This powerpoints contains information and statistics about RTAs in Nepal and plans and policy to control them.

1. Health Education Program Planning,
Implementation and Evaluation on
Road Traffic Accidents
PRECEDE/PROCEED
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Sandesh Bhusal
Institute of Medicine(IOM)
Kathmandu, Nepal

2. Presentation objective
 To share information about situation of Road Traffic
Accidents
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3. Contents:
 Introduction
 Baseline Information
 Introduction to PRECEDE /PROCEED Framework
 PRECEDE and PROCEED Model of Health Education
 Social Diagnosis
 Epidemiological Diagnosis
 Behavioral and Environmental Diagnosis
 Educational Diagnosis
 Administrative and Policy Diagnosis
 Process Evaluation
 Impact Evaluation
 Outcome Evaluation
 Goals and Objectives
 Logical framework Approach to Health Education
 Evaluation of Health Education Projects and Follow up
 References
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4. Introduction : RTAs
 A Road Traffic Accidents(RTA) can be defined as, an event that occurs on a
way or street open to public traffic; resulting in one or more person being
injured or killed, where at least one moving vehicle is involved.
 A road traffic injury is a fatal or non-fatal injury incurred as a result of a
collision on a public road involving at least one moving vehicle. –WHO
 Approximately 1.35 million people in the world die each year as a result of
road traffic crashes.
 More than half of all road traffic deaths are among vulnerable road users:
pedestrians, cyclists, and motorcyclists.
 Road traffic injuries are the leading cause of death for children and young
adults aged 5-29 years.
 RTA ranks as the 11th leading cause of death.
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5. Baseline Information
From Kathmandu Metropolitan City
• Total households: 4,36,355
• Total Population: 17,44,240 (M: 9,13,001 , F: 8,31,239 )
• Sex Ratio: 109.83 males per 100 females
• Ethnic Distribution:
 Brahman : 24%
 Newar : 22 %
 Chhetree : 20 %
 Tamang : 8 %
 Others : 23 %
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6. PRECEDE/PROCEED Framework
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Quality of
Life
Phase 1
Social
Diagnosis
Health
Phase 2
Epidemiologica
l
diagnosis
Health
Education
Policy
regulation
organization
Health
Program
Phase 5
Administrative &
policy diagnosis
Output Longer-term
health
outcome
Short-term
social impact
Short-term
impact
ProcessInput Long-term
social impact
Phase 6
Implementation
Phase 7
Process evaluation
Phase 8
Impact evaluation
Phase 9
Outcome evaluation
Predisposing
Reinforcing
Enabling
Phase 4
Educational
diagnosis
Behavior
Environment
Phase 3
Behavioral &
environmental
diagnosis

7. PRECEDE/PROCEED Model
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PRECEDE
Phase 1 : Social Diagnosis
Phase 2 : Epidemiological Diagnosis
Phase 3 : Behavioral and Environmental Diagnosis
Phase 4 : Education and Organizational Diagnosis
Phase 5 : Administrative and Policy Diagnosis
PROCEED
Phase 6 : Implementation
Phase 7 : Process Evaluation
Phase 8 : Impact Evaluation
Phase 9 : Outcome Evaluation

8. 1. Social Diagnosis
• Decreased quality of life,
• Increased absenteeism in work,
• Decreased economic productivity( GDP decreases by 3% ),
• Increased treatment cost,
• Reduced participation in social groups and voluntary activities,
• Increased anxiety, stress and depression which can lead to suicidal attempts,
• Deterioration in relationship with relatives and friends and society.
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9. 2. Epidemiological Diagnosis
Road traffic accidents of Kathmandu valley in 2072/73
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Cities No. of
Accidents
Injured
Deaths
No. of Affected
People
Serious Minor
Across Nepal 10,013 4,182 8,226 2,006 16,502
Kathmandu 5,668 275 3,901 166 10,103
• The rate of RTAs has increased by 2.83 percent within the four years when compared to
069/70.
• More than 3,000 motorbike accidents occur every year in Kathmandu.

