Can Effective Collaboration Improve Road Safety in Kenya

1
Can Effective Collaboration Improve Road Safety
in Kenya?

• The Ministry of Health and The Task Force for
  Global Health
• Nairobi, Kenya--May 29, 2009

2
Basic Assumptions

• We know what to do but we have trouble
  implementing it
• The trouble with implementation is the result of
  a lack of capacity
• Lack resources human, knowledge, and financial
• Lack political will
• It is possible to build capacity and effectively
  implement road safety measures that make a
  difference
• We have a lot to learn from the people in Kenya

3
There is a long history of road safety
initiatives in Kenya

• 1979National road safety project implemented
  with funding from Finnish government
• 1982National Road Safety Council
  establishedinterventions included driver
  training, education, accident investigation
  number of traffic crashes decreased
• 1991Kenya/Finnish program abruptly ended
• 2000--SIDA program Kenya
• 2003Minister of Transport called for an
  Integrated National Transport Policy covering
  all modes of transport

4
There is a long history of road safety
initiatives in Kenya

• 2004(Jan)Implementation of seat belts and speed
  governors for matatus enforcement led to drop in
  crashesstrict enforcement lasted only a few
  months
• 2004(Feb)Integrated National Transport Policy
  given to then Minister of Transport, led to
  National Road Safety Plan
• 2004 (April)World Report on Road Traffic Injury
  Prevention

5
Recommendations of the World Report (2004)

• Lead agency
• Data--Assessment of problem, policies and
  institutional settings.
• Plan--National road safety strategy and plan of
  action.
• Resources--Allocation of financial and human
  resources.
• Interventions--Implement specific actions speed,
  impaired driving, seatbelts, helmets, and roadway
  design.
• Collaboration--International cooperation.

Source The World Report on Road Traffic Injury
Prevention
6
The World Report Recommends that Kenya should
have a lead agency for road safety
education
Education
Academia
health
Hospital
Lead agency
police
Finance
Development Agency
transport
Auto Club
urban Planning
Roads
7
And the lead agency for road safety should have
these components
education
Education
Academia
health
Hospital
Lead agency
police
Finance

• Plan
• Resources
• Data
• Actions
• Collaboration

Development Agency
transport
Auto Club
urban Planning
Roads
8
Kenya Developed A National Road Safety Action
Plan in 2005

• Developed by the Ministry of Transport with
  support by the Government of Kenya/SIDA Roads
  2000 Project
• Supported by the Ministries of Roads Public
  Transport, Health, Education, Local Government,
  and the Police Department
• Many other non-government agencies supported this
  and contributed
• Covered 14 separate sectors from road safety
  coordination and management through emergency
  services and rehabilitation

9
The Kenyan National Road Safety Plan calls for a
lead agency with these components
education
Education
Academia
health
Hospital
Kenyan National Road Safety Plan
Lead agency
police
Finance

• Plan
• Resources
• Data
• Actions
• Collaboration

Development Agency
transport
Auto Club
urban Planning
Roads
10
The Kenyan National Road Safety Plan calls for a
lead agencybut it has not been created
education
Education
Academia
health
Hospital
Lead agency
Kenyan National Road Safety Plan
police
Finance

• Plan
• Resources
• Data
• Actions
• Collaboration

transport
Auto Club
urban Planning
Roads
11
What is the bottleneck blocking implementation?
education
Education
Academia
health
Hospital
Lead agency
police
Finance
Kenyan National Road Safety Plan

• Plan
• Resources
• Data
• Actions
• Collaboration

Development Agency
transport
Auto Club
urban Planning
Roads
12
Knowing is not enough we must apply. Willing is
not enough we must do. Goethe
Implementation is the Challenge
With thanks to Don Berwick
13
What is the bottleneck blocking implementation?

• Hypotheses
• Creating a lead agency requires political will
• Creating a lead agency requires resources
• Collaboration is difficult
• Multi-sectoral collaboration is even more
  difficult

14
Multi-sectoral Collaboration is Not Easy

• A coalition is like a marriage it is very easy
  to get into it but very hard to make it work
• Stakeholders speak different languages, have
  different cultures and every organization has its
  standard operating procedures
• There is competition for credit, power, and
  funding.
• Obstacles (and opportunities) occur at every
  level global, multinational agencies, regions,
  countries, communities.
• Each sector thinks it is not their
  responsibility.
• Diffusion of agency responsibilityInter-sectoral
  challenges can be particularly difficult
• Stakeholders all have different day jobs
• Each is already too busy with its own set of
  crises
• Road Safety is an underfunded area
• No one is eager to control it or be responsible
  or accountable.
• Funding is uncertain, short-term.

