Who we are?

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Background

The Croatian Healthy Cities Network (CHCN) was established in 1991, the same year the Republic of Croatia became an independent state, and it has been a legally registered non-governmental organization since 1992. However, the history of healthy cities in Croatia dates back to 1987, when the city of Zagreb became one of the first cities to participate in the WHO is healthy cities project. Today, the network is a voluntary, open association of cities and counties that are committed to improving the health and the quality of life of their inhabitants. The network is primarily funded through grants and membership fees.

CHCN is a member of the World Health Organisation, Office for Europe Network of the European National Healthy Cities Networks (NETWORK).

 

Strategic organization

The network is organized and hosted within the Andrija Štampar School of Public Health, which is one of the oldest schools of public health in Europe, founded in 1927. Translated directly, it is the "School of People's Health," and (as the name suggests) it has always strived to bridge public health theory with practice. Public health doctors were the first group in Croatia to embrace and encourage local authorities to put the healthy cities concept into practice, and they supported them with academic knowledge and research tools. Healthy cities enabled academics to access the real world of needs and opportunities, and reach and support citizens in the creation of a better life. This marriage of research and practice yields credible, powerful results that seize the attention of local and national policy-makers.

 

A mission focused on citizens

The CHCN takes a bottom-up approach by engaging citizens and local communities in a process that builds towards policies and plans at municipal, county and national levels.  The mission of the CHCN is to upgrade local capacity for health resources planning and management with the aim of improving: the quality of the environment; the conditions that create healthy lifestyles; and access to services that meet the needs of citizens. In its unique approach, the CHCN advocates the right to differences in local communities. In practice, this means identifying the needs and available resources within communities and respecting the individual characteristics of communities in health planning.  There is no universal, one-size-fits-all solution.

 

Reaching a higher level of excellence

Being aware that people's health and well-being are affected through (the complex interplay between) the natural, built and social environments, access to services and support CHCN, in the Phase VII, had chosen to work on: healthy urban planning (designing places that deliver equity and community prosperity), prioritizing investment in people in local policies and strategies (people at the center) and empowerment and participation. Throughout the phase VII CHCN will promote systematic action to address health inequalities through whole-of-local-government approach, i.e. promote health and well-being through municipal administrations. We are already bringing innovation in policy and (everyday) practice of different cities departments by providing relevant data for evidence informed decision making, by encouraging interdepartmental cooperation and mutual learning, by sharing (academic) knowledge and supporting comprehensive health planning. What we learned from our own and others' academic research is that effective, comprehensive and integrated strategies and interventions are essential in addressing complex challenges. The partnerships that create new working cultures and strengthen the (public health) capacity of institutions and city departments to support people-centered approach are essential. Throughout the years CHCN is committed to upgrade network activities to a higher level of excellence by: building public health and managing capacity of members - cities and counties (competence development), carrying out joint research and action projects ("learning by doing" approach), designing and implementing joint efficient interventions aiming at better health and improved quality of life in the community, providing academic facts and arguments to support  evidence informed decision making, lobbing and advocating. For years CHCN members - cities and counties have been seen as social entrepreneurs, introducing new ways of working and transforming local services delivery. Leading by example, in the Phase VII, CHCN will act as a partner and vehicle for change locally and nationally aiming to support development of inclusive society and resilient and empowered communities.

In Phase VII CHCN will focus its' activities on the needs of the people who live in vulnerable circumstances. Policies and interventions within a life-course approach will include action on children's well-being and early childhood development, persons with disability and elderly persons. In Phase VII CHCN will focus its' activities on transformation of services delivery. Health and social services, and especially primary care services, that reach out to families in their homes are important entry points for systematically supporting individuals and communities over the life course and especially during critical periods. We intend to strengthen the public health capacity of visiting nurses at primary health care level so that they can act not just as health services providers but as well as community health services coordinators. Through training and educational events CHCN will continue with its' activities on Healthy urban planning. With the aim to improve urban planning practices we intend to address the topics of Healthy, Resilient and Sustainable Cities, Green Cites, Universal design (accessibility), Mobility, Transport, Energy efficiency and local Food production (urban gardens). In Phase VII CHCN will advocate the importance of water protection, waste and sanitation, protection of soil and biodiversity. We will encourage public debates on climate change and mitigation of its' negative effect on local communities.

 

Raising public health capacity - tools for change

The Croatian Healthy Cities Network (CHCN) has been working for almost 30 years to increase the capacity of cities and counties to develop health policies and manage their implementation. The network has developed a variety of tools to support cities and counties to develop competencies and it has assisted in reorienting public health planning from central to the County and city levels, ensuring that resources are directed at the local priorities.

"Health-plan for it"

"Health - Plan for it" is a unique training program which strengthens the management and public health capacity of counties. It assists them to assess population health needs in a participative manner, to set priorities, to plan for health, and, ultimately, to ensure the provision of responsive, high quality services.

The program incorporates a multidisciplinary and intersectoral approach, permanent consultation with the community and the use of qualitative analysis. The training curriculum was developed as a blend of recognised management tools, public health theory and the practice and use of the Sustainable Management Development Program's (a program of the Centers for Disease Control's, Global Health Program in the USA) Healthy Plan-it material (CDC. SMDP. Healthy Plan-it.  A tool for planning and managing public health programs. Workshop kit. Atlanta., CDC,  2008.).

Between March 2002 and March 2009, eight training cohorts which involved approximately 220 participants from 20 counties, and 24 participants from the city of Zagreb which has the status of a county, completed the program. Each county produced a health profile and health plan with prioritized health needs and identified actions to address them.

This program has been supported by several ministries as well as by local county governments. "Health -Plan for it" is a model of good practice for cooperation between the academic community and local and national government. The training program has received numerous program awards from the CDC, including a distinction award on 16 January 2013. The CDC described it as an 'exemplary program that has improved management and leadership to strengthen country health capacity and improve health outcomes…'.

 

A Rapid Appraisal Procedure (RAP)

Due to post-war conditions, scarce assets and the need to determine a baseline for action in cities, the CHCN developed a method of rapid appraisal to assess community health needs. The Rapid Appraisal Procedure to Assess Community Health Needs (RAP) is a method of getting information about a set of problems in a short period, without large expenditures of professional time or financial resources.  It is a participatory process which takes about two months from start to finish. It involves representatives of different groups of citizens, local authorities, institutions, organizations and NGOs in a process that identifies both needs and solutions.

Between 1996 and 2011, 13 Croatian cities have carried out a RAP. These documents are sensitive to particular community needs; they are scientifically sound and action-oriented. The credibility of the RDP was strengthened by strict selection rules for participants and panelists; a process of triangulation of information sources, essays, observations; and by the collection of indicators from researchers that have included experts from public health, epidemiology and medical information science. Carrying out the RAP has enabled cities to establish and sustain alliances among key stakeholders through priority, thematic groups.

CHCN cities with RAPs

Action research

The network has a well-established history of carrying out joint action research, which is a method of "learning by doing". Such research improves the ability of cities to detect and respond to population needs with effective interventions. Practical research has been carried out by the network from 2005 to 2019 on rural elderly care policies, the causes and consequences of early youth drinking, improving the quality of health services, palliative care development, needs assessment of single-parent families in Croatian healthy cities and, most recently, investing in early childhood development.

For The Croatian Healthy Cities Network
Professor Selma Šogorić, President CHCN