(relevant guidelines, tools and information) The websiteprovidesmanyresources the lessonslearnt. highlights the achievements of cities and photographs andannouncements.It and globalexperiences,successstories, facilitate an exchange of national, regional hosts aninteractivemapandtoolsto Network websitein2012. The website Region, WHOlaunchedaHealthyCity programme intheEasternMediterranean t efforts its In • • • healthy city. colour codedtoshowtheir statusasa appear ontheinteractivemap. Citiesare Those citiesthathaveregisteredwill information tothewebsite. relevant upload then will offices country activities. The CBI focalpointsin WHO clips andintersectoralcollaboration success stories,photogallery, video major activities,calendarofevents, information suchas:cityplanofaction, City plannersarerequestedtosharekey in joiningtheNetwork. mayors and governors who are interested registration form is available on the site for provides supporttocityplannersanda The RegionalHealthyCityNetwork their healthycityprogrammes. implement,monitorandevaluate plan, that canbeusedtoassistcountries Regional HealthyCity

Green isfor citiesthathavebeen on certaincriteria. to berecognized asahealthycitybased Blue is used for cities that have applied Orange isusedforregistered cities. CONTENTS to tackleobesity determinants ofhealthinJordan Addressing thesocial o promote the healthy city PAGE 4 Aqaba, a healthylifestylein Walking topromote PAGE 2 initiative inHargeisa, Healthy city PAGE 7 response workshop equity assessmentand Promoting urbanhealth in Afghanistan, Islamic Republic of Since its launch in January 2012, cities intheprogramme toshowinteractive map cities registered webRegional HealthyCityNetwork site(http://applications.emro.who.int/hcn/) with evaluation. awarded ahealthycitylabel following PAGE 5 in healthy lifestyleproject Evaluation ofNizwa PAGE 2 Day rally in World No Tobacco Pakistan participates

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Acknowledgements Network , water inschools Improved drinking- PAGE 3 Society of CancerPatients Arab Emirates:Friends campaign inUnited Pink Caravan PAGE 5 registered by the endof2013. is hoped that as many as 200 cities will be Emirates have joined the Network and it Iran, Jordan,Moroccoand United Arab

PAGE 8 Résumé الموجــز initiatives newsletter Community-Based Initiatives Series Effects of urbanization on incidence on urbanization of Effects of noncommunicable diseases

Community-based Volume 7Issue22012

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PAGE 9 PAGE 6 publications New CBI PAGE 4 Jordan workers inJICA sitesin Training villagehealth 16

Volume 7 Issue 2 2012

Healthy city initiative in Hargeisa, Somaliland Engineer Hussein M. Jiciir became Mayor can contribute to increase health of Hargeisa in more than eight equity, including improvements in the years ago. He was among those of the socioeconomic status of low-income Somali diaspora who returned to his citizens and their access to quality health homeland. care services. In collaboration with the Ministry of Health and WHO, he launched the Hargeisa Based on the Mayor’s request, the WHO healthy city initiative in the north-west zone Regional Office assigned a consultant to of Somalia. This area is recovering from review and update the Hargeisa city profile, the effects of long civil strife and scarce assess availability and effectiveness of the resources and remarkable achievements Engineer Hussein M. Jiciir, Mayor of relevant services/interventions offered Hargeisa have been made under the leadership of by the municipality and identify gaps and the Mayor. These include: • contracting two private companies to priority areas in order that Hargeisa could • establishing a healthy city technical core deal with solid waste collection and serve as a model healthy city under the team and coordination forum initiative. dumping • developing a Hargeisa healthy city • establishing many collection points for WHO will continue its support to the profile in 2008 waste in different parts of the city municipality to sustain the healthy city initiative in Hargeisa and will encourage • adapting a decentralized approach in • purchasing three-wheeled vehicles to more innovative approaches, these will city management through involvement collect garbage from households to take include: of the district councils and community to collection points, and from there, to • conducting advocacy activities to raise representatives in planning and dumping sites. managing their district’s affairs awareness and political commitment for At present, more than 60% of households programme expansion • creating healthy market places and all market areas, hospitals and • building capacity of municipality team • constructing a new slaughter house government buildings are covered by the solid waste management system. members in the healthy city programme • establishing recreational activities The achievements made so far have • assisting the municipality in establishing • creating public-private partnerships inspired the municipality of Hargeisa to a healthy city information centre to to tackle issues related to solid waste increase the reach and range of innovative document city activities, achievements management. interventions such as: recycling plastic and good practices The Mayor has established a task force waste products, establishing playgrounds • supporting collaborative efforts at for solid waste management that meets and improving road conditions to reduce different levels, including intersectoral weekly to discuss issues related to solid the number of road traffic injuries. collaboration and partnership to further waste management and monthly with all Engineer Jiciir is also working on ways institutionalize the programme in stakeholders, including ministries of health, that the municipality and other sectors Hargeisa. water and education, district committees, local and international nongovernmental organizations and United Nations (UN) agencies. The task force is responsible for following up progress in implementation of the Hargeisa city development plan. The task force started its mission with an attempt to introduce healthy environments Three-wheeled vehicles collecting Trucks collecting waste from collection for the community by: waste from households in Hargeisa points in Hargeisa Pakistan participates in World No Tobacco Day rally

World No Tobacco Day was celebrated on sensitized to the dangers of smoking in 31 May 2012 in Pishin and Muzaffarabad their early years of life. A seminar was basic development need sites in also organized in Department of Sociology Pakistan. In order to promote a healthy University of Azad Jammu and Kashmir, lifestyle among youth, a cricket match attended by a larger number of students, was organized. In addition, community academia, civil society representatives leaders, elders, school teachers and youth and social activists. It is expected that the organizations conveyed anti-smoking activities will lead to positive changes and messages. Banners surrounding the sports healthy behaviours among people living in ground carried various health messages basic development needs implementation Community leaders convey anti-smoking on hazards of tobacco. Teenagers were sites. messages to youth and the community.

