Healthy cities emanated from Toronto in Canada but the concept has grown by magnitudes in other cities in the world. Despite being a new concept, the reception of healthy city across the global scale including Africa has been very significant to dispel any doubt about its success in the modern world. In particular, the concept of healthy city was mainly driven by the increasing awareness on the abject need of, ‘healthy public policy’ relative to the adoption of a tendency of victims-blaming the lifestyle mechanisms of health promotion and the understanding of new risks associated with health as a result of the changing urban environments. These factors are not exclusive to Canadian cities and other global cities that have embraced the practice. Instead, it has been a global value that has extended beyond the Canadian cities. Subsequently, the factors precipitating the spread of values and attributes of the city expansion mechanisms are also present in Kpone case which will therefore promote the adoption of the new concept of Main Street in the city development. Some of the factors that precipitate the adoption of healthy cities designs are the existence of widespread violence and accidents that are not fully addressed by the current frameworks of the city development.
‘WHO’ has been one of the organizations that have spearheaded the development of healthy cities in the world. Health is one of the fundamental considerations of any society. Subsequently, the push factor in this case is the society propagated by organizations that represents its interests. In this regard, new ideals incorporated in enhancing the city development prospects and results into improvements of lives have some direct or indirect push factors that culminate into their integration. In essence, ‘WHO’ has been playing a central role in facilitating and accelerating agenda setting process while at the same time raising models of guidance that anchors growth of the healthy cities not only in Canada but also on a global scale. These advances have fueled the growth of healthy cities worldwide. In addition, these advances have set up new ideas behind the development of novel public health movements as well as attempts to revitalize other public health advocacy in the city development prospects globally. This impact is particularly based on the impact of the healthy city project initiated by the ‘WHO’.
Since the championing of the ideal of healthy city, the European Healthy Cities project has gained a significant milestone while WHO has been at the center of its excellence. The development of the program in any city is dedicated to a strict schedule in which different aspects of health development are anchored on an independent phase with distinct attributes of social development. The different phases of integrating healthy city concepts in both old and new cities in Europe and other parts of the world forms an important element that demonstrates the possibility of development of new ideas of mutual interest to the city residents and its mutual developments based in certain basic ideals that are mainly moderated by the location aspects of the city as far as culture and geography is concerned.
In the development of the ideal of healthy city, the concept was introduced based on five main phases. The first phase of the development involves the establishment of new structures to act as change agents and subsequent introduction of new mechanisms of working for the healthy cities. These aspects mark the foundation for the development of new cities. The process however does not constitute the specific actions responsible for monitoring the projects. Instead, the periodical conferences and themes provided by the authorities or the stakeholders responsible for the development include health inequalities and community participations in the health services within the city precincts. On the other hand, the second phase entails the development of more specific measures with strong emphasis on the local health policies which also entails integrated city health planning prospects.
‘WHO’ as perceived to be largely responsible for this venture has been one of the main unit of propagating the concept of healthy cities across North America though a number of projects are also driven by private developers. Such cities and a wide range of others driven directly or indirectly by WHO, start to form alliances with other global-based cities. One of the distinct initiatives towards enhancing the development of healthy cities in the world was a special choice made by the ‘WHO’ in 1991 when it isolated a few number of cities as the main examples of healthy cities initiatives among them: Johannesburg, Sao Paolo and Accra Ghana. This process was progressive check up of the progress achieved in the development of the healthy city initiative and was followed by different advances that saw immense advances and successful adoption of the concept across many other cities that WHO did not have a direct participation. The spread and adoption of the healthy cities concept is a major indication of a serious but novel initiative particularly originating from foreign sources to establish and dominate in another setting. This provides an essential benchmark for the possible adoption and excellence of ‘Main Street’ Concept in the Kpone city of Ghana. As at 2000, more than 1000 cities worldwide had been established on the framework of healthy cities.
The goal of the healthy cities and healthy communities movement is
Many studies have been carried out both by the WHO and independent researchers. In particular, the evaluation made by WHO based on the European Healthy City Projects has been focusing on the scales and magnitudes of the Healthy City Movements. According to evaluations of the healthy cities, some of the push factors that have been identified as the main support factors include enhanced political support, broad community controls, adequate supply of resources and effective leadership among others. Recent assessments also indicate that healthy cities have been responsible for enhanced health equity.