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• Pedestrians were the most vulnerable (33%) followed by riders of motorized 2-3
• Two wheeler motorized vehicles were most frequently (67.2%)involved in RTAs,
• Around 75% of victims were between 15-49 years old,
Wheelers,
• Around half of the victims did not arrive in hospitals in one hour,
• More RTA occurred on daytime, Saturdays, July and November,
• The most common injury type was soft tissue injury (37.6%), followed by open
wound (20.9%), fracture (18%) and traumatic brain injuries (12.7%).
• Estimated road traffic death in Nepal = 15.9 per 1,00,000 population, (WHO 2016)

11. 3. Behavioral and Environmental diagnosis
Behavioral
 Over speeding,
 Overtaking,
 Not wearing helmet,
 Drunken driving,
 Sudden road crossing,
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Environmental
 Poorly designed roads,
 Poor lighting,
 Obstacles on road,
 Absence of traffic system,
 Lack of pedestrian footpath,
 Bad weather

12. Behavioral prioritization
Behavior Importance* Changeability* Total
Over speeding 5 3 8
Use of safety measures 5 4 9
Reduction of alcohol
consumption
5 2 7
Promoting pedestrian
behavior
5 4 9
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*Note: Very high -5, high – 4, nor high nor low – 3, low – 2, very low – 1

13. 4. Educational Diagnosis
Predisposing factors
• Ignorance,
• Pedestrian behavior,
• Self confidence or self-efficacy,
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Reinforcing factors
• Socio-economic status of family,
• Peer influences,
• Familial reasons,
Enabling Factors
• Availability and accessibility of resources
• Environmental conditions,
• Insufficient education on traffic rules.

14. 5. Administrative and Policy Diagnosis
• The UN Road Safety Collaboration (UNRSC) was established in April 2004 to better
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address road safety issues globally.
The UN Global Action mandates member countries to develop their individual
national plans for the decade (2011 to 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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1. Road safety management
• Establish the National Road Safety Council.
• Develop a national road-safety strategy and implementation modality.
2. Safer roads and mobility
• Develop design guideline for safer roads and construct required infrastructures.
• Investigate accident blackspot for all road type and construct countermeasures.
• Train stakeholders on safe roads and safety-audits.
3. Safer vehicles
• Develop and introduce standards for safe vehicles, spares.
• Review route permit procedure.
• Improve vehicle inspection procedure.
Activities proposed Nepal Road Safety Action Plan (2013 - 2020)

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5. Post-crash response
• Introduce toll-free telephone number for RTA emergencies.
• Develop ambulance policy for post-accident treatments and emergency treatment training.
• Research and prioritize treatments for serious injuries from RTAs .
4. Safer road users
• Strictly enforce the rules on the seatbelts, helmets use, public transport safety and develop
comprehensive code-of-conduct for all road-users.
• Public awareness campaign and research for all road-users.
• Include road-safety education in school curriculum with regular revisions.
Activities proposed Nepal Road Safety Action Plan (2013 - 2020)

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SDG 3.6 : BY 2020, 50% reduction in global
deaths and injuries from RTAs.

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Detailed Plan of Action

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Goal
 Reduce RTA fatality by 50% by the end of year 2022.
 Improve health related QoL of people attributed by road accidents in
Program Objective
Kathmandu.

21. Behavioral Objectives
• To promote use of helmets, seat belts and child restraints while driving,
• To promote pedestrian behavior,
• To promote driving without consumption of alcohol and psychoactive substance.
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Educational Objectives
• To develop knowledge and skills on traffic rules,
• To develop knowledge about causes of RTAs,
• To aware people to follow traffic rules,

22. Organizational and Policy objectives
• To introduce Road safety topic for school education,
• To make Footpaths mandatory for important roads,
• To make Strict licensing procedure,
• To establish Refreshment centers**,
• To enforce speed limit,
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** Suitable for long route vehicles only

23. Resource assessment
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Resource Source
IEC materials DPHO, Police Headquarter
Human resource Traffic police, local clubs
Funding Local government, different
organizations
Infrastructure Local people, pedestrians, students

24. Detail Plan of Action on Logical Framework
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Objectives Activities Indicators/ Targets Means of
verification
Overall Goal
Improve health
related QoL of
people attributed by
RTAs
HE program on
safety measures and
pedestrian behavior.
No. of hospitalized
people due to RTA
Health profile of that
area, Health facilities
records
Program Objective
Reduce RTA fatality
by 50% by the end
of year 2022.
HE program on
safety measures and
pedestrian behavior.
RTA incidence Traffic Directorate,
HMIS, Annual report
Title: Health Promotion and Education program on safety measures and pedestrian behavior to prevent
RTAs.