2 Community-based initiatives www.emro.who.int/cbi Volume 7 Issue 2 2012

Pink Caravan campaign in : Friends of Cancer Patients Society The Friends of Cancer Patients Society is a charitable, volunteer-based society under the umbrella of the Supreme Council for Family Affairs in Sharjah, United Arab of Emirates. The Society was established in 1999 under the patronage of Her Highness Sheikha Jawaher Bint Mohammed AI-Qasimi, Chairperson of the Supreme Council for Family Affairs, and wife of the Ruler of Sharjah and Federal Supreme Council Teaching the art of breast His Highness A Alqasimi, The Pink Caravan campaign self-examination Ruler of Sharjah used horses as part of its Member. Arabian theme The main goals of the Society and living a healthy lifestyle, the campaign and many improve registration and open are to support cancer patients especially for those living in fund-raising activities were the first dedicated cancer and their families, raise public remote areas. Throughout conducted. The event resulted centre in Sharjah (5–10 year awareness about cancer and the 10-day journey the in increased community to implementation). related risk factors and build Pink Caravan organized awareness of the importance The success of the Pink the capacity of medical staff entertainment including of periodical medical check- Caravan campaign is due to improve their performance drummers from South , ups to diagnose cancers at to the high-level political and keep them up to date VIP guests and artists who an early stage of onset and commitment and support, in prevention and control of acted as royal ambassadors diagnosed seven cases of partnership, intersectoral cancer. The Society has built for the campaign. The people who had previously collaboration and community partnerships with different Pink Caravan made use been unaware that they had participation. These factors partners, such as: National of social networking sites, breast cancer. are important indicators for Committee for Cancer Control, such as Twitter, YouTube The campaign aims to collect sustainability and community Gulf Federation for Cancer and Facebook, to promote scientific data, publish papers, ownership of the initiative. Control, United States/Middle East Partnership for Breast Cancer Awareness and Research and International Union against Cancer and WHO. Over the past decade, the Society has also conducted many training courses and conferences. It conducts screening campaigns for different kinds of cancers (breast, cervical, prostate, testicular, skin and colonic- rectal). In 2011, the Friends of Cancer Patients Society launched a A horse-riding event raised Increased community Drummers from 2-year Pink Caravan breast awareness of breast cancer awareness was an important entertain guests cancer awareness campaign element of each event that was launched using horses to travel throughout the United Arab Emirates to raise awareness of breast cancer. His Royal Highness, the Ruler of Sharjah, generously donated seven pure-bred Arabian horses from Al Qasimi Stables for public auction. The proceeds raised from the sale of the seven horses amounted to 1.5 million Dinars. A 10-day horse-riding event raised the public’s awareness of the importance of screening VIP guests and artists enjoy Pink Caravan parade the entertainment

Community-based initiatives 3 Volume 7 Issue 2 2012

Representatives from JICA and the Ministry of Health, Jordan, during the joint WHO/JICA training session for village health workers, Training village health workers in JICA sites in Jordan The Japan International Cooperation Jordan, in collaboration with WHO for only acquired new information applicable Agency (JICA) utilized the WHO training 22 village health workers and 5 of their to their future responsibilities but learnt manual for cluster representatives supervisors from Aqaba, Karak, Tafileh problem-solving techniques shared by and health volunteers during a joint and Ma’an in southern Jordan. The four facilitators and colleagues that they could WHO/JICA training session for village training modules cover: family health; then apply in the field during the course of health workers working in JICA project- emergencies; environmental health and their work. implementing sites. The training of village food safety; and control of communicable The WHO training manual for cluster health workers; who are recruited by the and noncommunicable diseases. representatives and health volunteers Ministry of Health in Jordan, is conducted Participants of the training gained a can be downloaded in , English through the Community Empowerment tremendous amount of knowledge that and French through the web site of the Programme. The programme directly is expected to have a positive impact on WHO Regional Office for the Eastern supports people at grass-roots level. JICA the health of the community and improve Mediterranean at: http://www.emro.who. organized the 4-day training workshop satisfaction with levels of the coverage of int/cbi/publications/manuals-and-guides. from 16 to 19 September 2012 in Amman, health care. They all felt that they had not html.

Walking to promote a healthy lifestyle in Aqaba, Jordan “Walk for a healthy life” is the theme part of their daily routine. The masses of promoted by both the community and city dwellers marching the streets every officials in Aqaba City, Jordan. Aqaba City evening have highlighted the need to is one of the recently registered cities create walking paths. Officials have been requested to close the corniche for three in the Regional Healthy City Network. hours in the evenings to accommodate People from all walks of life – young, old, the daily health walk. Medical authorities students, retirees and couples – are taking are also advocating for healthy nutritional advantage of the beautiful landscape and habits to get the utmost benefit from Promoting healthy lifestyles in Aqaba are changing attitudes to make walking walking.

