A decade of progress: comparative evaluation of the Israel Healthy Cities Network

Established in 1990, Israel's Healthy Cities Network (HCN) performed its first evaluation in 2003-2004. A decade later, the present evaluation was implemented to assess members' compliance with the European HCN requirements and to determine progress made since the initial evaluation. A total of 31 of the existing 42 HCN members participated in this mixed methods evaluation. Based on the Monitoring, Accountability, Reporting, and Impact assessment framework, the evaluation questionnaire integrated Healthy Cities' principles and strategies. Univariate and bivariate analyses were used to investigate municipality performance as well as associations between indicators and structural or process measures. Matched-paired t-tests were performed to compare HCN member cities' initial evaluation with the current evaluation. Qualitative analyses explored the processes involved in implementing the Healthy Cities approach. The current evaluation found that Israel's HCN complies with all European HCN requirements, except for producing a city health profile. Increased coordinators' time investment, maintaining municipal health steering committee meetings and attending HCN activities were positively associated with better score on all dimensions. There was no significant difference between the two evaluation scores for all HCN cities collectively; however, within city comparisons indicated significant change. Coordinators reported that there was added value in HCN membership and conveyed a need for better network facilities, publicity and improved public relations. This evaluation validates the previous evaluation's findings and informs decision makers and municipal leaders regarding potential areas to modify or expand, both on the municipality level and the network at large.

The development and achievement of a healthy cities network in Taiwan: sharing leadership and partnership building

The World Health Organization (WHO) Healthy Cities (HC) projects are the best known of the settings-based approaches to health promotion. They engage local governments in health development through a process of political commitment, institutional change, capacity-building, partnership-based planning and innovative projects. Many cities have promoted HC projects in Taiwan since 2002. In 2008, the Taiwan Alliance for Healthy Cities (TAHC) was launched to assist local governments in effectively establishing, operating and promoting HC projects. In this article, we share our experiences of establishing a platform and network to promote the HC program in Taiwan. Based on individual city profiles and governance in Taiwan, the TAHC developed a well-organized framework and model to encourage strong leadership in local governments and to promote participation and engagement in their communities. In the last 6 years, leaders from Taiwan’s local governments in HC networks have integrated the HC concepts into their governance models, actively engaging and combining various resources with practical expertise and private sectors. The network of health in Taiwan allows each city to develop its unique perspective on the HC projects. Using this method, not only local government meets its needs, but also increases governance efficiency and effectiveness, resulting in the promotion of its citizens’ overall sustainable urban health development. This HC network in Taiwan has partnerships with government and non-governmental organizations (NGOs), with academic support and citizen involvement, a dynamic data collection system and demonstrated leadership in the sharing of information in the Asian region.

European Healthy Cities evaluation: conceptual framework and methodology

This paper presents the methodology, programme logic and conceptual framework that drove the evaluation of the Fifth Phase of the WHO European Healthy Cities Network. Towards the end of the phase, 99 cities were designated progressively through the life of the phase (2009-14). The paper establishes the values, systems and aspirations that these cities sign up for, as foundations for the selection of methodology. We assert that a realist synthesis methodology, driven by a wide range of qualitative and quantitative methods, is the most appropriate perspective to address the wide geopolitical, demographic, population and health diversities of these cities. The paper outlines the rationale for a structured multiple case study approach, the deployment of a comprehensive questionnaire, data mining through existing databases including Eurostat and analysis of management information generation tools used throughout the period. Response rates were considered extremely high for this type of research. Non-response analyses are described, which show that data are representative for cities across the spectrum of diversity. This paper provides a foundation for further analysis on specific areas of interest presented in this supplement.