Building Healthy Cities Initiative

With their partners, BHC defines and funds a variety of people-focused activities, including smarter health services, increased data sharing, safer food preparation, air quality monitoring, healthy tourism, health promoting schools and reporting systems that all citizens can access. They also train vulnerable citizens to advocate for better access to city services. Each of these elements is nuanced, however, and is dependent on the city’s characteristics and needs. Similarly, understanding the underlying patterns driving current outcomes requires full participation of both city officials and community members. BHC found value in systems mapping as a way to bring key stakeholders together and identify the best opportunities to change urban systems to be more conducive of health. The goal is that this will result in a common agenda and list of priorities that city leaders and urban planners can follow, giving them the best change to improve the lives of citizens in these growing cities.

With cross-sectoral alignment around these key opportunity areas, stakeholders were again brought together to participate in a design thinking process where they built and innovated together what strategic action would look like. Urban planning can create health risks, or foster healthier environments that reduce the risk of disease. The systems map lays the groundwork for finding places of leverage and building coherent actions for addressing social and environmental determinants of health.

As a member of the Indore project team noted: “The systems mapping process has been able to bring stakeholders together which is very rare. We have had conversations with different groups such as women, youth, frontline health workers, sanitation workers at the same time were able to bring civil society organizations, NGOs, government officers together to discuss the opportunities, strengths and inhibitors present in the system which are impacting the whole city’s growth. Systems mapping has encouraged multi sector collaboration in the city as it helped us identify the need of a multi sector platform where different sectors can come together and address issues together. This resulted in the formation of a ‘Multi-sector smart health working group’ which is chaired by CEO smart city and Co-chaired by CMHO.” 

Throughout this project, a key component of EI’s partnership was to build local capabilities to not only utilize the mapping tools, but to integrate and advocate for systems thinking as a key component of urban planning and citizen engagement.

• A broader recognition of the fact that health is not simply an issue for the health sector to address alone, but requires cross-sector collaboration. Since the systems mapping exercise, project teams have seens an increase in multi-sector collaboration and a strong commitment to working across silos, with teams building new relationships and establishing new cross-sectoral agreements and working groups. 
• An increased appreciation of and openness to the perspectives of diverse stakeholders. The systems mapping process brought people together in a rare and unique way, giving groups like women, youth, frontline health workers and sanitation workers a space to express their perspectives in the midst of civil society organizations, NGOs and government officials. The ability to discuss the system’s opportunities, strengths and inhibitors with people experiencing these at different levels and degrees, gave participants an invaluable understanding of what elements impact the whole city’s growth. 
• A space to share difficult but important truths. In systems mapping exercises, participants discuss challenging, sometimes polarizing topics in the context of systems level change. When framed as a systems level challenge, the perception of blame or judgement is reduced so that people can work side-by-side to support positive change. 
• A greater awareness on the need for staff training and capacity building. Since the systems mapping exercise, the project team has seen requests from City Governments to provide staff training and capacity building to ensure these skills are embedded with ongoing city planning efforts. 
• Actionable plans to utilize systems mapping insights into city planning. Since the training, insights from the mapping process are being used to prioritize proposed city programs and initiatives.