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Photo from the validation workshop Improved drinking- Evaluation of Nizwa water in schools in healthy lifestyle project Tripoli, Lebanon in Oman Representative from WHO Lebanon and municipality with Nizwa, in Al-Dakhliyah noncommunicable diseases students during the presentation of their thesis in the governorate in Oman, is through strengthening Lebanese University about 175 km from . health care services and With a population of 82 679, ensuring access to effective The healthy city programme was implemented in Tripoli, it represents almost 83.8% interventions. The project Lebanon, in September 2010. A multisectoral programme of Oman’s total population, represents a successful model team was established comprising representatives from distributed between 120 of intersectoral collaboration education, the environment, health, local media, chamber of villages. for the prevention and control commerce and trade sectors, nongovernmental organizations of chronic diseases. The Nizwa healthy lifestyle and academia. project is a community-based After 4 years of implementation health promoting project. The the project was evaluated The coordinating committee identified four priority areas based project started in 1996 as a to measure its impact and on a city needs assessment carried out in early 2011. The four result of community demand. progress in implementation identified priority areas are: food safety, school health, solid Community involvement in of the five-year strategic plan waste management and tobacco control. the project is strong. It is and effectiveness in changing Since its onset, the healthy city programme has passed a supported by the Ministry of peoples’ behaviour and tobacco control law at the city level; implemented a smoke- Health and the WHO Regional identifying opportunities for Office. A strategic plan was improvement. It also aimed to free school initiative; undertook tobacco control public developed by different public assess the degree of political awareness campaigns; implemented an appropriate solid sectors, such as local media, commitment, partnership waste management system in selected slum areas with the education, municipality and community engagement. technical support of the WHO Centre for Environmental Health and social development, to The evaluation process was Activities (CEHA); assessed school health environment in translate commitment into conducted between March public schools, took corrective measures to improve the quality practice through implementing 2009 and August 2010. of drinking-water quality in these schools and ensured the interventions, fundraising The evaluation indicated a compliance of good manufacturing and hygiene practices and or providing other types of significant shift in people’s standards in 15 restaurants and 35 butcher shops. support. Many partnerships perceptions of their needs. have been created through the The availability of preventive In line with the healthy city programme goals for Tripoli, two project. services, such as screening students from the Faculty of public health in the Lebanese The main objectives of the for risk factors, walking paths, university conducted research for a thesis entitled “Assessment project have been to map healthy food, counselling and of the school health environment and water supply in 51 public the emerging epidemics of tobacco cessation services schools in the healthy city programme in Tripoli”. The results of noncommunicable diseases were facilitating healthy analysis of drinking-water in the schools indicated that drinking- and analyse behavioural, behaviours among people. water was unsafe in 17 out of 51 schools (33%). The study economic, political and The WHO community- social determinants of risk based initiatives issued revealed that 67% of schools suffer from very poor sanitation factors. The project also recommendations and and hygienic facilities. Consequently, the Mayor instructed city aimed to reduce the exposure suggested future steps for authorities to install ultraviolet water disinfecting systems and of individuals to the major the programme following the tanks in 12 out of 17 schools. The initiative was supported by determinants of risk factors for evaluation. the WHO country office.

Community-based initiatives 5 Volume 7 Issue 2 2012

New CBI publications

Good practices in delivery of primary health care in urban settings Community-Based Initiatives Series 15

Good practices in delivery of and trainers (in Arabic) primary health care in urban settings Rapid urbanization and its economic, social, can be used by health system policy-makers, city environmental and health impacts affect all planners, mayors, governors, mid-level managers, countries and regions of the world, particularly nongovernmental organizations and members developing countries. Almost half (49%) of the of academia as evidence for advocacy and to Region’s population are urban dwellers. Rapid strengthen political commitment to improve health urbanization is characteristic of many countries in care delivery in urban settings. This publication the Region. Large-scale metropolitan cities have was jointly produced by the WHO Regional Office sizeable slums and suffer from many shortcomings for the Eastern Mediterranean, in collaboration in health and health-related services. Chronic with the WHO Centre for Health Development, urban problems related to the environment, Kobe, Japan. The manual is accessible from nutrition, poverty, food safety and access to quality the Information resources web site of the WHO health services are issues that need to be seriously Regional Office for the Eastern Mediterranean. considered by urban planners. The good practices to access CBI publication visit : http://www.emro. in urban health care delivery documented from who.int/cbi/publications the Islamic Republic of Iran, Jordan and Oman

1 ΔϴόϤΘΠϤϟ΍ Ε΍έΩΎΒϤϟ΍ ΔϠδϠγ Training manual for community-based initiatives: a practical tool for trainees and trainers (in Arabic) Ε΍έΩΎΒϤϠϟϲΒϳέΪΗΐϴΘϛ ΔϴόϤΘΠϤϟ΍ This training manual for community representatives effective implementation of various development ϦϴΑέΪϤϠϟΔϴϠϤϋΕ΍ϭΩ΃ ϦϴΑέΪΘϤϟ΍ϭ outlines the approach and methodology of activities. This training manual will serve as a the programme and is based on the practical reference for master trainers and as an advocacy experiences of communities. The manual follows tool for the promotion of health and development a participatory training approach and provides initiatives in the Region. It is user-friendly and can support for the implementation of an effective be adapted to provide guidance in a wide variety follow-up and monitoring system. The manual of situations. The manual is accessible from will enable communities to identify and prioritize the Information resources web site of the WHO their needs and will help partners to develop more Regional Office for the Eastern Mediterranean. effective interaction and coordination by facilitating

Effect of urbanization on incidence of noncommunicable diseases Community-Based Initiatives Series 16

Effects of urbanization on incidence and trainers (in Arabic) of noncommunicable diseases The effects of rapid urbanization on lifestyles on lifestyle and in identifying policies, programmes and the consequent noncommunicable disease and interventions that could promote healthy outcomes are rarely documented, particularly lifestyles in urban areas, and on steps that could in the Eastern Mediterranean Region. WHO be taken to reduce community exposure to these Regional Office with the WHO Centre for Health risk factors. This publication provides evidence Development in Kobe, Japan, commissioned three that can support policy-makers and decision- studies on megacities –, ; Karachi, makers in allocating additional resources to Pakistan; and Isfahan, Islamic Republic of Iran to improving healthy lifestyle choices in urban areas. look in detail at risk factors for noncommunicable The manual is accessible from the Information diseases and their significance for urban settings. resources web site of the WHO Regional Office The studies focused on the effect of urbanization for the Eastern Mediterranean.

WHO-EM/CBI/058/A Training manual for the healthy city programme (in Arabic) The manual provides an overview of the healthy الدليل التدريبي .city programme and its operational procedures لربنامج املدن ّالصحية The manual can be used in building programme To access CBI publications visit: infrastructure, enhancing programme management http://www.emro.who.int/cbi/ capacities and in programme implementation. The publications training package comprises four modules which have been field-tested in countries of the Region. The manual is accessible from the Information resources web site of the WHO Regional Office for the Eastern Mediterranean.

