Good urban governance for health and well-being: a systematic review of barriers, facilitators and indicators

Rapid, unplanned urbanization is one of the major ecological and human challenges of the 21st century. UN Habitat predicts that, by 2050, nearly 70% of the world’s population will be living in cities, with disproportionate urban growth in low- and middle-income countries (10). While cities offer opportunities for employment and access to better public services, they also pose major health risks. Good local governance is critical for achieving the 2030 Agenda, and countries must strive to ensure that their cities are creating and improving their physical and social environments and their community resources to enable people to support each other and to develop to their maximum potential.  Building on good practices in the WHO Healthy Cities programme, the World Health Organization (WHO) has identified health promotion in urban and local settings as critical to achieving the Sustainable Development Goals (SDGs) and health equity. The WHO and UN Habitat 2016 Global report on urban health concluded that good urban governance – notably the role of city governments and strong leardership – is key to ensuring health equity and the health and well-being of their citizens (10).  WHO contracted the Institute of Social and Preventive Medicine, University of Bern, Switzerland, to review the evidence on two issues that are central to health promotion: achieving good governance for health and well-being, understood as participatory governance built on multisectoral action and civic engagement; and measuring the impact of governance on urban health outcomes. The aim of the systematic review was to identify barriers to and facilitators of multisectoral action and civic engagement and to suggest validated indicators and tools for assessing the processes and outcomes of participatory governance for health, equity and well-being in urban settings from published scientific evidence.  Findings from the systemic review informed the development of the Urban governance for health and well-being: a step-by-step approach to conducting operational research in cities.

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