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Background Civil Society Organizations (CSOs) play a pivotal role in influencing government's decision-making in road safety, but in order to meaningfully participate in this process, they need an environment that enables them to exist and effectively operate. Objective The purpose of this study was to generate research-based guidance on the enabling environment (EE) of road safety CSOs in three sub-Saharan countries (Ethiopia, Uganda and Zambia), thus contributing to the development of global, regional and country capacity to support the sustainable reduction in road traffic injury deaths. Methods This was a mixed methods study consisting of an online survey of members of road safety CSOs and in-depth interviews of government employees who were involved in road safety policy making and/or program implementation in the three countries. Participants were asked about collaboration between road safety CSOs and government, policies to support collaboration, and restrictions on road safety CSO activities. These activities were supplemented by desk review and in-person workshops to develop an EE framework. Results The overall environment was somewhat positive with some areas of difficulty and disagreement. CSO members in Ethiopia reported some difficulties accessing information, less cooperation, and less influence on policy changes than in the other two countries. Government officials reported that CSOs were free from activity restriction while CSO members in Ethiopia and Uganda reported some restrictions. There were differing opinions about existence of policies to support collaboration. An EE framework was developed with three domains for understanding road safety CSO-government engagement: legal and regulatory environment, political and governance environment, and policy environment. Conclusions The EE is a key factor in the effectiveness of CSO efforts to cooperate with government to implement life-saving road safety policies and programs. We found that despite some difficulties, road safety CSOs and government are finding many ways to work together. We recommend implementation of the EE framework as a way to establish a regular dialogue between government and CSOs on ways to improve CSO-government working relationships for improved road safety outcomes.
Rosen et al. (Fri,) studied this question.