title: Prioritizing action on health inequities in cities: An evaluation of Urban Health Equity Assessment and Response Tool (Urban HEART) in 15 cities from Asia and Africa.
abstract: Following the recommendations of the Commission on Social Determinants of Health (2008), the World Health Organization (WHO) developed the Urban Health Equity Assessment and Response Tool (HEART) to support local stakeholders in identifying and planning action on health inequities. The objective of this report is to analyze the experiences of cities in implementing Urban HEART in order to inform how the future development of the tool could support local stakeholders better in addressing health inequities. The study method is documentary analysis from independent evaluations and city implementation reports submitted to WHO. Independent evaluations were conducted in 2011-12 on Urban HEART piloting in 15 cities from seven countries in Asia and Africa: Indonesia, Iran, Kenya, Mongolia, Philippines, Sri Lanka, and Vietnam. Local or national health departments led Urban HEART piloting in 12 of the 15 cities. Other stakeholders commonly engaged included the city council, budget and planning departments, education sector, urban planning department, and the Mayor's office. Ten of the 12 core indicators recommended in Urban HEART were collected by at least 10 of the 15 cities. Improving access to safe water and sanitation was a priority equity-oriented intervention in 12 of the 15 cities, while unemployment was addressed in seven cities. Cities who piloted Urban HEART displayed confidence in its potential by sustaining or scaling up its use within their countries. Engagement of a wider group of stakeholders was more likely to lead to actions for improving health equity. Indicators that were collected were more likely to be acted upon. Quality of data for neighbourhoods within cities was one of the major issues. As local governments and stakeholders around the world gain greater control of decisions regarding their health, Urban HEART could prove to be a valuable tool in helping them pursue the goal of health equity.
authors.affiliation: WHO Centre for Health Development, Kobe, Japan. Electronic address: prasada@who.int.
authors.forename: Amit
authors.initials: A
authors.lastname: Prasad
authors.affiliation: WHO Centre for Health Development, Kobe, Japan.
authors.forename: Megumi
authors.initials: M
authors.lastname: Kano
authors.affiliation: WHO Centre for Health Development, Kobe, Japan.
authors.forename: Kendra Ann-Masako
authors.initials: KA
authors.lastname: Dagg
authors.affiliation: WHO Centre for Health Development, Kobe, Japan.
authors.forename: Hanako
authors.initials: H
authors.lastname: Mori
authors.affiliation: WHO Regional Office for Africa, Libreville, Gabon.
authors.forename: Hawa Hamisi
authors.initials: HH
authors.lastname: Senkoro
authors.affiliation: WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt.
authors.forename: Mohammad Assai
authors.initials: MA
authors.lastname: Ardakani
authors.affiliation: WHO Regional Office for the Eastern Mediterranean, Cairo, Egypt.
authors.forename: Samar
authors.initials: S
authors.lastname: Elfeky
authors.affiliation: WHO Regional Office for South-East Asia, New Delhi, India.
authors.forename: Suvajee
authors.initials: S
authors.lastname: Good
authors.affiliation: WHO Regional Office for the Western Pacific, Manila, Philippines.
authors.forename: Katrin
authors.initials: K
authors.lastname: Engelhardt
authors.affiliation: WHO Centre for Health Development, Kobe, Japan.
authors.forename: Alex
authors.initials: A
authors.lastname: Ross
authors.affiliation: WHO Centre for Health Development, Kobe, Japan.
authors.forename: Francisco
authors.initials: F
authors.lastname: Armada
mesh_terms: D000349:Africa; D001208:Asia; D002947:Cities; D002958:City Planning / Q000458:organization & administration; D003625:Data Collection; D060766:Drinking Water; D014943:Global Health; D054624:Health Status Disparities; D006801:Humans; D020380:Needs Assessment / Q000458:organization & administration*; D012499:Sanitation; D064890:Social Determinants of Health; D014504:Urban Health; D014944:World Health Organization / Q000458:organization & administration
chemical_list: D060766:Drinking Water
keywords: Africa; Asia; Global health; Health equity; Social determinants of health; Urban HEART; Urban planning; Urbanization