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Objectives Hierarchy Activities Indicators/ Targets Means of verification
1. To develop
knowledge and skills on
traffic rules,
- School program on
knowledge and skills
about traffic rules
- 100% of the students
will know the general
traffic rules
- Post session questions
2. To impart knowledge
about causes of RTAs,
- Educate the drivers
,motorcyclists, and
traveling public about
traffic rules and causes
of RTAs
- 100% of the
participants know the
causes of RTAs
- Post activities surveys
3. To promote
pedestrian behavior,
- Encouraging
pedestrians to follow
safe behavior,
- Radio/ TV program on
safe pedestrian
behavior,
- Wall painting in
public places,
- 80% pedestrian
following safe behavior
- Observation

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Detail on Activities

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Activities Target group Methods and
medias
Responsible
persons
Venue Date/ Time
School program on
knowledge and skills
about traffic rules
School
children
Mini-lecture ,
Posters,
Electronic
medias
Executive team
And Traffic police
Shivapuri HSS,
Pabitra
workshop
2076-1-1
10-12 am
Educate the drivers ,
motorcyclists, and
traveling public about
traffic rules and causes
of RTAs
Drivers ,
motorcyclists
and Public
Audiovisual
aids,
Traffic police and
BPH students
Ward no. 3,
kathmandu
2076-1-2 to
2076-1-5
Encouraging
pedestrians to follow
safe behavior,
Pedestrians Flip chart,
Poster,
Audiovisual
aids
Traffic police and
BPH students
Narayan Gopal
chowk,
Teaching,
Basundhara
2076-1-6 to
2076-1-8

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Activities Target
group
Methods and
medias
Responsible
persons
Venue Date/ Time
Radio/ TV program
on safe pedestrian
behavior
Public Audio tape Communication
team
Sandesh
FM/TV
Baisakh 1
onwards
Wall painting in
public places to
follow safe behavior (
Using Zebra cross,
Fly over bridge,
Driving without
drinking , safety
measures etc)
Pedestrians
and Drivers
Wall painting Hired painter Ward no. 3
Maharajgunj
2076-1-9 to
2076-1-11
Carry out medical
checkup (vision and
hearing) for the
drivers
Drivers Respective
instruments
Optometry and
BASLP students
Vishma
garden,
Teaching
hospital
2076-1-12 to
2076-1-14
12-3 pm

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Activities Target
group
Methods and
medias
Responsible
persons
Venue Date/ Time
Removing advertising
boards and other
items that obstructs
visibility of roads,
Drivers Local authority Representative of
Local authority
Ward no. 3
kathmandu
2076-1-15 to
2076-1-17

30. Risk Management
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Risk Management
The willingness of the program will
decrease during the program
people will be involves in all stage of
program: Planning ,Implementation,
Evaluation
Seasonal busyness of target people Program will be conducted in off time .

31. Monitoring of the program
• There will be one monitoring sub-committee including one representative from
ward, two BPH student, one target group representative and one representative from
Traffic police office.
• The focal person for the program monitors and advises where required, and will
ensure that there is good accountability and also acts as process facilitator.
• The monitoring committee will monitor in line with log framework of the program.
• Each monitoring will produce a report and the monitoring findings will be utilized
to modify and strengthen the health education program.
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32. Evaluation of the program
• Process evaluation – Evaluation of implementation of detail plan of action
and educational objectives and indicators
• Impact evaluation – Evaluation of behavioral, environmental and
epidemiological objectives and indicators
• Outcome evaluation – Evaluation of social indicators and objectives.
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33. Limitation of the plan
 The plan has been developed for learning process only and may not be
practical.
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37. References
• https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries
• https://www.nepjol.info/index.php/jhp/article/view/21802/17928
• https://www.researchgate.net/publication/312058580_Road_Traffic_Accident_an
d_its_Characteristics_in_Kathmandu_Valley
• http://worldpopulationreview.com/world-cities/kathmandu-population/
• http://dor.gov.np/home/publication/traffic-safety/force/road-safety-action-plan-
english
• http://cbs.gov.np/wp-content/uploads/2014/03/Volume05Part01.pdf
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