The Valencian Community Healthy Cities Network: assessment of the implementation process

In 1986 WHO-Euro began to develop the Healthy Cities projectwhich was later extended to Spain, in this paper the factorsrelated to the initial development of the Healthy Cities Projectin the member towns and cities of the Valencian Community HealthyCities Network, and the level of their development will be described. The project began in 1987 and the Network, at the time of thisstudy (March 1991), was made up of 48 towns and cities. Theinstrument used to assess the process of the project developmentwas a questionnaire administered by personal interview withthe three people responsible for the project in each city: theMayor, Health Councillor and Health Officer. A score was establishedto measure the level of development of the project in each citywhich included performance of the health diagnosis and plan,the existence of intersectoral committees and the creation ofchannels of community participation. A large proportion of the cities (72%) have carried out theHealth Diagnosis; 26% of the cities have intersectoral committeesand community participation is as yet in the initial stages.Political parties' support of their city's membership in theNetwork, has been almost unanimous with only three exceptions.Resources allocated to the project are not yet constant, althoughthere is important support from different levels, and on thepart of local and autonomous institutions. Differences can beobserved in the level of development of the cities which makeup the Network, related partly to length of time of membership,to the size of the city and to other factors difficult to assess.