Prototype for Health Education Program on prevention and Control of RTAs using PRECEDE/PROCEED Model through Public Announcement

1. Prototype for
Health Education Program on
Prevention & Control of RTAs
Through Public Announcement
Mohammad Aslam Shaiekh
Master of Public Health (MPH)
SHAS, P.U.
1Aslam Aman

2. Introduction
• A road traffic accident (RTA) is any injury
due to crashes originating from, terminating
with or involving a vehicle partially or fully
on a public road[1].
• Road traffic injuries are the 8th leading
cause of death. Death and injuries resulting
from road traffic crashes remains a serious
problem globally [2].
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3. Introduction Cont…
• The condition of road, negligence of driver,
Over speeding, drunk driving, mechanical
failure, fatigue, condition of the weather,
condition of vehicles, improper follow of
traffic rules and regulations are leading
factors of RTA.
• 5 Es (Education, Engineering,
Enforcement, Encouragement and
Evaluation/Adjustment) are the key
strategies of prevention and control of
RTAs [5]. 3Aslam Aman

4. Introduction Cont…
• The human, vehicle, environmental and
road related factors are associated with
RTAs.
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5. Problem Statement
5Status Paper on Road Safety of Nepal, DoR
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6. Problem Statement
• The largest proportion of road traffic deaths is in
middle-income countries (49.6%) followed by
low-income countries (41.9%) with remaining
8.5% deaths in high-income countries [3].
• 1.35 million people dying each year due to RTA.
• The 2030 Agenda for Sustainable Development
has set an ambitious target of halving the global
number of deaths and injuries from road traffic
crashes by 2020 (WHO | Global status report
on road safety 2018).
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7. Problem Statement
• The mortality rate per population due to RTI
almost doubled from 2001 to 2013,
suggesting that RTI is a silent epidemic in
Nepal.(Karkee and Lee, 2016).
• In 2009/10, RTAs killed more than 1,734
people and an additional 11,000 people were
injured.(Sharma KK, 2011).
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8. Problem Statement
• Researches indicate that people between
15-40 years of age are most affected in
RTAs, among which most of the motorcycle
accidents occurred in urban areas while
majority of buses and truck accidents
occurred in the rural areas.
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9. Rationale
• Why Prevention & Control of RTA:
• Injuries and deaths due to road traffic
accidents (RTA) are a major public health
problem in developing countries where more
than 85% of all deaths and 90% of disability
adjusted life years were lost from road traffic
injuries. (Nantulya et al)
• In Nepal, 9000 people have been died,
almost 20,000 were seriously injured and
44615 slightly injured in 54000 traffic
crashes in the past 10 years. (DOR, 2011)
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10. Why Prevention & Control of RTAs
• The condition of road, negligence of driver,
Over speeding, drunk driving, mechanical
failure, fatigue, condition of the weather,
condition of vehicles, improper follow of traffic
rules and regulations are leading factors of
RTA.
• Hence, these factors are preventable and can
be reduced through the intervention of public
health strategies and can prevent and control
the disabilities and deformities from RTAs.
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11. Rationale
• Why Public Announcement for Prevention &
Control of RTA:
Road traffic accidents (RTAs) have emerged as
an important public health issue which needs to
be tackled by a multi-disciplinary approach.
The trend in RTA injuries and death is
becoming alarming in countries like Nepal. The
number of fatal and disabling road accident
happening is increasing day by day and is a
real public health challenge for all the
concerned agencies to prevent it. 11Aslam Aman

12. Rationale
• Why Public Announcement for Prevention &
Control of RTA:
Awareness creation, strict implementation of
traffic rules, and scientific engineering
measures are the need to prevent RTAs.
Hence, Public Announcement is intended to
create awareness among the people about the
various modalities available to prevent road
accidents and also to inculcate a sense of
responsibility toward spreading the message of
road safety as a good citizen of our country.
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13. Public Announcement: Key Steps
• Choose Topic:
Narrow focus and to the point. For example
prevention and control of RTAs
One main idea for per PSA: for example only
key messages of prevention and control of
RTAs (Avoid the multi dimensional messages in
a single topic)
• Time for some research:
Current and up-to dated facts on the main
topics
Focus on key facts and figures (Statistics) and
references. 13Aslam Aman

