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A Strong, Flexible Framework for Road Safety and Injury Prevention

There is now considerable research-based expertise that can be applied to making road safety and injury prevention programs effective in altering behaviour. This knowledge base holds great potential for developing the organizational structures and management frameworks for benchmarking, planning, prioritising and evaluating the comprehensive, adaptive systems that are needed for cost-effective and cost-efficient progress worldwide. However, such a framework has so far been elusive in its development, let alone implementation.

Other fields that are similarly challenged to address program outcomes and accountability can provide examples of effective and adaptable approaches and systems. One such system is Outcome Mapping (OM), a planning and evaluation framework designed for international development program evaluation by Canada's International Development Research Corporation. Outcome Mapping has met with a high level of acceptance within the development community and is now also being used by Canadian practitioners in the public health and social service sectors.

The model's thoughtful integration of program planning, strategy formulation and results assessment brings new thinking to the development and implementation of road safety and injury prevention interventions. While no model is comprehensive enough to meet the dynamic contextual requirements of every program, Outcome Mapping's actor or person-centred (referring to key influencers) perspective provides road safety and injury prevention programs with powerful tools to define, track and respond to outcomes.

Outcome Mapping: The Best of Both Worlds

Outcome Mapping represents the "best of both worlds," that is: 1) the world of programs aimed at improving human well-being (i.e., saving lives and preventing injury); and 2) the world of individuals and organizations trying to make a difference but rarely able to measure the effect of their actions on bottom-line results.

Initially developed to assist international development and humanitarian assistance programs to achieve and report on results, Outcome Mapping can readily be adapted for road safety and injury prevention programs to provide an integrated and flexible framework for organizational and program planning, monitoring and evaluation. Outcome Mapping provides a system: for defining desired results in specific behavioural terms; for planning strategically how to achieve the results: for monitoring contributions to outcomes; and for identifying priority areas for detailed evaluations. For over ten years, an international community of Outcome Mapping practitioners has been developing, sharing and adapting innovative tools and frameworks for implementing and monitoring program results, including methods for training, workshop facilitation, and design and data management and presentation worksheets.

Outcome Mapping focuses on one type of result - the human and organizational behaviours causally linked to changes in human safety and well-being. Outcomes are defined as "changes in the behaviour, relationships, activities, or actions of the people, groups and organizations with whom a program works directly." Outcome Mapping differentiates among the multiplicity of stakeholders, identifying those on whose contributions the achievement of results depends. OM focuses on outcomes which are antecedent to ultimate, long-term impacts, yet which are close enough in time and action to program activities to be measureable. OM deals with causal attribution by focusing on incremental patterns of change in actions and interrelationships without which the large-scale impacts cannot be achieved or sustained.

Key Concepts of Outcome Mapping

Outcome Mapping is based on several key concepts that direct its implementation. The most important of these are:

 A focus on behavior change, seeing it as the change that must take place in order to create and sustain changes in "state" (i.e., fewer crashes, stronger economy, safe transportation, healthy communities);

 Planning, monitoring and evaluation of the roles and responsibilities of the actors and partners within the program's direct sphere of influence;

 Integration of monitoring and evaluation at the planning stage of a program;

 Learning how to increase program effectiveness in relation to its overall goals and desired sustained well-being;

 A participatory emphasis that can be used to actively engage the program team and partner organizations and foster ownership of programs and maintenance of results;

 Change is seen as incremental and cumulative, yet measureable at all stages;

 Capacity building to initiate and maintain the ability to respond to ongoing change;

 Facilitation of systematized self-assessment; and

 Adaptive approaches to implementation, with introduction to OM most often through a workshop that leads participants through the process in its entirety, providing hands-on experience working on programs or situations currently being faced by participants.

How Outcome Mapping Works

Outcome Mapping is divided into three stages - Intentional Design; Outcome and Performance Monitoring; and Evaluation Planning - and 12 steps. The seven steps of Stage1, Intentional Design, comprise the innovative, evaluative thinking on which Outcome Mapping is based. These steps are particularly relevant to organizational and program planning and development, and answer the questions Why, Who, What, and How?


Steps 1 and 2 - WHY?

 Create the Vision - What does the program want to contribute to the large scale picture?

 Determine the Mission - What needs to be done to effectively contribute to the world described in the Vision?


Step 3 - WHO?

 Determine Boundary Partners - Who are the key players (e.g., governments, NGOs, advocacy groups, experts, partners, and stakeholders) that must be actively involved in the development, implementation, and evaluation of the Mission?


Steps 4 and 5 - WHAT?

 Identify Outcome Challenges - What is the optimal role for each boundary partner in relation to the Vision?

 Identify and Agree upon Progress Markers - For each boundary partner, what are the milestones that set out the path for action, capacity-building and commitment? These markers derive from an analysis of the status quo (where they are now) and where they want to be in, for example, in one year and five years. These are "owned" by the boundary partners and each partner is responsible for their achievement. Progress markers are especially relevant because they can be generic enough to be compared within and across jurisdictions.


Steps 6 and 7 - HOW?

 Use Strategy Maps to think strategically about what needs to happen to make partners successful; and to determine what direct and indirect support would be required. A set of inter-related "maps" are developed to clarify the implementation components relative to all partners.

 Identify Organizational Practices - What are the actions that the program team needs to take to maintain their credibility, competence and relevance, enabling it to continue contributing to the Vision?


Why Outcome Mapping Works

Outcome Mapping provides a step-by-step process with a manual, workshop and facilitation details, forms, and guidelines to make implementation accessible to any program developer, practitioner or evaluator. It is flexible and iterative in its support of organizational learning and adaptive management, particularly useful in complex programming situations. Highly adaptable, the OM steps can be applied in full sequence or selectively, as best fits the needs of the organization and program.

Outcome Mapping is an actor-centred, adaptable system that has several unique aspects. It:

 makes an organization or program, accountable for its Mission, rather than its Vision.

 provides a system of interlocking tools - each with its own flexible and adaptable steps;

 focuses on behavioral change as outcomes;

 is bottom-up, recognizing the contributions of the various actors, thereby engendering ownership and participation;

 recognizes that results are usually due to an aggregate of causal factors and require the contribution of multiple actors; and

  is progressive - it marks movement starting early in the change process.

And finally, Outcome Mapping helps a program examine the key issues related to its mandate and expectations, including articulating the program's logic; recording monitoring data; determining positive performance and improvement areas; evaluating intended and unexpected results; gathering data on program contribution to changes in partners; and establishing evaluation priorities and an evaluation plan.

Road safety and injury prevention efforts can benefit in many ways from Outcome Mapping tools and adapting them to specific priorities and needs. It can be used at the project level where it is particularly effective in planning, monitoring and evaluating large projects, or at the program level. Outcome Mapping is particularly appropriate for interventions that focus on outcomes involving the active participation of partners to establish and maintain the results achieved on an ongoing basis. It is helpful in situations where programs recognize the need for team consensus-building, self-assessment and adaptive management. Road safety and injury prevention programs can use Outcome Mapping concepts and tools to complement existing planning and evaluation processes or to design new interventions with an integrated program framework.

Improving results of road safety and injury prevention is complex and requires contributions from many organizations and agencies. Outcome Mapping's key strengths, including its emphasis on outcome monitoring and evaluation, and its explicit recognition of the dependence on diverse boundary partners for achieving results could add significant value to road safety and injury prevention programs and assist practitioners and evaluators alike in their ongoing efforts to change behavior and save lives.


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