YEARBOOK 2000 - General characteristics of the local projects

By exploring the general characteristics of the local Healthy Cities programmes the primary objective we sought to achieve was to find out whether the Healthy Cities programme of a given town had its own organisational or institutional 'identity'. In this context, identity expresses to what extent the Healthy Cities programme is able or has the opportunity to appear as a separate/autonomous initiative on the scenes of local or national community and/or public life.

There are several reasons why appearing as an autonomous initiative may be of importance for the operation, the level of commitment and the efficient implementation of tasks; it could, for example, generate more support, lead to more efficient lobbying, etc. At the same time, only a well separated organisation can meet the requirement formulated by the WHO as 'new organisational structure'. Autonomy also plays an important part in the definition of the competences and responsibilities, because in case of a well separated programme neither the competences nor the responsibilities can be questioned, presupposing clear relationships and situations.

Among the general characteristics of the member towns, one question was about the year when the town joined National the programme of Healthy Cities. Individual members joined the programme at various times since the autumn of 1989. Diagram 1. shows the distribution of the towns by the year in which they joined the programme.

The data show that 22% of the members who joined the association in 1989, while nearly by 2000 became members half of them (44.4%) joined the programme in 1997 or later.

The type of organisation in which the local programmes operate was also considered to be an important element of the general characteristics, because this allows to judge beyond doubt the level of autonomy that the organisation managing the local Healthy Cities programme enjoys.

As the data available illustrate, 44% of the programmes implemented in the member towns operate as a part of some department within the local government or other - mainly health services -, while the remaining part is operated by various independent non-profit organisations. The distribution of the organisation types is shown in Diagram 2.

Distribution of organisation types operating the programme in member towns. (n=17)

17.65 % = public foundation ; 47.1% = local government; 23.5% = foundation; 11.8% = association

When speaking about the forms of operation, we should point out that 75% of foundations, and 66% of the organisations operating today as public foundation were established before 1993, before the amendment of the Act on Associations, that is, when the notion of public foundation did not appear in the law. The fact that the local governments are often found among the foundations mentioned above is an unquestionable proof of the commitment of local decision-makers to the maintenance and objectives of the programme, therefore the foundations and public foundations are treated as one category in the course of the analysis.

The visual signs indicating the location of the co-ordinating offices of local programmes can be interpreted as important indicators of 'organisational identity'. The findings of the survey have revealed, however, that 39 % of the respondent organisations do not use any sign or notice to make it clear for all those interested in which building or room the project office can be found. At the same time every one of the organisations specified very clearly where the programme co-ordinator can be connected, making their staff easily available. These considerations allow us to suppose that it would not be too difficult to put up the signs or notices, and the fact that they are missing should not lead to any serious conclusions.

The last question of the first part concerned the general characteristics of the local programmes was meant to find out whether there had been any local or national events which had a significant impact on the operation of the local Healthy Cities programme. 66 % of the respondents gave a negative answer to this question. The remaining 34% typically mentioned only positive changes, eg. more attention paid by the local political leaders to the programmes and the implementation of their objectives, these changes, however, did not lead to significant changes in the operation of the programme. This increased political attention may be interpreted as an indication of the potential strategic importance of the Healthy Cities movement in the local political life and this situation means exploitable opportunities for future operation and safeguard of interests.

Summarising what has been discussed so far we can state that in nearly half of the member towns it is necessary to further increase organisational identity and awareness of the programme as a separate entity. Half of the associations and foundations have failed to produce signs (boards, notices) put up in places where they can be seen by a lot of people and communicating the operation of the programme, and half of them do not operate as autonomous organisations. 40% of the organisations which do not have proper visual signs for the programme are not independent bodies, but belong to some office or department within the local government. In either case it is a problem that they have no visual indication of the programme, but in the case of community organisations their presence would be even more important.

Several questions arise concerning the member towns, where the programme operates as part of the local government, but without the independent signs of identification: is the Healthy Cities programme represented as the programme operated by the local government, or only one of its departments, or as the programme run by the Healthy Cities movement? Similarly: if the co-ordinator intends to raise funds for the implementation of the programmes, should he or she act as the employee of the local government or as the co-ordinator of the programme? The main point here is, of course, not the type of organisation, but the extent to which the programme can be identified.

It clearly follows from the above outlined questions that it is very important both for the municipal leadership and the programme co-ordinator, and consequently for the members of the local community to be able to define unambiguously the status of those responsible for the organisation and implementation of the programme, and this will also make it possible to avoid the overlap or confusion of the various responsibilities and statuses. As a result, the potential partners can easily decide what kind of relations they intend to establish and maintain with the representatives of the programme.

At the same time, if the member town fails to indicate quite clearly the local Healthy Cities project office, it also gives up the possibility to communicate its relationship with internationally recognised organisations, like the UN and WHO, to the members of the local community and other partners. Losing such an opportunity will also deprive the programme (and thereby the municipality) of other advantages which would facilitate the enforcement of interests and the generation of financial support as well. .

Another remark related to the general characteristics of the organisations is that in some member towns the local Healthy Cities project has been operating within the local government not as a separate body, but as a part of some department or office, ever since the day they joined the programme and in some cases this can be more than 10 years! It is possible, that at the beginning such a solution may have proved to be temporarily effective in the management of initial uncertainties, but the long-term operation within the same structure seems to indicate that either their has been no ambition to become independent, or the local project never had a chance to do so. Whatever the case may be, it is reasonable to raise the issue - and consequently refer to the task - what would be the best approach to finding a solution to this situation and thereby to the implementation of the WHO principles.

Independent operation should not be considered equivalent with the existence of the separate body - like a non-profit organisation - because autonomy can be achieved within the organisation of the local government, too, as illustrated by several foreign examples. This solutions may even have advantages in some situations - e.g. the availability of the existing infrastructure, more informal internal communication, etc. At the same time, the programme offices which operate in this way should be placed in a part of the building, that is close enough to the upper level of leadership - e.g. to the mayor - so that there should be no difficulty in ensuring the multi-sectoral character, without the danger of the programme getting attached to one of the sectors - e.g. health services, or environmental protection, etc..- due to the long established routine.

Unfortunately, this is the course of development which does not seem to take shape in the case of certain organisations, as far as we can judge from their operation so far. This conclusion can be borne out by the lack of clear identification of the organisations which belong to an office, and - as it will be detailed later on - by the 'eclectic' character of the employment, the infrastructure made available for them, and the financial background. Consequently, short-term objectives of development should include strategies aimed at finding a solution to these situations.