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Sustainable Development and
Environmental Health

Healthy Settings

Healthy Municipalities and Urban Health

For over twenty years, the Healthy Municipality Initiative has been a powerful strategy of participatory health promotion at the local level in Latin America. The movement arose from the need to effectively address the economic, social, and political determinants of health. The focus is on empowering and mobilizing the local level to improve the health of communities. The movement implies the support of local government in the establishment of healthy public policies, active community participation, the creation of supportive environments, the reorientation of health services, and the promotion of healthy lifestyles.

To be considered as healthy, a municipality, city or community must go beyond attaining certain levels of health indicators to continually create and improve the physical and social environments and expand community resources to help people to support each other in developing to their maximum potential.


The strategy strives to attain healthy communities by:


  • Securing local government commitment by the mayor and local councilors to build a healthier community.

  • Facilitating intersectoral collaboration whereby business, religious organizations, social services, planners, and environmental groups come together with residents to form a common vision and shared work plan for a healthy community.

  • Promoting the development of public policies that have a positive effect on the health of people.

  • Fostering community participation where community groups, organizations join together in the identification of health needs and in designing and implementing the action to be taken.

  • Giving visibility to health through advocacy and health communications.

  • Establishing sustainable mechanisms for supporting community activities.


    What makes healthy municipalities special?. They:


  • Focus on health and development rather than problems and risks.

  • Work toward providing a clean and safe physical environment.

  • Maximize human and financial resources to address community needs.

  • Foster innovative alliances and partnerships for health.

  • Involve the community in local government.

  • Develop collective community spirit and action.

  • Celebrate historical and cultural heritage.


    Health-Promoting Schools

    The Health-Promoting Schools Regional Initiative (HPSRI) serves as a strategic mechanism for advocacy; social facilitation and mobilization; multisectoral and interagency collaboration for strengthening regional, national, and local capacities in health promotion to provide conditions for learning and integral human development. The Initiative has contributed to a better understanding of the comprehensive needs of the child and youth school population for a larger visibility in the political, socioeconomic, and public health agendas of the Member States and has promoted a better understanding of the importance of joint collaboration between the health and education sectors and the strategic potential that schools have for health promotion, sustainable development, and socioeconomic and spiritual growth of communities. Health-Promoting Schools constitute an ambitious strategy for school health promotion and a mechanism for multisectoral efforts and resources aimed at the improvement of health conditions and well-being, thus increasing opportunities for better quality education and sustainable human development for all members of the educational communities. The Health-Promoting Schools model is based on the coordinated and synergistic implementation of three main components:

    1. Comprehensive Health education, including Life Skills training.
    2. Creation and maintenance of healthy psychosocial and physical school environments.
    3. Health and nutrition services, including mental counseling and the promotion of active life.


    Local Development and Community Participation

    The equity and the social inclusion are the guiding principles of the process of local development shaped as an environment and a set of tools to strengthen the local management, the democratic participation of the citizenship in the decisions that affect and define the health conditions and quality of life in the context of a reflexive public sphere, dynamic and that responds to the needs and aspirations of the population. The public policies are a motor for the development with equity, while the participation and the citizen empowerment are the inspiration and the creativity for the sustainable social development.

    Four strategic actions are fundamental in order to strengthen the processes of local development:

    1. Expansion of the capacity for articulation of PAHO internally and with other organizations in order to promote the sustainable local development.

    2. To promote the convergence of related agendas in order to implement locally the strategies of health promotion, the Millenium Declaration for theDevelopment and agenda 21 for the environment.

    3. Construction of local observatories as an exercise to strengthen the social pacts by the health in urban areas and rural communities.

    4. Implement the strategy of municipios and healthy communities, articulating the aspects of productivity, economic and social development with primary care and the health promotion in order to promote the improvement of quality of life.



    Healthy Municipalities


    Health-Promoting Schools


    Regional Office for the Americas of the World Health Organization
    525 Twenty-third Street, N.W., Washington, D.C. 20037, United States of America
    Tel.: +1 (202) 974-3000 Fax: +1 (202) 974-3663

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