14. Public Announcement: Key
Steps…Cont’d
• Considering audience:
 Focus on the needs of targeted audience’s and give
preference to key targeted group. For example
Drivers, foot path mover and traffic polices may be
the target audience for RTA
• Grabbing the audience’s attention :
 Attention, knowledge, responsibilities to use traffic
rule, misbehave and the perception on RTA of key
audience like foot path movers, drivers, passengers,
traffic polices should be grabbed through the public
announcement. 14Aslam Aman

15. Public Announcement: Key
Steps…Cont’d
• Create a script and simple statements:
Develop script and statement on the based
of evidence.
The Script should be highlight the major
points on behavior change to prevent the
RTA
Emotional statement/message should
created that’s why audience can be emoted
to change the behaviour. 15Aslam Aman

16. Public Announcement: Key
Steps…Cont’d
• Create a script and simple statements: A
sample for prevention & control of RTAs.
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17. Public Announcement: Key
Steps…Cont’d
• Editing:
Before announcing the message/PSA publicly,
do the pretest of information to check the
accuracy, modeling, key contents, sequences,
fitness and others. And do modify if there is to
make any changes.
• Announcement:
Announce the PSA on appropriate time through
different media like radio and TV.
Find the audience’s reaction and responses.
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18. 18Aslam Aman

19. 1. Social Diagnosis
• Poor transport facilities
• Under-development of country
• Poverty
• Illiteracy
• Difficult geography.
• Road encroachment (अतिक्रमण)
• Inadequate institution for driving training
• Low level of parental monitoring
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20. 2. Epidemiological Diagnosis
• Seven people die every day in road accidents
all over Nepal.
• In the last fiscal year, 2017-18, 2,541 people
died in road accidents. This is highest death
toll recorded since FY 2001-02.
• Last year, the country witnessed 10,965 road
accidents in different parts of the country,
which also critically injured 4,144 persons,
according to the Nepal Police [6].
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21. 2. Epidemiological Diagnosis
• Official data shows 2,004 deaths occurred in
9,146 accidents during FY 2014-15. This
figure rose to 2,006 deaths in 10,013
accidents next year. Road fatalities further
increased to 2,384 in 10,178 road accidents
during FY 2016-17.
• The Nepal Police data shows maximum
number of accidents involved motorcycles
(6,874) followed by jeeps and cars (5,212),
lorries and tankers (2,430), and buses
(2,005) [6]. 21Aslam Aman

22. 2. Epidemiological Diagnosis
• As in recorded in previous years, human errors
such as driver’s negligence, speeding, drink-
drive, rashly overtaking vehicles, overloading
and mistakes of passengers are the major
causes of road accidents and fatalities. Data
shows drivers’ negligence cause over 77
percent (8,461) of the accidents, followed by
speeding (1395) in the last fiscal [6].
• Road experts have argued that the negligence
of drivers and the acute lack of proper roads
and infrastructure have caused maximum
accidents in the country. 22Aslam Aman

