Background ‘Beterem in the City’ is a model developed in 2008, based on criteria established by Safe Communities, to promote and manage child safety in municipalities. The model incorporates components of public health, organisational consultation and safety management and is tailored to unique characteristics of municipalities in Israel. A formative and summative evaluation of program effectiveness was conducted.

Methods The three year evaluation process comprised various methods. Quantitative tools included: 1. Surveys with program directors and managers in 23 cities 2. Surveys with organisational consultants; 2. Surveys of safe behaviour in four cities. Qualitative tools included: 1. Interviews with program developers and stakeholders; 2. In-depth review of program implementation in four cities, based on interviews and program documentation

Results The evaluation indicates that the implementation of the model is incomplete and demands improvement. Those components that are implemented in full demand less time, resources, and expertise as compared to the components that were not implemented. Program components that were found to be correlated with positive outcomes include effective management and utilisation of the organisational consultation hours.

While ‘Beterem in the City’ has potential to lead organisational change and increase child safety over time, the current model is ambitious and may not be suitable for the organisational culture and management in most municipalities in Israel. In spite of these results, the evaluation points to success in implementing the model and better outcomes over time and in cities with stronger and more evolved management structures.

Conclusions ‘Beterem in the City’ needs to be adapted to different types of municipalities in Israel, including Arab cities and cities with a low socio-economic population. In order to implement the model effectively additional resources, from national bodies, will need to be directed to the program.