Urban Governance for Health and Wellbeing

Urban environments influence health in a variety of ways through the dynamic interactions of the individual with the policy, physical, social, cultural and economic environment. These en-vironments are shaped by the decisions of actors with different levels of influence, interests and priorities. Because health is created outside the health sector, multisectoral action is needed. Meaningful community involvement in governance processes is also essential, as it builds trust, promotes transparency and holds government institutions accountable. The process also in-creases community ownership of interventions and strengthens individual, community and population resilience, which is essen-tial in times of crises.

The inability of current urban infrastructure to cope with increas-ing demand for public services leads to adverse health and so-cial impacts. Shortcomings in strategic urban planning and in addressing the social determinants of health, such as employ-ment, income and housing, often result in social inequalities, poverty, crime, environmental hazards and unmet needs of vul-nerable populations, significantly affecting their health and well-being. Initiated by Switzerland and building on good practice in the World Health Organization European Region, the global pro-ject aims to promote good urban governance for health through community empowerment and the capacity building for city au-thorities and leaders, multisectoral action, and participatory ur-ban planning with active community involvement.

The first phase benefited from an additional credit for the COVID-19 response in Latin America. The aim of this second phase is to consolidate the results achieved in the first phase in Latin America and to focus more on Africa for the next phase.

End beneficiaries: Urban popu-lations in underserved neighbour-hoods and conditions of vulnera-bility in six cities.

Direct: Mayors and senior city of-ficials in six cities; community leaders and civil society groups, including community-based or-ganizations working in under-served neighbourhoods; World Health Organization local, re-gional and global offices.

1. Governance or conceptual frameworks for health and well-being adopted and implemented at international level;
2. Institutional mechanisms and policy tools for multisectoral ac-tion and community engagement developed and implemented to increase action and investment in health and well-being at the regional level;
3. Human capacity for urban gov-ernance for health and well-be-ing strengthened in six cities.

Principaux résultats attendus:  

• Output 1: City-to-city exchanges organized, tools/re-sources developed and support provided to promote good urban governance for health and well-being.
• Output 2: Multi-sectoral mechanisms strengthened in the six cities.
• Output 3: Multi-level, in particular national and subna-tional, discussions and coordination undertaken to strengthen urban governance for health and well-being.
• Output 4: Monitoring tools developed, and cities’ ap-proaches to transform urban governance for health and well-being documented and disseminated.
• Output 5: Global policy document with evidence and ex-periences on urban governance for health and well-be-ing developed and disseminated.
• Output 6: Community engagement mechanisms strengthened and citizens or citizen groups equipped with knowledge and skills to participate in decision-mak-ing processes in the six cities.
• Output 7: Links with academia strengthened, capacity building program for urban governance for health and well-being developed and where feasible, integrated into academic and civil service training programs.

Principaux résultats antérieurs:  

Highlights of Outcome 1: Changes in mindsets within health and other sectors, leadership and commitment to governance for health and well-being at the city level were key achievements that will ensure existing and adopted institutional and policy frameworks can have their intended impact on health status and well-being.

Highlights of Outcome 2: The expansion of knowledge on health promotion, social determinants of health, equity and inequalities, and the development of the power skills of government agencies through this project were key achievements which strengthened the public sector’s capacity for governance for health and well-being.

Highlights of Outcome 3: Cities expressed the considerable re-sources (human, financial and time) needed for participatory processes, but saw the value of involving different sectors and partners, of engaging and consulting with the community, which helped government authorities to meet the needs of the commu-nity and saw other municipalities interested in replicating the ap-proach.