6 Community-based initiatives www.emro.who.int/cbi Volume 7 Issue 2 2012

Participants of the workshop on promoting urban health equity assessment and response, including the WHO Regional Director for the Eastern Mediterranean Dr Ala Alwan (front, centre) Promoting urban health equity assessment and response workshop, 2 – 4 September 2012 Urbanization and health is a (schools, hospitals, workplaces meeting was to develop an collaboration and partnership priority area for most countries and food markets); and outline for national strategic and develop strategies to of the world. At present, develop an outline for national plans of action to operationalize reduce urban health inequity. the Rio Political Declaration in 49% of the population of the strategic plans of action to The following recommen- countries. Eastern Mediterranean Region operationalize the Rio Political dations were the outcome of Declaration in countries. are urban dwellers and it is The meeting was inaugurated the meeting. estimated that by 2030 two The 2011 World Conference by Dr Ala Alwan, WHO • Expand the use of WHO’s thirds of the world’s population on Social Determinants of Regional Director for the Urban HEART to at least will live in the urban areas. Health generated tremendous Eastern Mediterranean, who one city in each country. The urban challenges become enthusiasm and demand from reiterated the importance of complex due to unplanned Member States for support with health equity embodied in the • Incorporate city emergency urban growth which puts work on social determinants Rio Political Declaration on management as a populations at increasing of health. The Rio Political the Social Determinants of component of Urban risk of poor quality of life, Declaration and the World Health and subsequently at HEART. poor health coverage, poor Health Assembly resolution the World Health Assembly • Introduce healthy settings in infrastructure and sanitation, in May 2012, in resolution highlighted the five priority selected healthy city project higher vulnerability to WHA65.8. Dr Alwan urged areas that are the main basis sites in all countries of the disasters, and hence, higher representatives of countries to for developing a global plan of Region and scale up the risk of communicable and find ways to motivate key local action and regional strategic community-based initiatives noncommunicable diseases, policy-makers to support work directions. These five action programme. injury and mortality. To areas are: on the social determinants of address urban health equity health, to enhance community • Develop a national plan an intercountry workshop on • strengthening global empowerment in local health of action to operationalize promoting urban health equity governance and and social development, the Rio Declaration on the assessment and response was collaboration to design a sustainable Social Determinants of held in Cairo, Egypt, from 2 to • improving governance for mechanism for intersectoral Health. 4 September 2012. health and development The objectives of the workshop • increasing participation were to: share the experiences in policy-making and of Urban Health Equity implementation Assessment and Response • reorienting the health sector Tool (Urban HEART) in four towards reducing health cities of Ariana of , Sale inequities of , Giza of Egypt and Tehran of Islamic Republic • monitoring progress and of Iran; review a manual on increasing accountability. implementing healthy settings Another objective of the Urban challenges are complex due to unplanned urban growth

Community-based initiatives 7 Volume 7 Issue 2 2012

Addressing the social determinants of health in Jordan to tackle obesity

Acknowledgements

• Dr Asma Al-Khoudari, Coordinator, Sharjah Healthy City Programme, United Arab Emirates In line with the 2011 Rio Political Declaration • Increase physical activity among on the Social Determinants of Health, the members of the community. • Dr Reham A. J. Al Majali, Head Government of Jordan established an To achieve the objectives the following of Healthy Village Programme, intersectoral technical committee and a activities were implemented. Ministry of Health, Jordan social determinants of health steering • The municipality of greater Amman • Dr Sana Naffa, National committee. The committee identified opened four public gardens at specific obesity as a major social determinant of Professional Officer, Health times for women only, to encourage health in Jordan. The 2009 demographic Systems Strengthening, WHO women to exercise and walk country office, Jordan and health survey found that: • The nutrition labelling committee • 27.8% of women in Jordan are • Dr Nohal Al-Homsi, CBI Focal Point, simplified food labelling overweight and 28.7% are obese WHO country office, Lebanon • The Ministry of Health of Jordan • the weight of 56.5% of Jordanian women • Ms Ruth Mabry, Technical Officer, established a web site to raise people’s posed a health risk WHO country office, Oman awareness of the social determinants • 3% of children under 5 were recorded as • Dr Ghulam N. Kazi, CBI focal point, of health and physical activity. overweight in 2009 WHO country office, Pakistan To identify the effectiveness of walking • chronic diseases cost Jordan about • and simplifying food labelling 91 Dr Humayun Rizwan, CBI focal 1.2 billion Jordanian Dinars in 2006 point, WHO country office, Somalia women, whose ages ranged between according to the Ministry of Health of 18 and 45 years, were asked to take • Dr Fuji Mohamed, CBI Technical Jordan. part in an exercise. A team of trained Officer, WHO country office, The intersectoral committee proposed the personnel from the Directorate of Health Somalia following interventions at national level. Safety in Amman weighed the target • Enhance community awareness on groups on a regular basis for 45 days. the importance of a balanced diet and Their initial mean body weight was 83.7 healthy eating habits kg. Participants achieved an average weight loss of 1.5 kg over 45 days of • Establish a monitoring system to walking and following nutritional advice. estimate overweight and obesity in all One woman lost 3.8 kg. age groups and between sexes

