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Second Healthy City Workshop Bam

Healthy City Concept, Objectives,

Key Elements, Process, Structure

and Partners

By: K. Khosh-Chashm,

WHO Consultant

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Part I

Concept, objectives,history, and programme

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Health Determinants

in an urban setting

Physical

Environment

Social

Environment

Life-style

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Physical Environment

Geography, landscape and climate

Ecological footprint

Architecture

Housing, streets, and physical layouts

Physical, chemical and biological systems

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Urban Environmental Systems

Physical

system

-Temperature

- Sun intensity

- Electromagnetic

radiation

- Radionuclide

radiation

- Dust

Chemical

system-Chemicals in air

- Chemicals in soil

-Chemicals in water

- Chemicals in food

Biological

system

-P

lants-Birds

-Domestic

animals

-Microorganisms,(bacteria, virus,

fungi, algae, etc.)

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Social Environment

Culture, social and religious norms

Social structure, cohesion and participation

Traditional and formal social support networks

Economic opportunities, system and structure

Participation in economy and decision making

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Behaviour

Healthy lifestyle

Social mindedness and consciousness

Self esteem happiness

Aspiration, ambition, dynamism

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Living in a city: health and quality of life

People live longer and healthier lives if:They breath clean air and drink safe water

They live in safe and comfortable housing

They have health supporting behaviour andeasy access to health care services

They have meaningful jobs and income.

They have security

They have friends and feel they belongto their community

They can make choices for their lives.

They have a peaceful home

They have trees, plants and feel they relateto the architecture.

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BackgroundThe international Healthy Cities movement

was first conceived in Canada in 1984 as a

result of theHealthy Toronto 2000: BeyondHealth Care symposium, and was launched

in Europe in 1986 by the World Health

Organization (WHO). The movement has

since spread across the globe and nowinvolves more than 3,000 municipalities.

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Healthy cities in EMR

The initiative started in 1989

First healthy cities workshop inCairo

Iran was one of the first countries to

support the concept and hassupported the programme in the

Region.

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Objective

Improve the health and qualityof life of the citizens.

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ECONOMIC

DEVELOPMENT

WATER

SUPPLY SANITATION

HEALTHSERVICES

SOCIAL

SERVICES

INCOME

GENERATION

HEALTHY CITY

CONCEPT

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THE AIMS OF HEALTHY CITIES

INITIATIVE

Improve health and environmental

services

Make people partners

Strengthen social support network

Stimulate economic development dialogue

Put health at Center of city social and

political agenda.

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HEALTHY CITY PROJECTS They do not interfere with the work of

responsible agencies: they do not build

heavy investment projects such as water

supply network, sewerage, or housing, or

industries, schools, etc.

Healthy city projects are low investment

support activities.

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Healthy cities projects

They assist in creating linkages between

concerned city and national authorities,

facilitating community participation,

raising awareness and fostering

partnership

They make the implementation of

existing projects more efficient andbetter.

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Strategies/approaches

Develops strong promotional process

Promotes the needs of women and children.

Promote care of elderly

Strengthens health and environment

institutions.

Encourages/establishes networking.

Mobilizes NGOs, Universities, etc... Mobilizes resources.

Creates links between related health

programmes.

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Objective of Healthy Cities

Action in EMR

The basic objective ofhealthy cities

action in the EMR is to improve the

health ofurban dwellers, especially in theurban poor areas, giving priority to the

up-grading ofenvironmental health

services and conditions in the cities and

facilitating networking.

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Part II

Healthy Cities Structure

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Healthy Workers

Providers

People

Recipients

Environment

Environmental Workers

Providers

People

Recipients

Healthy Workers

Providers

People

Recipients

Health

Education

Traditional approach

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Law enforcement

Municipality

Private sector

Health sector

Environment sector

Education Sector

NGOs

Partners

comeand

work together

to improve

health andquality oflife

Healthy City Approach

City dwellers

Economic sector

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Formation of

advocacy/start-

up group

Establishment of

Healthy City

working committee

Implementation

How to mobilize and organize

the HC programme

Appointment ofa

HC coordinator

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How to mobilize and organize

the HC programme

Establish a HC advocacy start-up group

5-6 Likeminded persons who are truly interested in

health and their city.

