Governance and financing are fundamental challenges to achieving urban health. This policy brief, aimed at urban health decision-makers, supports action on how to structure governance on urban health, across levels of government and among a broad range of stakeholders and strengthen financing for action. The brief is part of a series of four policy briefs that collectively support the implementation of strategic approach to urban health.
The health systems we enjoy today, and expected medical advances in the future, will be difficult to finance from public resources without major reforms. Public health spending in OECD countries has grown rapidly over most of the last half century. These spending increases have contributed to ...
What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).
Finance for City Leaders presents an up-to-date, comprehensive, and in-depth analysis of the challenges posed by rapid urbanization and the various financing tools municipalities have at their disposal.
Over the next 20 years, most low-income countries will, for the first time, become more urban than rural. Understanding demographic trends in the cities of the developing world is critical to those countries - their societies, economies, and environments. The benefits from urbanization cannot be overlooked, but the speed and sheer scale of this transformation presents many challenges. In this uniquely thorough and authoritative volume, 16 of the world's leading scholars on urban population and development have worked together to produce the most comprehensive and detailed analysis of the changes taking place in cities and their implications and impacts. They focus on population dynamics, social and economic differentiation, fertility and reproductive health, mortality and morbidity, labor force, and urban governance. As many national governments decentralize and devolve their functions, the nature of urban management and governance is undergoing fundamental transformation, with programs in poverty alleviation, health, education, and public services increasingly being deposited in the hands of untested municipal and regional governments. Cities Transformed identifies a new class of policy maker emerging to take up the growing responsibilities. Drawing from a wide variety of data sources, many of them previously inaccessible, this essential text will become the benchmark for all involved in city-level research, policy, planning, and investment decisions. The National Research Council is a private, non-profit institution based in Washington, DC, providing services to the US government, the public, and the scientific and engineering communities. The editors are members of the Council's Panel on Urban Population Dynamics.
The world development institutions commonly present 'urban governance' as an antidote to the so-called 'urbanisation of poverty' and 'parasitic urbanism' in Africa. Governance for Pro-Poor Urban Development is a comprehensive and systematic analysis of the meaning, nature, and effects of 'urban governance' in theory and in practice, with a focus on Ghana, a country widely regarded as an island of good governance in the sub region. The book illustrates how diverse groups experience urban governance differently and contextualizes how this experience has worsened social differentiation in cities. This book will be of great interest to students, teachers, and researchers in development studies, and highly relevant to anyone with an interest in urban studies, geography, political economy, sociology, and African studies.
“Grounded in the urban politics of the 21st Century world-wide, this thoughtful volume hooks urban food – and especially its production – to social justice in a realistic and manageable way.” —Diana Lee-Smith, Mazingira Institute, Kenya “An excellent international overview of urban food democracy and governance, with impressive geographical reach.” —Andre Viljoen, University of Brighton, UK This edited collection explores urban food democracy as part of a broader policy-based approach to sustainable urban development. Conceptually, governance and social justice provide the analytical framework for a varied array of contributions which critically address issues including urban agriculture, smart cities, human health and wellbeing and urban biodiversity. Some chapters take the form of thematic, issue-based discussions, where others are constituted by empirical case studies. Contributing authors include both academic experts and practitioners who hail from a wide range of disciplines, professions and nations. All offer original research and robust consideration of urban food democracy in cities from across the Global North and South. Taken as a whole, this book makes a significant contribution to understanding the potential enabling role of good urban governance in developing formal urban food policy that is economically and socially responsive and in tune with forms of community-driven adaptation of space for the local production, distribution and consumption of nutritious food.
The economic activity that drives growth in developing countries is heavily concentrated in cities. Catchphrases such as “metropolitan areas are the engines that pull the national economy” turn out to be fairly accurate. But the same advantages of metropolitan areas that draw investment also draw migrants who need jobs and housing, lead to demands for better infrastructure and social services, and result in increased congestion, environmental harm, and social problems. The challenges for metropolitan public finance are to capture a share of the economic growth to adequately finance new and growing expenditures and to organize governance so that services can be delivered in a cost-effective way, giving the local population a voice in fiscal decision making. At the same time, care must be taken to avoid overregulation and overtaxation, which will hamper the now quite mobile economic engine of private investment and entrepreneurial initiative. Metropolitan planning has become a reality in most large urban areas, even though the planning agencies are often ineffective in moving things forward and in linking their plans with the fiscal and financial realities of metropolitan government. A growing number of success stories in metropolitan finance and management, together with accumulated experience and proper efforts and support, could be extended to a broader array of forward-looking programs to address the growing public service needs of metropolitan-area populations. Nevertheless, sweeping metropolitan-area fiscal reforms have been few and far between; the urban policy reform agenda is still a long one; and there is a reasonable prospect that closing the gaps between what we know how to do and what is actually being done will continue to be difficult and slow. This book identifies the most important issues in metropolitan governance and finance in developing countries, describes the practice, explores the gap between practice and what theory suggests should be done, and lays out the reform paths that might be considered. Part of the solution will rest in rethinking expenditure assignments and instruments of finance. The “right” approach also will depend on the flexibility of political leaders to relinquish some control in order to find a better solution to the metropolitan finance problem.
Sixth edition of the hugely successful, internationally recognised textbook on global public health and epidemiology, with 3 volumes comprehensively covering the scope, methods, and practice of the discipline
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