23. 3. Behavioral & Environmental
Diagnosis
• Behavioral:
– High speed driving
– Substance abuse (Alcohol, Drugs and “Being
drinking”)
– Cell phone use while driving
– Violate safety rules (use of Helmets, Gloves,
Shoes, Glasses)
– Motorists Driving styles
– Overtake
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24. 3. Behavioral & Environmental
Diagnosis Cont…
• Behavioral:
– Engaging in stunt competition.
– Lack of appropriate and skillful driving
experience
– Breaking traffic rules
– Driver negligence.
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25. 3. Behavioral & Environmental
Diagnosis
• Environmental:
– Low level of parental monitoring
– Lack of Trained driving institutions to provide
training
– Hard and difficult geographical structures
– Gender Sensitivity (Male accounts for about
70% of fatalities from RTAs)
– Lack of access to get adequate information
about traffic rules.
– No confidentiality on driving.
– A single driver for long routes.
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26. 3. Behavioral & Environmental
Diagnosis
• Environmental:
– Weather conditions
– Conditions of vehicles
– Road conditions
– No adequate inspection of driving license
– No adequate footpaths for Pedestrians.
– No proper installations of sign boards and
reflective mirrors in bend way.
– Visual cognitive
– Mobility impairment
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27. 3. Behavioral & Environmental
Diagnosis
• Environmental:
–Narrow Bridges
–Poor visibilities and blind corner
–Random roadside parking
–Reckless pedestrian crossing
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28. 3. Behavioral & Environmental
Diagnosis
• Cause of RTA: from System Approach
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29. Inventory of Behaviors
Positive Factor
• Mobilization of Traffic polices all over the
country.
• Rule of penalties for rule breakers
• License inspection
• Inspection of Ma.Pa.Se,
• Audio-visual orientation to drivers and co-
driver
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30. Inventory of Behaviors
Negative Factor
• Substance abuse during driving
• Random roadside parking
• High Speed driving
• Violate safety rules and overtake
• Use of Cell Phone during driving
• Teasing the women and girls.
• Engaging in completion and stunts
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31. Decision Matrix
Lists of
behaviors
Importanc
e
Changeability Total Score
Substance
abuse during
driving
5 4 9
High Speed and
Overtaking
4 3 7
Violate safety
rules and
random road
side parking
4 4 8
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32. 4. Educational Diagnosis
Predisposing Factors:
• Lack of awareness of traffic rules to all
stakeholders
• Poor knowledge of traffic rules
• Attitude towards road uses
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33. Re-enforcing factors
• Inspections from the traffic polices
• “Volunteering Traffic” as for developing the
sincere people toward their road safety
• Provision of penalties for rule breakers
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34. Enabling factors
• Trained and Skillful driver and institutions
• Traffic bits in different sites of highway for
monitoring the road safety
• Awareness campaign in community level
(Educational session in schools, Audio-visual
orientation to drivers and co-driver,
Orientation class to drink and drive
(Maa.Paa.Se) drivers, Orientation to driving
institute trainers and trainees, Distribution of
IEC materials and Celebration of Traffic week
annually. 34Aslam Aman

35. Enabling factors
• Different I/NGO, CBOs working in the field
of road safety.
• Identification of the most accident prone
area and installation of the caution sign
• Fire extinguisher and emergency doors in
public vehicles
• Insurance provision and First aid kits
• Driver change and refreshment provision
in long route driving
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36. 5. Policy & Administrative
Diagnosis
Policy Diagnosis:
• The first Vehicle Act was enacted in 1964 to
manage the vehicles plying in roads and
public transportation and was followed by
Transportation Management Act in 1970.
Later, a combined Vehicle and
Transportation Management Act, 1993
(VTMA) and VTM Regulations, 1998
replaced them.
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37. 5. Policy & Administrative
Diagnosis
Policy Diagnosis:
• Technical and safety requirements for all
types of vehicles have been provisioned in
Vehicle and Transportation Management Act,
1993 (VTMA) and Vehicle and
Transportation Management Regulations,
1999 (VTMR).
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38. 5. Policy & Administrative
Diagnosis
Policy Diagnosis:
• Some provisions regarding vehicle standard and safety in
VTMR 1998 are:
- Standard dimension of the public vehicles
- Number of seats, height, width and folding provisions
- Fire extinguisher and emergency doors in public vehicles
- Insurance provision and First aid kits
- Lock in good condition on doors and windows
- Shock observer in good condition
- Speed limit
- Axle load limit
- Driver change and refreshment provision in long route
driving
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39. Policy Diagnosis
 Vehicle and Transportation Management Act, 1993 (VTMA) and
VTM Regulations, 1998 have various provisions on roads safety
aspects, some of them are:
- It is mandatory to wear a seat-belt; Traffic Police monitors and
enforces its compliances.
- Motorcycle day time head light is not mandatory.
- Use of motorcycle helmets to the rider is mandatory but there is
no standard of helmets defined.
- Use of child seat restraints in cars and child helmets for
motorcycle is not mandatory hence not in use widely.
- Road safety education in schools is made compulsory by
introducing road safety chapters in school level text books.
- Drinking and driving is prohibited by law and strong monitoring is
being made by Traffic Police especially at night time..
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40. Policy Diagnosis
 Department of Road (DoR), Traffic Safety Unit (TESU)
Activities
- Installing road signs and safety barriers at accident
prone locations on various highways
- Zebra crossings, traffic lights and some over head
crossing bridges are built and being used by the
pedestrians in urban areas especially in capital city
Kathmandu
- Constructing separate bicycle land and footpath for
pedestrian in major roads
- Maintenance activities on the road as well as road side
maintenance for removing or cushioning roadside
obstacles
- Activities for planting trees along road side and
trimming these in certain intervals 40Aslam Aman