8 Community-based initiatives www.emro.who.int/cbi Résumé

Réseau régional des villes-santé de faire mieux connaître l’importance habitudes alimentaires saines pour profiter Dans le cadre de ses efforts de promotion du dépistage et de l’adoption d’un mode au maximum des bienfaits de la marche. du programme des villes-santé dans la de vie sain, particulièrement pour les Amélioration de l’eau potable dans les Région de la Méditerranée orientale, personnes vivant dans les zones reculées. écoles de Tripoli (Liban) Le succès de la campagne Caravane rose l’OMS a lancé en 2012 un site Web pour À Tripoli, au Liban, le programme des villes- est dû à un engagement et un soutien le Réseau villes-santé. Ce site contient santé a été lancé en septembre 2010 par politiques à haut niveau, aux partenariats, une carte interactive et des outils visant la formation d’une équipe multisectorielle à la collaboration intersectorielle et à à faciliter l’échange d’expériences, de composée de représentants de divers la participation communautaire. Ces réussites exemplaires, de photographies secteurs. Au début de l’année 2011, facteurs sont des indicateurs importants et de communiqués aux niveaux national, le comité de coordination de la ville a pour la pérennité de cette initiative et son régional et mondial. Il met en évidence les identifié la sécurité sanitaire des aliments, appropriation par la communauté. réalisations des villes et les enseignements la santé scolaire, la gestion des déchets qui en ont été tirés. Le Réseau régional Évaluation du projet sur les modes de solides et la lutte antitabac comme défis villes-santé apporte un soutien aux vie sains de Nizwa (Oman) prioritaires. Deux étudiants de la Faculté urbanistes et un formulaire d’inscription Le projet de Nizwa sur les modes de vie de Santé publique de l’Université du est disponible sur le site pour les maires sains est un projet communautaire de Liban ont mené, dans le cadre de la et les gouverneurs qui souhaitent rejoindre promotion de la santé qui s’est déroulé préparation d’une thèse, une étude le Réseau. Depuis son lancement en à Oman. Les principaux objectifs du intitulée « Assessment of school health janvier 2012, des villes d’Afghanistan, projet consistaient à cartographier les environment and water supply in 51 public des Émirats arabes unis, de République épidémies émergentes de maladies schools in the healthy city programme in islamique d’Iran, de Jordanie et du Maroc non transmissibles et à analyser les Tripoli » (Évaluation de l’environnement de ont rejoint le Réseau et l’on espère déterminants comportementaux, économi- santé scolaire et de l’approvisionnement que 200 villes se seront inscrites d’ici ques, politiques et sociaux des facteurs en eau dans 51 écoles publiques de Tripoli fin 2013. de risque. Le projet visait également à dans le cadre du programme des villes- Une initiative des villes-santé à réduire l’exposition des individus aux santé). Les résultats de l’analyse de l’eau Hargeisa (Somaliland) déterminants majeurs des facteurs de potable dans les écoles ont révélé que En collaboration avec le ministère de risque des maladies non transmissibles en 17 des 51 écoles (soit 33 %) utilisaient la Santé et l’OMS, Hussein M. Jiciir, renforçant les services de soins de santé de l’eau impropre à la consommation. ingénieur et maire d’Hargeisa, a lancé et en assurant l’accès à des interventions En conséquence, le maire a demandé l’initiative des villes-santé dans la zone efficaces. Ce projet représente un modèle aux autorités municipales d’installer des nord-ouest de la Somalie. Cette région se de collaboration intersectorielle ayant systèmes de désinfection de l’eau par relève des effets d’une longue guerre civile fait ses preuves pour la prévention des rayons ultraviolets et des réservoirs dans et de maigres ressources. Des réalisations maladies chroniques et la lutte contre 12 de ces 17 écoles. remarquables ont eu lieu sous la direction ce type de maladies. Après quatre Nouvelles publications sur les du maire. Une série d’activités a été mise années de mise en œuvre, le projet a initiatives communautaires en œuvre dans le cadre de l’initiative : été évalué afin de mesurer son impact Le programme des initiatives communau- adoption d’une gestion décentralisée de la et les progrès accomplis. L’évaluation a taires a publié quatre nouveaux ouvrages ville, création de partenariats public-privé révélé un changement significatif dans en 2012 : pour s’attaquer aux problèmes liés à la les perceptions que les habitants ont de gestion des déchets solides. Aujourd’hui, leurs besoins. La disponibilité des services 1) Training manual for the healthy city plus de 60 % des foyers et tous les de prévention, tels que le dépistage des programme (Manuel de formation pour le marchés, hôpitaux et bâtiments publics facteurs de risque, les chemins piétonniers, programme des villes-santé) (en arabe) qui sont desservis par le système de gestion une alimentation saine, des services de fournit un aperçu du programme des villes- des déchets solides. L’OMS maintiendra conseil et d’aide au sevrage tabagique, santé et des procédures opérationnelles ; son soutien à la municipalité afin d’assurer ont facilité l’adoption de comportements 2) Training manual for community-based la pérennité de l’initiative ville-santé à favorables à la santé parmi les habitants. initiatives; a practical tool for trainees and Hargeisa et continuera d’encourager des La marche pour promouvoir un mode trainers (Manuel de formation pour les méthodes plus innovantes. de vie sain à Aqaba (Jordanie) initiatives communautaires : outil pratique pour les stagiaires et les formateurs) (en La Caravane rose, campagne de « La marche pour une vie saine » est arabe), qui est un manuel de formation sensibilisation au cancer du sein aux le thème mis en valeur à la fois par la standard destiné aux représentants Émirats arabes unis : Friends of Cancer communauté et par les représentants de communautaires ; Patients Society (Association des amis la ville d’Aqaba (Jordanie), qui compte des patients atteints de cancer) parmi les villes récemment inscrites au 3) The effect of urbanization on incidence Placée sous l’égide du Conseil suprême Réseau régional des villes-santé. Des of noncommunicable diseases (Effet de des Affaires familiales de Sharjah (Émirats personnes de tous horizons profitent du l’urbanisation sur l’incidence des maladies arabes unis), l’association caritative magnifique paysage et changent leurs non transmissibles) ; et 4) Good practices Friends of Cancer Patients Society habitudes pour intégrer la marche à leurs in delivery of primary health care in repose sur le bénévolat. En 2011, cette activités quotidiennes. Les foules de urban settings (Les bonnes pratiques en association a lancé une campagne de citadins marchant dans les rues chaque matière de prestation des soins de santé sensibilisation au cancer du sein d’une soir ont fait apparaître la nécessité en milieu urbain). Toutes les publications durée de deux ans intitulée « Caravane de créer des chemins piétonniers. La sur les initiatives communautaires sont rose », qui fait appel à des chevaux pour corniche est maintenant fermée pendant disponibles à la rubrique Ressources contribuer à promouvoir la campagne trois heures chaque soir pour permettre d’information du site Web du Bureau dans l’ensemble des Émirats arabes unis. la marche quotidienne. Les autorités régional de la Méditerranée orientale. Des manifestations équestres ont permis médicales préconisent également des

