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RATIONALE
In developing countries, the rapid rate of urbanization has outpaced the ability of governments
to build essential infrastructure for health and social services. Among many features of
urbanization in developing countries include greater population densities and more congestion,
concentrated poverty and slum formation, and greater exposure to risks, hazards and
vulnerabilities to health (eg. violence, traffic injuries, obesity, and settlement in unsafe areas).
The concentration of risks is seen in the poorest neighbourhood’s resulting to health inequities.
From the above, it will require more than the provision and use of health services to improve
the health of urban populations. UHSD must help cities address the challenges of rapid
urbanization brought about by the interplay of different social determinants of health.
A. Goals
1. To improve Health System Outcomes Urban Health Systems shall be directed towards
achieving the following goals:
i. Better Health Outcomes;
ii. More equitable healthcare financing; and
iii. Improved responsiveness and client satisfaction
2. To influence social determinants of health the DOH must help influence social determinants
of health in urban settings, with focused application on urban poor populations particularly
those living in slums
3. To reduce health inequities Urban Health Systems Development seeks to narrow the
disparity of health outcome indicators between the rich and the poor
C. Specific objectives:
1. To establish awareness on the challenges of Urban Health;
2. To initiate inter-sectoral approach to Urban Health Systems Development; and
3. To guide LGUs to develop sustainable responses to the Urban Health challenge
COMPONENTS
The following are the developmental components of the UHSD Program:
3. Capability Building
Short Course on Urban Health Equity (SCUHE) is a 6-month course offered to cities and urban
stakeholders that aims to improve the knowledge, practice and skills of health practitioners,
policy and decision-makers at the national, regional and city levels to identify and address
urban health inequities and challenges, particularly in relation to social determinants of health.
GENERAL PRINCIPLES
1. Healthy urbanization. Urban Health Systems (UHS) must promote healthy urbanization so
that cities develop in ways that achieve better health and avoid risks to ill health under
conditions of rapid urbanization.
Healthy urbanization is the desired direction of urban health systems development that
aims to protect and promote public health rather than threaten or erode health of
individuals and communities in urban areas.
Empowerment' refers to the process by which people gain control over the factors and
decisions that shape their lives. It is the process by which they increase their assets and
attributes and build capacities to gain access, partners, networks and/or a voice, in order to
gain control. "Enabling" implies that people cannot "be empowered" by others; they can
only empower themselves by acquiring more of power's different forms (Laverack, 2008). It
assumes that people are their own assets, and the role of the external agent is to catalyse,
facilitate or "accompany" the community in acquiring power.
Community empowerment, therefore, is more than the involvement, participation or
engagement of communities. It implies community ownership and action that explicitly
aims at social and political change. Community empowerment is a process of re-negotiating
power in order to gain more control. It recognizes that if some people are going to be
empowered, then others will be sharing their existing power and giving some of it up
(Baum, 2008). Power is a central concept in community empowerment and health
promotion invariably operates within the arena of a power struggle.
Community empowerment necessarily addresses the social, cultural, political and economic
determinants that underpin health, and seeks to build partnerships with other sectors in
finding solutions.
Briefer on the Urban Health Equity Assessment and Response Tool (Urban HEART)
I. Rationale:
Rapid unplanned urbanization gives rise to urban poverty, health problems, and health
inequities in the cities. Disparities in health system outcomes between the affluent and the
poor are becoming more prominent in highly urbanized areas as government sectors find it
hard to cope with the increasing demands of the fast growing population of urban poor.
To address the above concerns, the Urban HEART or the Urban Health Equity Assessment and
Response Tool was developed by the WHO Centre for Health Development in Kobe, Japan to
assist Ministries of Health of countries in systematically generating evidence to assess and
respond to unfair health conditions and inequity in the urban setting. It was initially launched in
Tehran, Iran on April 2008, and the Philippines along with Iran, Zambia, and Brazil were the
pilot sites to test the Urban HEART in each country.
Seven cities initiated the use of the Urban HEART in the Philippines in 2008-2009, namely:
Paranaque City, Taguig City, Olongapo City, Naga City, Tacloban City, Zamboanga City, and
Davao City. The cities helped develop the tool for applicability in varied urban settings in the
country.
Urban Health Systems need to establish evidence on the status of the disadvantaged
population in the highly urbanized areas in order to develop objective interventions to address
inequities. Department Memorandum No. 2010-0207 dated August 20, 2010 on the “Use of the
Urban Health Equity Assessment and Response Tool in Highly Urbanized Cities” is intended to
help Highly Urbanized Cities (HUCs) generate systematic data on health inequities to guide
effective interventions.
DOH-FDA Administrative Order No. 2011-0008 of the Department of Health, issued by then
Health Secretary Esperanza Cabral in March 2010, ordering the removal of the phrase “no
approved therapeutic claim” from all advertisements, promotional and sponsorship activities
and materials of those products.
In lieu of that phrase, the following message was ordered posted: Mahalagang Paalala: Ang
(name of product) ay hindi gamot at hindi dapat gamiting panggamot sa anumang uri ng
sakit. Important reminder: This is not a medicinal drug and should not be used to treat the
symptoms of any disease).”
The same message is required to be clearly and audibly voiced over in audio advertisements or
promotions, without being cut off, in the last line regardless of their duration.
MATIAS H. AZNAR MEMORIAL – COLLEGE OF MEDICINE
PREVENTIVE COMMUNITY MEDICINE
(PCM III)
Report on
GROUP 1
Members