41. Policy Diagnosis
 The UN Road Safety Collaboration
(UNRSC), Global Plan for the Decade of
Action for road-safety (2011-2020)
incorporating interventions under the
following five pillars to road safety.
- Road safety management
- Safer roads and mobility
- Safer vehicles
- Safer road users
- Post-crash response
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42. Administrative Diagnosis
• UNRSC (The UN Road Safety Collaboration
), Department of Road (DOR), Ministry of
physical infrastructure and Transportation
(MoPIT), MoFALD, Department of Transport
Management (DoTM), Road Safety and
Traffic Unit (RSTU), Volunteer traffics, traffic
polices ADB are key implementer for
prevention and control RTAs
• Timely Inspections by RSTU
• Supportive Supervision and Monitoring. 42Aslam Aman

43. Plan of Mass Health Education
Method
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44. Program Goal
• The overall goal of this program is to
decrease the disabilities, deformities and
death rates from RTA trough providing
adequate information about preventive &
control measures of RTA, awareness and
advocacy by public announcement.
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45. General Objectives
• To prevent and control the RTAs by raising
awareness, advocacy and providing
knowledge and information regarding
prevention and control of RTAs by public
announcement.
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46. Specific Objectives
• Public/people will get information about
the risk factors of RTAs like (Substance
abuse during driving, High speed &
Overtaking, Violation of safety rules and
random road side parking, use of cell
phone during driving etc.)
• People will adopt the positive behavior to
prevent and control of RTAs after the
getting information from public
announcement 46Aslam Aman

47. Target Groups
• Primary targets for this program will be
drivers, pedestrians, passengers and
traffic polices.
• Secondary targets will be all the people
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48. Methods and Media
Methods:
• Public announcement
Media:
• Newspaper
• Radio and TV
• Poster and Pamphlets distribution
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49. Analytical Framework for Developing the
Information/Messages
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50. Contents of Message for Public
Announcement
• Impact of RTAs
• Risk Factors of RTAs
• Preventive and control measures of RTAs
• Post accidents care and their
management
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51. Key Message for Public
Announcement
• Impact of RTAs
- Road traffic injuries cause emotional,
physical and economic harm.
- Damage the vehicles and road, bridges.
- Tangible costs (repair cost, treatment cost,
insurance cost)
- Hospitalization
- Handicap/Disabilities
- Death
51Aslam Aman

52. Key Message for Public
Announcement
• Risk Factors (causes) of RTAs
A Distracted Driving:
a. Talking on the cell phone
b. Sending text messages
c. Eating/Substance abuse
d. Arguments/Loud chatting
B. Speeding:
a. Ignoring the speed limits
b. Rule breaking and overtake
C Drunk Driving:
a. Drinking make to lose focus and function properly
b. Favor to happen the crash 52Aslam Aman

53. Key Message for Public
Announcement
• In General : the risk factors are
- Substance abuse of during driving
- High Speed and Overtaking
- Violate safety rules and random road side
parking
- Use of cell phone during driving
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54. Key Messages for Public
Announcement
• Prevention and Control Measures of RTAs:
- Avoid substance abuse during driving
- No drink and drive
- No use of cell phone during driving
- Proper follow of signals, speed control and
instructions and use of safety (Seat belt, helmets,
boots, gloves, glasses),
- Avoid speed driving and overtaking
- Proper parking of vehicles
- Proper use of Zebra crossing and footpath by
pedestrians and passengers.
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55. Key Message for Public
Announcement
• Post accident/crash management:
- Introduce toll-free telephone number for RTA
emergencies.
- Ambulance services for post-accident treatments and
emergency.
- Develop strategy and introduce revolving fund for RTA
victims and disabled.
- Open Trauma Care Centers and train for RTA injured.
- Establish road-safety unit in the Ministry of health and
Population and institutionally enhance it.
- Develop ambulance network along the major
highways, urban and rural roads.
55Aslam Aman

56. Resources Management
• Local media like FM, newspaper, community
radio, will be used to disseminate the
information for public announcement
• Multiple media like radio, TV and Newspaper
will be used to cover the large number of
public
• The Short and sweet (2-3 minutes) but
SMART messages/information will be
announced publicly. 56Aslam Aman

