Working out technology of the Strategic Plan of Health Promotion and Protection for the population of the city of Stavropol

K. R. Amlaev, Md. PhD- HCP coordinator

Stavropol, Russia

Context:

The necessity of key life activity spheres reforming of the Russians became obvious for all society sectors. This resulted in working out priority national projects: “Health”, “Qualitative education”, “Available and comfortable housing”, “Agro-industrial complex development”. It’s obvious that nowadays Russian social policy is aimed at the common citizen’s problems solutions and, first of all, at creating conditions for a considerable health improvement of the common people and  demographic situation in the country in whole. But federal authorities efforts are insufficient for achieving goals.

In this connection the local level activities in health promotion and protection sphere acquire a great importance (within the framework of administrative reform being implemented). The advantages of such kind an approach are based on a clear understanding of a definite municipal unit’s problems, it has more possibilities for a flexible technology correction, effective feedback and uses local “social capital”, that is, all local community sectors take part in its creation.

Rationale

The goal of this research work was to make out structural and methodological approaches to the realization of municipal projects on people’s health promotion and protection on the basis of intersectoral cooperation.

The following tasks were set up in accordance with the goal:

·        to make an analysis of local health projects implementation and to find out potential intersectoral cooperation partners, leaders and experts capable to make up a municipal team;

·        to form an organizational structure capable of providing intersectoral process of municipal health policy development and implementation;

·        to work out and adopt indicators of city life activity assessment at a municipal level;

·        to reveal priority problems of medical, social and socioeconomic health determinants of Stavropol city population on the basis of quantitative data received in accordance with indicators of city life activity assessment for a research period and sociological life quality study results;

·        to work out intersectoral Strategic Plan of Health Promotion and Protection for the population of the city of Stavropol taking into account “Health Profile” analysis results.

Description

At the first stage the analysis of socioeconomic municipal programmes was made. Then intersectoral expert groups in definite spheres of city life were formed aimed at defining social determinants indicators having an impact on citizens’ health and characterizing city vital activity. Adopted in the city of Stavropol the indicators system was worked out on the basis of indicators which had been offered by the Healthy Cities Support Russian Centre.

The development of socioeconomic determinants study strategy was carried out in following stages:

·       identification of phenomena and processes liable to statistical study;

·       formulation of goals for calculation of indices, definition of data type demanding development;

·       definition of the indicators contents;

·       definition of indicators assessments methods and the procedure of primary data processing for getting aggregate data;

·       definition of main data sources required for indicators calculation.

The indicators system of the municipality socioeconomic development must be aimed at the support of decision-making process at a city level and promote solution of three main tasks:

1)                      preliminary analysis of the situation at the territorial unit. The municipality’s problems are described with the help of formalized indicators set. These indicators analysis in dynamics, their comparison with similar indicators in other territorial units or with definite normative values make it possible to reveal critical problem spheres and potential “poles for growth”;

2)                      estimated effect assessment of the territorial development programmes activities. Constantly growing amount of information makes it possible to calculate anticipated effect of their implementation on the basis of comparison with other territorial units where similar activities have been carried out. Such kind of approach makes it possible to estimate effect of the whole programme realization at least approximately;

3)                      monitoring and assessment of the adopted municipal development programmes implementation. Periodical informational control of the situation in the territorial unit is carried out for programme implementation assessment and its effectiveness. Thus, a basis for feedback tools in the course of territorial management is created as well as for the required correction of middle- and long-term planning and current plans updating.

Organizational project structure promoted effective project realization.

Scheme №1 Organizational Healthy cities project structure

in the city of Stavropol

Steering Committee (coordinative committee)-

Chairperson (the head of the city)

Project Bureau- Coordinator

Working groups on indicators                              Working groups on the

working out and monitoring                          IV Phase project key strategies

1.     Group on city housing-municipal strategy and environmental well-being

2.     Group on informational policy development and relations with the public

3.     Group on public security strategy

4.     Group on educational milieu formation

5.     Group on financial and economical policy developing

6.     Group on cultural and health-promotion milieu formation

7.     Group on public health policy developing

Working groups on the IV Phase project key strategies

1.     Healthy urban planning group

2.     Health impact assessment group

3.     Healthy ageing group

4.     Physical activity group

At the second stage the qualitative and quantitative data on implemented programmes were collected and analyzed in accordance with adopted indicators.  “City Health Profile” was worked out on the intersectoral cooperation basis,  Healthy City Development Conception was worked out , the goals and tasks of its implementation were defined. A number of projects were implemented on the intersectoral cooperation basis.

1)    “Finding out specialists in the preventive medicine field”. This project made it possible to find partners in health institutions.

2)    Tobacco consumption prevention action “Non-smoking class”. This project made it possible to establish intersectoral relations with the Education Department.

3)    “HIV prevention integrated system in youth milieu” project promoted establishing partner relations with Youth Department and institutes of higher education

4)    “City Health Festival” project made it possible to spread healthy city ideology among a great number of citizens.

5)    “Opinion” project made it possible to make an objective study of the Stavropol citizens’ life quality. In the course of study 2003 residents of Stavropol and people working in it were questioned. The method of study was holding a questionnaire which was published in the newspaper “Evening Stavropol”. The readers had to fill it by their own. The participants of the questionnaire got the prizes from the organizers.

The questionnaire included the following issues:

·       Life style assessment (bad habits, physical culture activities, food quality, leisure).

·       Environmental situation assessment(quality of air, water, planting, noise)

·       Stavropol social infrastructure assessment (leisure places, sport facilities).

·       Key city problems estimation with negative health impact and ways of their solution.

·       City safety assessment.

·       Subjective assessment of city dwellers social activities.

·       Study of citizens concrete proposals on a healthier urban environment and social infrastructure improvement.

6)    “Health at work place” and “Stop, hypertension” projects implementation strengthened intersectoral relations with partners at enterprises.

7)    Health impact assessment project in urban planning sphere promoted establishment of partner relations with the Urban planning and the Municipal economy Departments.

At the third stage intersectoral working groups on the IV phase “Healthy cities” project key strategies were set up as well as intersectoral plans of operation. Their main activities and “Elderly People Health Profile” were realized.

At the fourth stage experts analytical activity was carried out, Healthy City Project preliminary results were discussed. The application forms for getting grants were sent to different organizations aimed at holding discussion at city community. A number of seminars, round table discussions and conferences resulted in priorities defining by communities’ representatives, the course was updated, a scheme-plan of municipal programmes implementation was made out. These activities influenced the Strategic Plan of Health Promotion and Protection for the population of the city of Stavropol.

Achievements:

Thus, in the course of this activity city life assessment indicators were adopted, strong horizontal intersectoral relations were established, city leaders raised awareness of health value as the most important life quality indicator. Most of the citizens were involved in the decision-making process and priorities defining.

Conclusion:

The activity on the development of the Strategic Plan of Health Promotion and Protection for the population of the city of Stavropol promoted optimization of city activities on people’s health strengthening and civil society formation.