Developing a Conceptual Framework of Urban Health Observatories toward Integrating Research and Evidence into Urban Policy for Health and Health Equity
Detailed information on health linked to geographic, sociodemographic, and environmental data are required by city governments to monitor health and the determinants of health. These data are critical for guiding local interventions, resource allocation, and planning decisions, yet they are too often non-existent or scattered. This study aimed to develop a conceptual framework of Urban Health Observatories (UHOs) as an institutional mechanism which can help synthesize evidence and incorporate it into urban policy-making for health and health equity. A survey of a select group of existent UHOs was conducted using an instrument based on an a priori conceptual framework of key structural and functional characteristics of UHOs. A purposive sample of seven UHOs was surveyed, including four governmental, two non-governmental, and one university-based observatory, each from a different country. Descriptive and framework analysis methods were used to analyze the data and to refine the conceptual framework in light of the empirical data. The UHOs were often a product of unique historical circumstances. They were relatively autonomous and capable of developing their own locally sensitive agenda. They often had strong networks for accessing data and were able to synthesize them at the urban level as well as disaggregate them into smaller units. Some UHOs were identified as not only assessing but also responding to local needs. The findings from this study were integrated into a conceptual framework which illustrates how UHOs can play a vital role in monitoring trends in health determinants, outcomes, and equity; optimizing an intersectoral urban information system; incorporating research on health into urban policies and systems; and providing technical guidance on research and evidence-based policy making. In order to be most effective, UHOs should be an integral part of the urban governance system, where multiple sectors of government, the civil society, and businesses can participate in taking the right actions to promote health equity.
KeywordsUrban health observatory Health equity Urban health metrics Health information Governance
- 1.Vlahov D, Boufford JI. Urban health in a global perspective. In: Vlahov D et al., eds. Urban health: global perspectives. New York: Wiley; 2010: 1–12.Google Scholar
- 2.Putra BS, Vallespín AF. Democratization of local government (decentralization). University of Freiburg web site. http://www.southeastasianstudies.uni-freiburg.de/areastudies/activities/research/democratization-of-local-government-decentralization. Accessed September 8, 2011.
- 5.UN Department of Economic and Social Affairs. The 2010 Revision of the World Population Prospects. http://esa.un.org/unpd/wpp/index.htm. Accessed September 5, 2011.
- 6.Fiel S et al. Global Research Network on Urban Health Equity (GRNUHE) http://www.bvsde.paho.org/texcom/cd045364/GRNUHEreport2010.pdf. Accessed September 5, 2011.
- 7.Chan M. Introduction. In: Vlahov D et al., eds. Urban health: global perspectives. New York: Wiley; 2010: 17–20.Google Scholar
- 11.WHO Commission on Social Determinants of Health. Knowledge Network on Urban Settings: our cities, our health, our future: acting on social determinants of health equity in urban settings. Geneva, World Health Organization, 2008. http://www.who.or.jp/publications/2008-2010/KNUS_final_report.pdf. Accessed 8 August, 2011
- 13.Ross Z, Matte T, Kitson H. Taking the pulse of an urban world: mechanisms for characterizing urban health and urban health equity. White Paper prepared for the World Health Organization Centre for Health. Kobe: WHO Kobe Centre; 2011.Google Scholar
- 14.Gattini CH. Implementing national health observatories: operational approach and strategic recommendations. Technical Series on Information for Decision-Making. PAHO. Santiago do Chile, 2009.Google Scholar
- 15.Urbana S. Marco Conceptual y Analítico. Una propuesta para el diseño de políticas públicas, estrategias e intervenciones em salud urbana em las grandes ciudades de las Américas. México: OPS–OMS; 2006.Google Scholar
- 16.Vlahov D, Caiaffa W. Healthy urban governance for population health in Belo Horizonte: participatory budgeting. In: Sclar, E.D. and Volavka-Close, N. eds. The urban transformation: health, shelter and climate change adaptation. London: Earthscan; 2012:63–81.Google Scholar
- 17.Fazekas M, Ettelt S, Newbould J, Nolte E. Framework for assessing, improving and enhancing health service planning. Technical report. RAND Corporation, 2010. http://www.rand.org. Accessed January 24, 2012.
- 18.UN-HABITAT. A guide to setting up an urban observatory. The Global Urban Observatory. United Nations Centre for Human Settlements (Habitat). Nairobi, Kenya. http://www.unhabitat.org/downloads/docs/LUO_guideline.pdf. Accessed September 09, 2011.
- 19.WHO. Framework and standards for country health information systems/Health Metrics Network, World Health Organization. 2nd edition, 2008.Google Scholar
- 21.Noyes J, Lewin S. Chapter 5: extracting qualitative evidence. In: Noyes J, Booth A, Hannes K, Harden A, Harris J, Lewin S, Lockwood C. eds. Supplementary guidance for inclusion of qualitative research in Cochrane Systematic Reviews of Interventions. Version 1 (updated August 2011). Cochrane Collaboration Qualitative Methods Group, 2011. http://cqrmg.cochrane.org/supplemental-handbook-guidance. Accessed January 13, 2012.
- 22.Srivastava A, Thomson SB. Framework analysis: a qualitative methodology for applied policy research. JOAAG. 2009; 4(2): 72–79.Google Scholar
- 23.World Bank classification by income [Internet homepage]. http://data.worldbank.org/country. Acessed January 13, 2012.
- 26.Caiaffa WT, Nabuco AL, Friche AAL, Proietti FA. Urban health and governance model in Belo Horizonte, Brazil. In: Vlahov D, Boufford JI, Pearson C, Norris L, eds. Urban health: global perspectives. San Francisco: Jossey-Bass; 2010: 437–452.Google Scholar