Second Healthy City Workshop Bam

Healthy City Concept, Objectives,

Key Elements, Process, Structure
and Partners
By: K. Khosh-Chashm,
WHO Consultant
 Part I
Concept, objectives,
history, and programme
 Health Determinants
in an urban setting

Social
Genetic Predisposition Environment
Life-style
Physical
Environment
Physical Environment
Physical, chemical and biological systems

Housing, streets, and physical layouts

Geography, landscape and climate

Architecture

Ecological footprint
 Urban Environmental Systems
Physical Biological
system system
-Temperature -Plants
- Sun intensity -Birds
- Electromagnetic -Domestic
animals
radiation Chemical
system -Microorganisms,
- Radionuclide (bacteria, virus,
radiation -Chemicals in air fungi, algae, etc.)
- Dust - Chemicals in soil
-Chemicals in water
- Chemicals in food
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

 Behaviour

Healthy lifestyle

Social mindedness and consciousness

Self esteem happiness

Aspiration, ambition, dynamism

 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 and
easy access to health care services
They have meaningful jobs and income.
They have security
They have friends and feel they belong
to their community
They can make choices for their lives.
They have a peaceful home
They have trees, plants and feel they relate
to the architecture.
 Background
The international Healthy Cities movement
was first conceived in Canada in 1984 as a
result of the Healthy Toronto 2000: Beyond
Health Care symposium, and was launched
in Europe in 1986 by the World Health
Organization (WHO). The movement has
since spread across the globe and now
involves more than 3,000 municipalities.
 Healthy cities in EMR
• The initiative started in 1989
• First healthy cities workshop in Cairo
• Iran was one of the first countries to
support the concept and has
supported the programme in the
Region.
 Objective

Improve the health and quality

of life of the citizens.
 WATER SANITATION
SUPPLY

HEALTH
ECONOMIC HEALTHY CITY SERVICES
DEVELOPMENT
CONCEPT

INCOME SOCIAL
GENERATION SERVICES
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.
 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.
 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 and
better.
 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.
 Objective of Healthy Cities”
Action in EMR
The basic objective of “healthy cities”
action in the EMR is to improve the
health of urban dwellers, especially in the
urban poor areas, giving priority to the
up-grading of environmental health
services and conditions in the cities and
facilitating networking.
 Part II
Healthy Cities Structure
 Healthy Workers People

Health
Recipients
Providers

Environmental Workers People

Environment
Recipients
Providers

Healthy Workers People

Education
Recipients
Providers

Traditional approach
 Partners
come and
work together
to improve
health and
Health sector NGOs
quality of life
Environment sector Law enforcement
Municipality City dwellers
Private sector
Economic sector
Education Sector

Healthy City Approach

 How to mobilize and organize
the HC programme

Formation of Establishment of
advocacy/start- Healthy City
up group working committee

Implementation Appointment of a
HC coordinator
 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.
Health

Education

Environment

Media

Municipality/Ministry of Interior
 Characteristics and responsibilities
of the advocacy group
• To have leadership quality and genuine interest
for health and caring for their city.
• To contact; community groups, religious
organizations, public health and environmental
departments, municipality departments,
institutions dealing with urban, social and public
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 wide
public support.
Healthy Cities Committee
 Responsibilities of HC Committee

• To develop HC work plans projects and

activities.
• To ensure extending outreach to lowest community level
for 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.
Healthy City Forum
 Healthy City Forum

Objectives
To promote and make health more visible
To facilitate health partners come together
To facilitate preparing city health profile
To facilitate identifying health priorities and goals
To facilitate developing city health plan
To involve youth promote, their aspirations and needs.
To mobilize media and all other resources for health
Examples:
City Health Forum

Green
PCVD
Industries

Road Traffic Nutrition

Accident

No Smoking
 Part III

Bam Healthy city

project
Bam Healthy City Project has two
Phases:

I. Interim
II. Long term
Objectives of Bam Healthy City
Interim
• To support the activities of different sectors,
especially health, environment and social
services (addressing the current urgent
needs.
• To facilitate community orientation and
participation in needs identification,
prioritization, planning and implementation.

• To provide effective coordination for the

work of supporting NGOs, UN and external
support agencies.
 Objectives of Bam Healthy City

Long term
To create institutionalized dialogue,
mechanisms and collaboration between all
stakeholders in concept development, planning
and implementation of reconstruction activities.
These include housing, education, environment,
municipal management, social welfare services,
economic development, and employment to
ensure that health, environment, ecological and
health related social norms are well
incorporated and coordinated in the
reconstruction process.
 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

 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.
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 communication
and relationship between city, province and national
authorities in a coordinated and supporting fashion.
 Bam

People from surrounding areas will be attracted

to Bam
Y
Macro

Mini

Micro

Coordinated
Economic
Development
Plans

X
 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 different
scenarios 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 region
perspective.
• Macro, mini and micro national economic
development plans for Bam area, provincial mini
schemes, and city level
 Critical issues in reconstruction of
Bam
• Bam attracts huge international interest. Success can
bring huge prestigious rewards for Iran. Failure, God
forbidden, 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 for
this Garden City should be compatible with the Iranian
culture, rich and attractive traditional architecture and
natural ecology.