Community-based initiatives 9 Volume 7 Issue 2 2012

Séminaire-atelier sur la promotion de de mise en œuvre du programme des Afin d’identifier l’efficacité de la marche l’outil d’évaluation et d’intervention besoins fondamentaux en matière de et de simplifier l’étiquetage des denrées pour l’équité en santé en milieu urbain, développement de Pishin et Muzaffarabad alimentaires, 91 femmes âgées de 18 à du 2 au 4 septembre 2012 au Pakistan. Afin de promouvoir un mode 45 ans ont été sollicitées pour participer L’urbanisation et la santé constituent un de vie sain auprès des jeunes, un match de à un exercice. Une équipe composée domaine prioritaire pour la plupart des cricket a été organisé. Des responsables de membres formés du personnel de la pays du monde. Actuellement, 49 % de la communautaires, des aînés, des Direction de la Sécurité sanitaire à Amman population de la Région de la Méditerranée enseignants et des associations de jeunes a pesé les participantes des groupes cibles orientale vit dans les villes et l’on estime que ont communiqué des messages durant de manière régulière pendant 45 jours. d’ici 2030, les deux tiers de la population la manifestation. Les adolescents ont été Les participantes ont perdu en moyenne mondiale vivront dans des zones urbaines. sensibilisés aux dangers du tabagisme et 1,5 kg en 45 jours grâce à la marche et au Pour aborder l’équité en santé en milieu de l’apparition d’une dépendance au tabac respect des conseils nutritionnels. urbain, un séminaire-atelier interpays au cours de leurs premières années. Un Formation d’agents de santé villageois sur la promotion de l’outil d’évaluation et séminaire intéressant, auquel ont assisté sur les sites de la JICA en Jordanie de nombreux étudiants, universitaires, d’intervention pour l’équité en santé en L’Agence japonaise pour la Coopération représentants de la société civile et milieu urbain a eu lieu au Caire (Égypte), internationale (JICA) a utilisé le manuel militants sociaux, a également été organisé du 2 au 4 septembre 2012. Les objectifs de formation destiné aux représentants au sein du Département de sociologie de du séminaire-atelier étaient les suivants : de groupes et aux volontaires de santé l’Université de l’Azad Jammu-et-Cachemir. partager les expériences réalisées avec au cours d’une session de formation l’Outil d’évaluation et d’intervention pour Prise en compte des déterminants conjointe OMS/JICA destinée aux agents l’équité en santé en milieu urbain (Urban sociaux de la santé dans la lutte contre de santé travaillant sur les sites de mise HEART) utilisé dans quatre villes : Ariana l’obésité en Jordanie en œuvre des projets de la JICA. La JICA a en Tunisie, Salé au Maroc, Giza en Égypte Conformément à la Déclaration politique organisé ce séminaire-atelier de 4 jours du et Téhéran en République islamique de Rio de 2011 sur les déterminants 16 au 19 septembre à Amman (Jordanie) d’Iran ; examiner un manuel sur la mise sociaux de la santé, le Gouvernement de pour 22 agents de santé villageois et en place d’environnements sains (écoles, Jordanie a établi des commissions afin de 5 superviseurs venus d’Aqaba, Karak, hôpitaux, lieux de travail et marchés de faire face au problème de l’obésité en tant Tafileh et Ma’an dans le sud du pays. Les denrées alimentaires) ; et élaborer un que déterminant de la santé majeur en participants à la formation ont acquis une projet pour des plans d’action stratégiques Jordanie. Une enquête nationale réalisée somme de connaissances considérable afin de mettre en œuvre la Déclaration en 2009 a révélé que près d’un tiers des qui devrait avoir un impact positif sur la politique de Rio dans les pays. femmes étaient en surpoids ou obèses, santé de la communauté et améliorer la Le Pakistan participe au rassemblement que leur poids constituait une menace pour satisfaction quant aux taux de couverture de la Journée mondiale sans tabac leur santé et que les maladies chroniques des soins de santé. Le 31 mai 2012, la Journée mondiale avaient coûté environ 1,2 milliard de sans tabac a été célébrée sur les sites dinars jordaniens à la Jordanie en 2006.

والجيزة بمصر، وطهران بجمهورية إيران واألكاديميين وممثلي المجتمع المدني 1.5 كيلو جرام من وزنهن بعد ممارسة المشي اإلسالمية؛ ومراجعة الدليل الخاص بإعداد والناشطين االجتماعيين. لمدة 45 ًيوما واتباع النصائح الغذائية. المواقع الصحية )المدارس، والمستشفيات، التعاطي مع املُ ِّحددات االجتماعية لل�صحة يف تدريب العاملني ال�صحيني القرويني فـي مواقع وأماكن العمل، وأسواق الغذاء(؛ ووضع تصور االأردن ملعاجلة م�شكلة ال�سمنة اجلايكا باالأردن عام لخطط العمل االستراتيجية الوطنية ً استخدمت الوكالة اليابانية للتعاون الدولي لتفعيل اإلعالن السياسي لريو دي جانيرو في تماشيامع إعالن ريو السياسي حول ِ 2011 )الجايكا( الدليل التدريبي لمجموعات ممثلي البلدان. ُالم ّحددات االجتماعية للصحة ، َّشكلت الحكومة األردنية ًلجانا لمعالجة مشكلة األحياء والمتطوعين الصحيين، خالل دورة باك�ستان ت�شارك فـي احتفاالت اليوم العاملي السمنة باعتبارها ًمحددا من المحددات تدريبية مشتركة بين منظمة الصحة العالمية/ ملكافحة التبغ االجتماعية الرئيسية للصحة في األردن. وقد الوكالة اليابانية للتعاون الدولي، استهدفت في 31 أيار/مايو 2012تم االحتفال باليوم ُأ ِجري مسح وطني في العام 2009، ُوخلص العاملين في مجال صحة القرى في المواقع العالمي لمكافحة التبغ في المواقع التي هذا المسح إلى أن ثلث النساء ًتقريبا يعانين التي ُت ِّنفذ مشروعات تحت رعاية الوكالة تطبق برنامج االحتياجات األساسية للتنمية من زيادة الوزن أو السمنة، وأن أوزانهن ُت ِّمثل اليابانية للتعاون الدولي. َّونظمت الوكالة في مدينتي بلوشستان ومظفرأباد. وأقيمت مشكلة على صحتهن، كما أشار المسح إلى أن اليابانية للتعاون الدولي حلقة عملية تدريبية / 19 16 4 مباراة في الكريكيت لتشجيع الشباب األمراض المزمنة َّكلفت األردن 1.2 مليار دينار على مدى أيام من إلى أيلول سبتمبر 22 2012 على تبني نمط حياة صحي. وقد َّبث قادة أردني في 2006. ولتحديد فاعلية المشي في َّعمان، لتدريب من العاملين في 5 المجتمع وكبار السن والمدرسون ومنظمات وتبسيط البيانات التعريفية على بطاقات مجال صحة القرى و مشرفين من مدن العقبة الشباب خالل هذه المناسبة رسائل تهدف األغذية، ُط ِلب من 91 سيدة تتراوح أعمارهن والكرك وتفليح ومعان في جنوب األردن. وقد ً ً إلى مكافحة التدخين. وتم توعية المراهقين بين 18 و45 سنة أن يشتركن في رياضة اكتسب المشاركون في هذا التدريب قدرا كبيرا من المعرفة التي ي َت َّوقع أن تؤثر ًتأثيرا ًإيجابيا بأخطار التدخين واكتساب عادة االعتماد المشي. وقام فريق من الموظفين المدربين ُ على صحة المجتمع، وأن ُت ِّحسن الرضا عن على التبغ في سن مبكرة. كما ُع ِق َدت ندوة التابعين لمديرية السالمة الصحية في َّعمان مستويات التغطية بالرعاية الصحية. مهمة في قسم علم االجتماع، بجامعة أزاد بوزن المجموعات المستهدفة بصفة منتظمة جامو وكشمير، حضرها جمع غفير من الطلبة لمدة 45 ًيوما، وقد تمكنت المشاركات من فقد

