The Valencian Community Healthy Cities Network: assessment of the implementation process

In 1986 WHO-Euro began to develop the Healthy Cities project which was later extended to Spain, in this paper the factors related to the initial development of the Healthy Cities Project in the member towns and cities of the Valencian Community Healthy Cities Network, and the level of their development will be described. The project began in 1987 and the Network, at the time of this study (March 1991), was made up of 48 towns and cities. The instrument used to assess the process of the project development was a questionnaire administered by personal interview with the three people responsible for the project in each city: the Mayor, Health Councillor and Health Officer. A score was established to measure the level of development of the project in each city which included performance of the health diagnosis and plan, the existence of intersectoral committees and the creation of channels of community participation. A large proportion of the cities (72%) have carried out the Health Diagnosis; 26% of the cities have intersectoral committees and community participation is as yet in the initial stages. Political parties' support of their city's membership in the Network, has been almost unanimous with only three exceptions. Resources allocated to the project are not yet constant, although there is important support from different levels, and on the part of local and autonomous institutions. Differences can be observed in the level of development of the cities which make up the Network, related partly to length of time of membership, to the size of the city and to other factors difficult to assess.