15
Road Safety What Effective Collaboration has
Achieved

• Framing road safety as a multi-sectoral issue
  has
• Made the point that this is a devastating
  epidemic with extraordinarily high levels of
  injuries and deaths
• Brought rigorous scientific attention to the
  prevention, treatment, and rehabilitation of
  injuries
• Focused on the important contributions needed
  from transportation, police, health, finance,
  urban planning, education, and environmental
  protection.
• This multi-sectoral approach has been reflected
  in the composition of
• the Commission for Global Road Safety
• various stakeholder forums,
• the Regional Committee for Road Safety in Latin
  America and the Caribbean.
• The health sector has played a role in convening
  multi-sectoral coalitions
• that effectively brought the issue to the
  attention of the UN with the World Bank, FIA
  Foundation, WHO, GRSP, UNICEF, and non-profits
  all playing an important role
• that convened the regional actor for road safety
  for Latin America and the Caribbean.
• The multi-sectoral systems approach will also
  play a key role in the Global Ministerial
  Conference in Moscow, November 2009.
• Opportunity to bring additional attention to
  Kenyas problems and needs
• Opportunity to work together on crafting and
  getting support for solutions

16
Question Can non-government organizations help
to build government capacity?

• What are the key capacity gaps that limit the
  countrys ability to deliver road safety
  programs?
• What is the road traffic injury (RTI) information
  and RTI surveillance capacity?
• Who might be the potential stakeholders who
  should participate?
• What problems and what solutions might be unique
  to developing road safety capacity in large,
  poor, urban settings?

17
Can non-government organizations help to build
the capacity of the lead agency?
health
Education
Acade-mia
police
Academia
Auto Club
Lead agency
Bilateral Aid Organization
Hospital
Finance
Hospital
Advoca-cy NGO
transport
Development Agency
urban Planning
Roads
Insur- ance
Vehicle Drivers
Auto Club
Private Sector

• Plan
• Resources
• Data
• Actions
• Collaboration

18
If non-governmental organizations can help, how
should they be organized?

• Option 1 as a separate supporting organization?
• Option 2 integrated into the lead agency
  organization
• Option 3 another structure

19
Option 1 As a separate supporting organization
health
Education
Acade-mia
police
Academia
Auto Club
Lead agency
Bilateral Aid Organization
Hospital
Finance
Hospital
Advoca-cy NGO
transport
Development Agency
urban Planning
Roads
Insur- ance
Vehicle Drivers
Auto Club
Private Sector

• Plan
• Resources
• Data
• Actions
• Collaboration

20
Option 2 integrated into the lead agency
organization
Acade-mia
Education
health
Bilateral Aid Organization
Academia
Hospital
Hospital
Finance
Lead agency

• Plan
• Resources
• Data
• Actions
• Collaboration

police
Advoca-cy NGO
Development Agency
urban Planning
Vehicle Drivers
transport
Auto Club
Roads
Insur- ance
Private Sector
Auto Club
21
Framework for Creating Successful Collaborations
Our framework, derived from the common elements
of successful collaborations, provides a pathway
for meeting challenging goals.
Collaborative partnerships have the best chance
for success when members lay the foundation in
the first mile for the last mile success and take
mutual responsibility along the journey for
leadership, management, and culture within the
partnership
22
Building Capacity

• What are the key capacity gaps that limit the
  countrys ability to deliver road safety
  programs?
• What is the road traffic injury (RTI) information
  and RTI surveillance capacity?
• Who might be the potential stakeholders who
  should participate?
• What problems and what solutions might be unique
  to developing road safety capacity in large,
  poor, urban settings?

23
What kind of ancestors will we be?

• We must work quickly
• In AIDS, the public health community failed to
  respond to the problem as it was growing rapidly
  in developing nations. As a result, we ended up
  with the worst public health disaster the world
  has seen.
• We must work together
• The biggest single failure in the fight against
  AIDS in the first 15 years of the pandemic was
  the failure to collaborate.
• Dr. Michael Merson, former Dean, Yale School
  of Public Health
• We cannot make the same mistake again
• Road crash fatalities in developing countries are
  expected to increase 83 between 2000 and 2020,
  and we must get ahead of the curve nowbefore the
  predicted explosion takes place.
• Unfortunately, the international community and
  the developed nations have still not responded
  adequately to this emerging crisis.
• We desperately need your support in this fight
  against the new global epidemic of road traffic
  injuries.

24
Contact Information
Mark L. Rosenberg, MD, MPP404-687-5635mrosenberg
_at_taskforce.org Lisa Hayes, MBA404-592-1471lhaye
s_at_taskforce.org Center for Global Health
Collaboration www.globalroadsafety.org The Task
Force for Global Health www.taskforce.org