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)

© GeoNames, HERE, MSFT, Microsoft, NavInfo, Thinkware Extract, Wikipedia

Powered by Bing

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)

– Twitter

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