Evaluation of partnership working in cities in phase IV of the WHO Healthy Cities Network.

An intersectoral partnership for health improvement is a requirement of the WHO European Healthy Cities Network of municipalities. A review was undertaken in 59 cities based on responses to a structured questionnaire covering phase IV of the network (2003-2008). Cities usually combined formal and informal working partnerships in a pattern seen in previous phases. However, these encompassed more sectors than previously and achieved greater degrees of collaborative planning and implementation. Additional WHO technical support and networking in phase IV significantly enhanced collaboration with the urban planning sector. Critical success factors were high-level political commitment and a well-organized Healthy City office. Partnerships remain a successful component of Healthy City working. The core principles, purpose and intellectual rationale for intersectoral partnerships remain valid and fit for purpose. This applied to long-established phase III cities as well as newcomers to phase IV. The network, and in particular the WHO brand, is well regarded and encourages political and organizational engagement and is a source of support and technical expertise. A key challenge is to apply a more rigorous analytical framework and theory-informed approach to reviewing partnership and collaboration parameters.

Partnership structures in the WHO European Healthy Cities project.

The development of new partnership structures for public health is an important goal of the World Health Organization's Healthy Cities project which covers a network of European municipalities. A review was carried out of the partnership structures and key changes arising from the project, based on the responses of 44 cities to a structured questionnaire, interviews with 24 city representatives and publications from the project from 1988 to 2003. Cities reported elaborate partnership mechanisms usually combining formal and informal working methods. Differences between cities could partly be related to differences in the way that local government is organized within countries and partly differences in local choices and circumstances. A relationship between the effectiveness of partnership arrangements and delivery of key elements of the project was discernable. Most cities reported having changed their processes for decision-making and planning for health as a result of membership of the WHO European Healthy Cities Network. One of the most potent stimuli for these changes was the action to which a city had committed as part of its membership of the Network.

The evolution of the WHO city health profiles: a content review.

The WHO European Healthy Cities project developed city health profiles (CHPs) to provide the evidence base for health planning. A CHP is a public health report that brings together key pieces of information on health and its determinants in the city and interprets and analyses the information. This CHP would then form the basis of a city health development plan that would set out strategies and programmes of intervention to improve the health of a city's population. A content review of the CHPs produced by the cities in the WHO European Healthy Cities Network in 1995 and repeated 10 years later, attempted to undertake a systematic and comprehensive content review of the CHPs. The results show that in both reviews, demographic information was covered comprehensively. The inadequate coverage of areas of health status and socio-economic conditions in the 1995 review was covered comprehensively in 2005. Coverage of lifestyles, infrastructures and public health policies and services had improved since the 1995 review. The findings indicate that profiles presenting information on health and its determinants provide an evidence-base to inform health planning for the city. However, problems were still encountered in undertaking appropriate analysis to identify inequalities within the city and make recommendations that could be translated into targets. Just as the cities have adapted and evolved throughout the WHO Healthy Cities project, so have CHPs. The range of health profiles produced by cities demonstrate how they have evolved from basic tools that started by collecting routinely available information on death and disease to sophisticated mechanisms that gather an array of relevant information from a wide variety of sources through a range of methods. Most cities have understood the concept of a CHP as an evidence-based tool to inform health policy and planning and to strengthen the public health agenda.