:
1. Do you think the DoA was a success?
2. Was the Global plan for the Decade
(and the 5 pillars) a useful framework?
3. Do you think there should be a 2nd
Decade?
4. Other interesting suggestions
In-depth interviewsDo you think the DoA was a success?
Mean = 5 (range 2-8)
“I think it was a success if you compare to what we had before and what we have
now… in terms of coordination, movement, building, strengthening of civil society,
attention in general, funding”
“if you take the lives saved compared with the projection… its quite significant” and
“…we can see an elevation of status”
“lots of frameworks which helped but haven’t translated to a national level”
“put a good dent in the awareness piece of it”… “think it could have been much
more”
“the biggest disappointment is about funding…”
“so much energy went into the launch of the decade… but there wasn’t a steady
drumbeat…” “started well but fizzled out”
In-depth interviews
Was the Global plan for the Decade (and the 5 pillars) a useful framework?
• Unanimous yes
• A new way of thinking
• Encouragement to put in place evidence-based interventions
“some countries used it to develop their own action plans”
“drew attention to RS management and post-crash”
“add a speed pillar”
In-depth interviews
Do you think there should be a second Decade?
• 78% said yes
• Focus on global fund, a sensible target, regional efforts…
• But be “more strategic in getting political will” and “should not lose
momentum” and “super clear on focus… and what outcomes are going
to be”
• Those who said no felt that without funding it was pointless or that the
SDGs have taken over
In-depth interviews
Other reflections
“That the level of funding being put into road safety is orders of magnitude
short of what's actually necessary to manage the problem”
“there is money if there is political will”
“goal for the Decade was not clear … because the SDG took over”
“NGOs should be more ‘angry’ “ to be more of a catalyst”
“”limited capacity in countries”
“we need to continue building capacity on data collection, enforcement,
trauma care…”
“true multisectoral collaboration remains a challenge”
Review of the literature
Key words:
(Decade[Title/Abstract] AND ("accidents"[MeSH
Major Topic] OR "road"[Title/Abstract])) AND
((((Decade[All Fields] OR Decade[Title]) AND
road[Title/Abstract]) AND "accidents"[MeSH Major
Topic])
Databases:
PUBMED/Medline, EMBASE, Google Scholar,
TRID, SafetyLit, LILACS, LATINDEX and SciELO
Languages:
English, Spanish, French
Review of the literature
Total articles meeting criteria:
79
Main themes:
• 18 countries
• Africa: Kenya, Uganda
• Americas: Brazil, Colombia, Mexico, Argentina, Nicaragua
• East Med: Saudi, Iran, Qatar
• S-E Asia: Cambodia, India, Bangladesh, Thailand, Indonesia
• W Pacific: Philippines
• Europe: Germany, Italy
• Regions
• 4 continents, Europe, East Africa, Africa, Southern Africa, SS Africa, Asia, Eastern Med, Global
Which Pillars were addressed?1 = 38 (trends, strategies, management)2 = 53 = 24 = 21 (VRUs, children, research)5 = 6Some covered multiple pillars
SG report analysis
• Why thematic content analysis of five SG’s progress reports and not
textual discourse analysis?
• Began with physical reading of reports to understand the structure,
content and get a sense of themes covered
• Utilized Nvivo to create database of the text of reports
• Coded text reporting on activities according to themes
• Refined codes to eliminate overlaps and double counting
• Computed salience
• Identified 7 key themes
▪ each with sub-themes
Description of themesTheme Description
Meetings Conferences, national and regional workshops/trainings and major events on road safety
Information Collection and dissemination of data and information through technical reports, guidelines, scientific articles, conducting research and sharing
experience
Management Activities related to planning, coordinating, facilitating, collaborating/creating multisectoral partnerships, launching programmes, establishing
institutions/lead agencies, strengthening capacity, preparing national plan/strategy etc in support of road safety policies
Behaviour change Programmes to improve driver behaviour, safety of children, increase seatbelt use, decrease distracted driving, increase use and availability of
helmets, decrease speed, decrease drinking and driving, decrease driving under the influence of illicit drugs through legislation and enforcement
including passing legislation that meets best practices
Advocacy Activities related to securing public and political support for or recommendation or policy related to road safety including campaigns
Roads Activities related to improving safety of road infrastructure, including planning, risk mapping and harmonization of international standards on
roads
Vehicles Programmes to improve vehicle safety through installing intelligent systems in vehicles, improving safety features of vehicles and harmonizing
safety standards of vehicles
Other Funding, policy instruments, technical assist and post-crash care
Themes by year of SG’s progress report
Theme 2011 2013 2015 2017 2019
Advocacy 12 16 5 6 8
Behaviour 8 3 13 9 11
Information 20 14 15 26 18
Management 14 11 4 21 19
Meetings 7 14 16 30 24
Roads 2 4 13 17 7
Vehicles 3 9 6 9 11
Other 10 8 8 18 17
Themes by country income level
Theme High-income [n=32]
Middle-income
[n=70] Low-income [n=14]
Advocacy 8 9 5
Behaviour 4 16 2
Information 6 10 3
Management 2 16 10
Meetings 12 32 6
Roads 8 9 0
Vehicles 1 3 0
Other 4 12 5
Themes by region
Theme
Africa
[n=25]
Asia and
Pacific [n=35]
Europe and
other [n=34]
Latin America and
Caribbean [n=22]
Advocacy 6 7 9 4
Behaviour 5 12 4 5
Information 1 1 6 4
Management 10 9 5 8
Meetings 12 18 16 9
Roads 3 9 9 5
Vehicles 0 2 0 1
Other 6 9 7 5
Limitations of SG reports
• Activities analysed are not representative of all DOA initiatives
• Activities are not representative of all organizations, regions and
countries
• Verification and follow up on a few key activities has not been done
Conclusions
• Decade was successful in terms of:
▪ Awareness raising (weeks,
conferences, days)
▪ SDGs x2
▪ Funding at a global level
▪ NGO alliance
▪ Capacity development
▪ Data improvement (in countries)
▪ Trauma care focus increased
• More focus needed on:
▪ Political will at a country level
Funding at a country level
▪ Regional activities
▪ Targets and indicators
▪ More capacity development
Next steps
• Further analysis
• Preparation of a booklet for Sweden
• Academic article