57. Detail Plan of Action
S.
N
Contents Messages Methods &
Media
Durat
ion
Target
Group
1 Impact of
RTAs
-Road traffic injuries cause
emotional, physical and
economic harm.
-Damage the vehicles and
road, bridges.
-Tangible costs (repair cost,
treatment cost, insurance
cost)
-Hospitalization
-Handicap/Disabilities
-Death
Public
announceme
nt through
radio, TV and
local
newspaper
6
Month
Drivers
,
Pedest
rians,
Passe
ngers,
Traffic
police
2 Risk Factors
of RTAs
-Substance abuse of during
driving
-High Speed and Overtaking
-Violate safety rules and
random road side parking
-Use of cell phone during
Public
announceme
nt through
radio, TV and
local
newspaper
6
Month
Drivers
,
Pedest
rians,
Passe
ngers,57Aslam Aman

58. Detail Plan of Action
S.
N
Contents Messages Methods &
Media
Durat
ion
Target
Group
3 Prevention
and control
measures of
RTAs
-Avoid substance abuse
during driving
-No drink and drive
-No use of cell phone during
driving
-Proper follow of signals,
speed control and
instructions and use of
safety (Seat belt, helmets,
boots, gloves, glasses),
-Avoid speed driving and
overtaking
-Proper parking of vehicles
-Proper use of Zebra
crossing and footpath by
pedestrians and
passengers.
Public
announceme
nt through
radio, TV and
local
newspaper
6
Month
Drivers
,
Pedest
rians,
Passe
ngers,
Traffic
police
58Aslam Aman

59. Detail Plan of ActionS.
N
Contents Messages Methods &
Media
Durat
ion
Target
Group
4 Post
accidents/Cr
ash
management
-Introduce toll-free
telephone number for RTA
emergencies.
-Ambulance services for
post-accident treatments
and emergency.
-Develop strategy and
introduce revolving fund for
RTA victims and disabled.
-Open Trauma Care Centers
and train for RTA injured.
-Establish road-safety unit in
the Ministry of health and
Population and institutionally
enhance it.
-Develop ambulance
network along the major
highways, urban and rural
roads.
Public
announceme
nt through
radio, TV and
local
newspaper
6
Month
Drivers
,
Pedest
rians,
Passe
ngers,
Traffic
police
59Aslam Aman

60. 6. Implementing Strategies
• The Health education program on prevention and
control of RTAs will be announced for 6 months.
Public announcement of information/messages of
Health education programme will be done as
described in plan of action
• Program will be implemented through the
coordination of local medias, Health coordinator of
Municipality, DoR, MoPIT, MoFALD, DoTM and
RSTU.
• Use of local media and local languages for public
announcement
• Community engagement and participation for the
program planning and implementations
• Monitoring, recording and reporting of the impact of
program progress 60Aslam Aman

61. 7. Evaluation of Health Education
Program
7. Process evaluation
• Scientific development of evidence based
messages focusing on BCC approach for
prevention and control of RTAs
• Use of appropriate materials for the public
announcement
• Need based and target oriented information
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62. 8. Impact Evaluation
– Assessment of knowledge and
practice/behaviors (No use of cell phone, No
drink and drive, Use of safety) of the people
(through Post survey)
– Decrease in prevalence of RTA
– Use of Safety and follow of traffic rule &
regulations
– Speed control and No overtaking
– Impact Evaluation through community survey.
62Aslam Aman

63. 9. Outcome Evaluation
– Decrease mortality and morbidity due to RTAs
– Decrease in disabilities, deformities from RTAs
– Increase in Positive attitude and
Behavior/practices of driving
– Increase in Follow up of traffic rules and use of
safety measures
– Enhancement in quality of life
– Decrease in emotional, physical and economic
harm
– Decrease in Tangible costs (repair cost, treatment
cost, insurance cost)
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64. Bibliography
1. WHO | Global status report on road safety 2018.
2. Krishna Prasad Dhakal, 2018. Road Traffic
Accidents in Kathmandu Valley. Journal of Health
Promotion
3. World Health Organization, 2018. Global status
report on road safety 2018.
4. World Health Organization, 2009. Global Status
Report on Road Safety: Time for Action.
5. Sk shrestha, senior divisional engineer,
department of roads nepal, Road safety situation in
Nepal, Sanjay kumar.
6. https://kathmandupost.com/national/2018/08/12/seve
n-people-die-every-day-in-road-accidents-in-nepal
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