10 Community-based initiatives www.emro.who.int/cbi Volume 7 Issue 2 2012

الموجــز

ال�شبكة االإقليمية للمدن ال�صحية تبني أنماط حياة صحية السيما بين األفراد بتشكيل فريق عمل متعدد القطاعات يضم َ في إطار جهود منظمة الصحة العالمية الذين يعيشون في المناطق النائية. ُويعزى ممثلين من مختلف القطاعات. وفي مطلع العام 2011، حددت اللجنة التنسيقية بالمدينة للترويج لبرنامج المدن الصحية في إقليم النجاح الذي حققته حملة القافلة الوردية إلى عدة تحديات ذات أولوية؛ وهي: سالمة الغذاء، شرق المتوسط، أطلقت المنظمة في 2012 االلتزام والدعم السياسي الرفيع المستوى، والصحة المدرسية، ومعالجة النفايات ًموقعا ًالكترونيا عن شبكة المدن الصحية. وعقد الشراكات بين المؤسسات العاملة بمجال التوعية بسرطان الثدي، والتعاون فيما الصلبة، ومكافحة التبغ. وقام طالبان من ويحتوي هذا الموقع على خريطة وأدوات بين القطاعات، والمشاركة المجتمعية. وهذه كلية الصحة العمومية بجامعة لبنان بإعداد تفاعلية بهدف تيسير تبادل الخبرات الوطنية العوامل كلها مؤشرات هامة على استدامة أطروحة بحثية عنوانها “تقييم بيئة الصحة واإلقليمية والعالمية وقصص النجاح المبادرة والشعور المجتمعي بملكيتها. المدرسية وإمدادات المياه في 51 مدرسة والصور واإلعالنات. كما ُي ِّسلط الموقع الضوء حكومية مشتركة في برنامج المدن الصحية على اإلنجازات التي حققتها المدن، ُوير ِّكز تقييم م�شروع نزوى الأمناط احلياة ال�صحية، بمدينة طرابلس”. وأشارت النتائج التي أسفر على الدروس المستفادة. ُوت ِّقدم الشبكة ُعمان عنها تحليل المياه في المدارس إلى أن 17 اإلقليمية للمدن الصحية الدعم إلى مخططي مشروع نزوى ألنماط الحياة الصحية هو مدرسة )وهو ما يمثل 33%( من المدارس التي المدن، ويوجد على الموقع استمارة تسجيل مشروع مجتمعي لتعزيز الصحة في سلطنة شملها البحث )51 مدرسة( تستخدم مياه لرؤساء البلديات والمحافظين ممن يرغبون ُعمان. وتتمثل األهداف العامة لهذا المشروع غير مأمونة للشرب. مما حدا برئيس بلدية في االنضمام إلى الشبكة. وقد انضم إلى في رسم خريطة للوبائيات ُالم َست َّجدة لألمراض مدينة طرابلس إلى توجيه السلطات لتركيب الشبكة، منذ انطالقها في كانون الثاني/يناير غير السارية، وتحليل ُالم ِّحددات السلوكية أنظمة وصهاريج لتطهير المياه باألشعة فوق 2012، مدن في األردن وأفغانستان واإلمارات واالقتصادية والسياسية واالجتماعية لعوامل البنفسجية في 12 مدرسة من بين المدارس العربية المتحدة وجمهورية إيران اإلسالمية الخطر المرتبطة بها. وكان المشروع يرمي السبع عشرة. والمغرب، ومن المأمول أن ُي َّسجل بالشبكة ًأيضا إلى تقليص ُّتعرض األفراد ُللم ِّحددات 200 مدينة قبل نهاية العام 2013. املطبوعات اجلديدة لربنامج املبادرات الرئيسية لعوامل الخطر المرتبطة باألمراض املجتمعية مبادرة املدينة ال�صحية فـي هرجي�سا، ب�أر�ض غير السارية من خالل تقوية خدمات الرعاية ال�صومال “�صوماليالند” الصحية، وضمان إتاحة التدخالت الفعالة. أصدر برنامج المبادرات المجتمعية أربع ويمثل هذا المشروع ًنموذجا ًناجحا للتعاون مطبوعات جديدة في العام 2012؛ وهي: )1( أطلق المهندس حسين محمود جيغر، رئيس فيما بين القطاعات للوقاية من األمراض الدليل التدريبي لبرنامج المدن الصحية بلدية هرجيسا، مبادرة المدينة الصحة في المزمنة ومكافحتها. وقد جرى تقييم المشروع )باللغة العربية(، ُوي ِّقدم هذا الدليل نظرة عامة المنطقة الشمالية الغربية من الصومال، بعد أربع سنوات من تنفيذه بغية قياس تأثيره لبرنامج المدن الصحية وإجراءاته الميدانية؛ وذلك بالتعاون مع وزارة الصحة الصومالية ومدى تقدمه. وقد أوضح التقييم حدوث تحول )2( كتيب تدريبي للمبادرات المجتمعية: أداة ومنظمة الصحة العالمية. وقد بدأت هذه جوهري في إدراك الناس الحتياجاتهم. وساعد عملية للمدربين والمتدربين )باللغة العربية(، المنطقة تتعافى من ويالت صراع مدني طويل توافر خدمات الوقاية على تبني سلوكيات والذي ُي ِّل مث