Municipality/Ministry of Interior

Health

Media

Education

Environment

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Characteristics and responsibilities

of the advocacy group

To have leadership quality and genuine interestfor health and caring for their city.

To contact; community groups, religious

organizations, public health and environmentaldepartments, municipality departments,institutions dealing with urban, social andpublic policies, agencies and individuals

concerned with urban studies, private sectors,civil society, NGOs public figures, sport

personalities, media, professional associations,women and youth organization, etc.

To promote the HC concept and build widepublic support.

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Healthy Cities Committee

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Responsibilities of HC Committee

To developHC work plans projects andactivities.

To ensure extending outreach to lowest community levelfor priority health programmes.

Encouraging community groups to be involved.

To facilitate the function of the city health forum

Mobilize people and resources for priority projects.

Prepare city health profile.

To collect information and facilitate networking.

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Healthy City Forum

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Healthy City Forum

Objectives

Topromote and make health more visible

Tofacilitate healthpartners come together

Tofacilitatepreparing city healthprofile

Tofacilitate identifying health priorities and goals

Tofacilitate developing city health plan

To involveyouthpromote, theiraspirations and needs.

To mobilize media and all other resources for health

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City Health Forum

Road Traffic

Accident

Nutrition

No Smoking

PCVD

Green

Industries

Examples:

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Bam Healthy city

project

Part III

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Bam Healthy City Project has twoPhases:

I. Interim

II. Long term

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Objectives of Bam Healthy City

Interim To support the activities of different sectors,

especially health, environment and socialservices (addressing the current urgentneeds.

To facilitate community orientation andparticipation in needs identification,prioritization, planning and implementation.

To provide effective coordination for thework of supporting NGOs, UN and externalsupport agencies.

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Objectives of Bam Healthy City

Long termTo create institutionalized dialogue,

mechanisms and collaboration between allstakeholders in concept development, planningand implementation of reconstruction activities.These include housing, education, environment,municipal management, social welfare services,economic development, and employment toensure that health, environment, ecological andhealth related social norms are wellincorporated and coordinated in the

reconstruction process.

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Needs and opportunities

Total Institutional reconstruction:

Government offices, municipal offices, social services,

schools, teaching and learning institutions, police,media, Etc.

This task is the first priority

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Needs and opportunities

Total physical reconstruction:Housing, roads, government buildings, water, sewerage,

health services, transportation, communication, utilities, etc.

Social and total economic reconstruction:Survivors rehabilitation, reestablishment of social networks,

resolving disputes, economic rehabilitation: commerce,

service sector, banking, agriculture, industry etc.

Environmental rehabilitation:Rehabilitation of urban gardens, cleaning of rubbles, repair

of irrigation system, etc.

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In view of such monumental work ahead and

inter related activities, no where more than in

Bam dialogue, coordination, collaboration are

needed.

Healthy city programme with a wider city and district

perspective provides a unique opportunity to bring all

sectors closer and help to create better communicationand relationship between city, province and national

authorities in a coordinated and supporting fashion.

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Bam

People from surrounding areas will be attracted

to Bam

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Y

X

Macro

Mini

Micro

Coordinated

Economic

Development

Plans

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Critical issues in reconstruction of

Bam People from surrounding areas of the city will migrate

to city because of job opportunities and housing.

Population analysis and consideration of differentscenarios will be critical for short and long term

development plans for different sectors. All agricultural, industrial and commercial economic

plans for Bam should have a district and Bam regionperspective.

Macro, mini and micro national economic

development plans for Bam area, provincial minischemes, and city level

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Critical issues in reconstruction of

Bam Bam attracts huge international interest. Success can

bring huge prestigious rewards for Iran. Failure, Godforbidden, has a big negative impact.

Innovative ideas in all sectors should be considered.

Bam has a tremendous potential for tourism,consequently the reconstruction and physical layout forthis Garden City should be compatible with the Iranian

culture, rich and attractive traditional architecture andnatural ecology.