Six Lessons Learned from Large Scale Road Safety Programs

Each year – according to the Global Status Report on Road Safety 2018 – 1.3 million people die on the world’s roads. Another 20-50 million sustain non-fatal injuries, and among 15-29 year-olds road traffic injuries (RTIs) are the leading cause of death globally.

Statistics such as these fuel our work here at the Johns Hopkins International Injury Research Unit to work tirelessly within the road safety field and strive to reduce the burden of RTIs around the world. 

As we conclude another phase working with Bloomberg Philanthropies and international partners, we can reflect on our time working across 10 cities and 10 countries to reduce non-fatal and fatal RTIs and impact key risk factors.

1. Understand your data sources
   When our team was in Vietnam, studying mortality due to RTIs, we had a number of secondary data sources at our disposal and each provided us with different information. From police and hospital data, to national surveys and commune level vital registration information, we were able to draw diverse insights on everything from injury and fatality rates to crash frequencies and details.
   
   Such is the case for road safety data around the world: to ensure the full story, it’s important to gather from multiple sources and understand the value that each has.
    
2. Repeated measurements are useful in monitoring trends and identifying focus areas
   As we learned when we studied helmet use, speeding, restraint use, and drink driving in these cities and countries, repeated rounds of measurement are important to identify patterns and trends; they can help with identification of emerging issues as well as highlight areas of programmatic success.
   
   If we hadn’t looked at multiple rounds in Bangkok, for example, we wouldn’t have as clearly been able to conclude that females had a significantly lower rate of helmet use, or to focus on passengers, weekends, and evening/night-time enforcement.
    
3. Mixed methods approach necessary to understand underlying factors
   To truly paint accurate road safety pictures, we utilized a combination of both quantitative and qualitative studies. And in doing so, this mixed-methods approach provided a clearer understanding of factors underlying the observed trends or outcomes than if we implemented a more one-dimensional focus.
   
   While conducting KAP roadside interviews in two Kenyan towns, we analyzed nearly 5,000 respondents’ answers to questions on the top factors related to the decision to speed, as well as the proportion that knew the speed limit at the part of the road. These analyses were helpful in assessing each towns’ road safety climate. Complementing them, however, were the insightful interviews that provided a more detailed commentary on the situation.
    
4. Coordinated efforts necessary for sustained improvement
   It takes a village to oversee continued progress, which we learned throughout our work, including during drink-driving observations in Addis Ababa.
   
   Assessing the drink-driving rate in the Ethiopian city over more than three years, for example, we could cross-reference critical points of partner efforts such as mass media campaigns and enforcement. In doing so, we learned the significant impact of each strategy and, in tandem with each other, the overall value provided to the community.
    
5. External activities do have an impact
   Sometimes, independent and uncontrollable events and activities can become mechanisms for change, too.
   
   During our time in Cambodia, for example, we tracked helmet wearing rates among drivers and pinpointed several newsworthy dates that triggered an impact. From the floods in Kandal and Kampong Speu, to the national elections, and even the funeral of a former king, the scope and visibility of enforcement in the region became catalysts for behavior change, both positive and negative.
    
6. You can’t do it alone!
   Through the collaboration with multidisciplinary partners, messages can be amplified and the reach can be widened.
   
   Studying information sharing across stakeholders in Colombia, we were able to glean the true potential of campaigns when working in larger networks and increasing capacity development. As we mapped, our network of report sharing between local stakeholders, such as Universidad de Los Andes and Universidad de Antioquia, as well as other organizations including iRAP, World Bank, Vital Strategies, and World Resource Institute, we saw a greater impact and effect on our stakeholders, ranging from the media and general public, to the Bogota Traffic Police and other city government agencies.