ًدليال ًتدريبيا ًمعياريا للممثلين ومن شح في الموارد. وقد تحققت إنجازات صحية بين األفراد، ومن هذه الخدمات تحري المجتمعيين؛ )3( أثر التمدن على وقوع الفتة للنظر تحت قيادة المهندس حسين عوامل الخطر، وإنشاء ممرات للمشي، وتناول األمراض غير السارية؛ )4( الممارسات الجيدة جيغر. كما ُن ِّفذ طيف من األنشطة في ظل األغذية الصحية، وتقديم المشورة وخدمات في تقديم الرعاية الصحية األولية في المواقع مبادرة المدينة الصحية ًبدءا من تبني نهج المساعدة على اإلقالع عن التدخين. الحضرية. وتتوافر جميع إصدارات برنامج المركزي في إدارة المدينة إلى عقد شراكات المبادرات المجتمعية على الموقع اإللكتروني بين القطاعين العام والخاص لمعالجة قضايا امل�شي لتعزيز منط حياة �صحي فـي مدينة العقبة، االأردن للمكتب اإلقليمي لشرق المتوسط تحت قسم تتعلق بمعالجة النفايات الصلبة. واليوم “موارد المعلومات”. ُي َّطبق نظام معالجة النفايات الصلبة في ما “امش لحياة صحية”، هذا هو الشعار حلقة عملية لتقييم تعزيز االإن�صاف والت�صدي %60 يزيد على من المنازل وجميع األسواق الذي ُي ِّروجله سكان مدينة العقبة األردنية للجور فـي ال�صحة فـي املناطق احل�ضرية، 2-4 والمستشفيات والمباني الحكومية. وسوف والمسئولون فيها، وقد َّسجلت مدينة العقبة، �أيلول/�سبتمرب 2012 تواصل منظمة الصحة العالمية تقديم الدعم من بين مدن أخرى، في الشبكة اإلقليمية للمدن لبلدية هرجيسا بما يضمن استدامة مبادرة الصحية ًمؤخرا. ويستفيد الناس على اختالف ُي ِّمثل التمدن والصحة ًمجاال ذا أولوية 49 المدينة الصحية، وسوف تواصل تشجعيها مشاربهم من الطبيعة الخالبة للمدينة، ويغيرون لغالبية بلدان العالم. وأن % من سكان إقليم على تبني ُن ُهج أكثر ًابتكارا. من مواقفهم تجاه تبني رياضة المشي كجزء شرق المتوسط يعيشون اليوم في المناطق حملة القافلة الوردية فـي االإمارات العربية من نظامهم اليومي. وتعج شوارع المدينة في الحضرية، وتشير التقديرات إلى أن ثلثي املتحدة: جمعية �أ�صدقاء مر�ضى ال�سرطان المساء بالجموع الغفيرة من السكان مما يبرز سكان العالم سيقطنون في المناطق الحضرية 2030 الحاجة إلى إنشاء ممرات للمشي. ويتم اآلن بحلول عام . وقد ُع ِقدت في مقر المكتب جمعية أصدقاء مرضى السرطان هي جمعية 2 4 إغالق الكورنيش لثالث ساعات في المساء كي اإلقليمي بالقاهرة، في المدة من إلى 2012 / خيرية تطوعية تعمل تحت مظلة المجلس يستوعب نشاط المشي اليومي. كما تدعو أيلول سبتمبر ، حلقة عملية بلدانية األعلى لشؤون األسرة بإمارة الشارقة، السلطات الطبية إلى ضرورة تبني عادات لتقييم تعزيز اإلنصاف والتصدي للجور بدولة اإلمارات العربية المتحدة. وقد أطلقت غذائية صحية لتحقيق االستفادة القصوى من في الصحة في المناطق الحضرية لمناقشة 2011 هذه الجمعية في عام حملة القافلة رياضة المشي. موضوع تحقيق اإلنصاف في الصحة في الوردية لمدة عامين للتوعية بسرطان الثدي، المناطق الحضرية. وتمثلت أهداف هذه حت�سني مياه ال�شرب فـي املدار�س فـي مدينة واستخدمت القافلة الخيول للترويج للحملة الحلقة العملية في ما يلي: تبادل الخبرات في طرابل�س، لبنان في جميع أنحاء اإلمارات. كما أقيمت مناسبات ما يختص بأداة تقييم اإلنصاف والتصدي وأنشطة لركوب الخيل بهدف تسليط الضوء بدأ برنامج المدن الصحية فعالياته في مدينة للجور في الصحة في المناطق الحضرية في على أهمية الفحص المبكر للسرطان، وضرورة طرابلس بلبنان في أيلول/سبتمبر 2010 أربع مدن هي: أريانا بتونس، وسال بالمغرب، Community-based initiatives 11 For further information contact: Community-based Initiatives World Health Organization Regional Office for the Eastern Mediterranean Abdel Razzak Al Sanhoury Street, PO 7608 Nasr City, Cairo, Egypt Telephone: 00-202-2276-5000 Facsimile: 00-202-2670-2492/4 e-mail: [email protected] web site: http://www.emro.who.int/cbi

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