Although Healthy City Movements have been considered to have positive implications on enhanced city designs and development, some health specialists are opposed to benefits attributed to the healthy cities despite their perceived benefits on the city residents and visitors. For instance, some actors have claimed that project evaluations based on the actual effects on the health of cities should be evaluated. In recent accounts, the US commission of Determinants on Health sought to press researchers into establishing some findings on the health equity issue impacting on the health of cities as a result of established healthy cities initiatives in order to fast-track evidence for the relevant and efficient local governments. The essence of evidence gathering regarding the results of healthy cities has also been acknowledged by important figures. But, the prospects of generating material evidence to the essence of healthy cities has been a challenging process with the outcomes being critically challenging to measure.
In this regard, there has been piling pressure on the entities responsible for the development of healthy cities to champion a mechanism of demonstrating tangible evidence on the impact of the systems on the health systems and health inequality issue for it to withstand the test of credibility despite reflections made that healthy cities are irrelevant in spearheading health problems resolves that are currently emerging unresolved and perhaps forming the main bloc of social determinant of health. Academic literatures have been insightful while exposing some more theoretical and technical discussions surrounding the benefits attributable to the healthy cities in the global space as far as city designs and planning is concerned.
The healthy cities movement focuses on
In particular, some experts emphasize that for any project of the kind to excel; it must be based on the local contexts and prescribed on few specific actions as far as health is concerned. On the basis of its establishment, a clear focus must be drawn in order to promote possible and clear achievement of the set objectives in the long-run. Besides, the political, social, economic and cultural impact on the society within the city settings was also a major consideration in the establishment of healthy cities across different cities by virtue of geographical differences and the social-cultural environmental variations. For instance, in the wake of enhanced healthy city development, one approach that has been proposed is the ‘utility-based’ mechanism of healthy cities which entails the consideration of the benefits that the intervention has on the overall city residents and the country at large. This is indifferent to the ‘Main Street ’ project which must be anchored on the basis of the benefits its yields on the city dwellers and others parties involved.
Healthy cities have been arguably been considered the best-known and biggest of all setting approaches. The initiatives governing the establishment of the healthy cities is the long-term international development mechanism aiming at placing health issue on the top of agendas and decision making platform in order to enhance comprehensive regional strategies in health protections and a sustainable development. Some of the basic attributes of the healthy cities interventions is empowerments, community participations and equity among participants among others elements that prescribes to the need of strong social composition of a city manifested by good health. Healthy city initiatives therefore seek to achieve among other things: health-supportive environments, ease of access to quality healthcare services, sanitations and hygiene as well as improved quality of lives. These elements are constituted mainly on the basis of the values important to the local community as well as international interests on majority.
For instance, being a healthy city is dependent not only on the current health infrastructures but also the commitments of the individuals to enhance the city’s environments and willingness to make the best connections through political, social and economic arenas.
The evaluations of the healthy cities programs have demonstrated their success in enhancing an understanding of the environmental and health linkages and the establishment of inter-sectoral collaborations in enhancing sustainability of the program. The most excellent healthy cities program has certain distinct attributes that reflects upon every step of its growth. In particular, a healthy community must be established and driven through: clear visions, strong commitments to the community member, wide range of stakeholders from the local representation and a mechanism of institutionalization of the program. Lack of permanency of a program among other outcome-related elements has been developed with minor commitments from public stakeholders or the stability of the local players.
Majority of studies have also established that many cities particularly in the developing countries lack resources for developing effective guidance in order to facilitate project guidance through the development of essential health profile and sufficient evaluations before commencement. While many national and regional networks subsists to promote sharing of strategies, minor information has been published on the profiles of the country and the factual execution plans beyond the prospects of WHO have been poorly invested upon. Lack of a wide network in the development and adoption of such initiatives like healthy cities have failed in some cities while at the same time excelled in others due to the existence of a varying proportion of essential support factors including local participation. This shows that the consideration of new ideals in the city development demands significant participation of the local population as far as project management and values is concerned. Besides, the outcomes of any new initiatives must be easily measurable and presentable for the purpose of evidence to local and international scenes.