YEARBOOK 2000 - Summary

The summary given below intends to draw the readers' attention to the important points made during the detailed analysis of the survey and the evaluation of the local programmes of member towns of the Hungarian Association of Healthy Cities

As to the general characteristics of the organisations it was be established that local projects should be intensified as the expression of a local initiative in several member towns, because many member towns lack the signs communicating the existence and operation of the project, put up in place where they can be seen by everybody. On the other hand, the local Healthy City project does not always operate within well separated, independent organisational framework. This is true mainly for the local projects which operate as a part of an office or department of the local government. It should be highlighted here again that the main objective is not the establishment of independent institutions, but clear-cut separation of the duties and responsibilities.

Another important experience in this context is that the number of co-ordinators working full-time or part-time in a well defined framework of working hours and responsibilities, or on a voluntary basis is extremely small, and, on the other hand, they have only limited staff employed with a certain regularity in order to facilitate the operation of the programmes. At the same time, they receive significant support from the members of the local community who volunteer for various tasks, and this is a good indication of the social importance and support of the programmes.

The long term operation of the programmes cannot be based exclusively on voluntary contributions, therefore a higher degree of institutionalisation and a clear-cut definition of the local project should be among the main objectives to be achieved in the near future.

An important task related to the issue of institutionalisation is the need to define the proper affiliation of the co-ordinator, and identify unambiguously the functions related to the Healthy Cities project and his other responsibilities. In this context the conditions of employment should also be clarified and support staff needs to be hired. Another weak point is the lack of foreign language skills, which should be developed with a view of not only developing international relations but making them successful as well.

As to the decision-making structure related to the local programmes the following issues should be pointed out: experience related to local government propositions about the local programmes has shown that if the proposition is made by the mayor or his/her deputy, it is easier to make people understand that the programmes are of a multi-sectoral character, and need commitment from more than one actor for implementation. At the same time, it may become necessary to seek the agreement and comments of certain committees, but - for reasons detailed earlier - it is a more effective solution to have the proposition submitted by one of the above officials.

The systems supporting the local Healthy City project include both community organisations established by local communities and the representatives of the business sector. However, it is worth considering whether support is restricted to 'donations' or supporters are also willing to take an active part, as for example in the transfer of programmes, the implementation of programme elements within their own organisation, or the enforcement of the multi-sectoral attitude to the notion of health in the daily operation of the supporting organisation.

Another important feature of supporting systems is that the local support areas exercise a certain influence on one another, and there is reason to believe that if the local project manages to gain support in one dimension, this will make it easier to obtain support in other areas. The dimension of political support should be emphasised in this context, supposing that it means real support and not only 'rhetoric' slogans and takes the form of financial assistance as well.

Formal and informal networking of local projects are characterised by the outstanding role of two organisations: the municipal government and the Hungarian Association of Healthy Cities.

Infrastructural background made available for the operation of local projects is generally favourable. Every member town has put offices at the disposal of the project free of charge. Each co-ordinator has access to telephone and fax, can use a computer, printing and copying equipments. In this respect the only weak point is the lack of Internet connection and e-mail in several member towns. The solution of this problem is only a matter of determination, because technical conditions are ensured in nearly all the member towns.

As far as the financial background of the programmes is concerned, it has been found that there is no uniform process or practice to ensure the financial background to the projects, or to characterise the decision-making power over the costs of operation and programmes. This situation could be improved significantly by clear-cut identification of local projects and the definition of various competencies.

The survey of local projects has shown that local programmes running for a longer period focus primarily on the organisation of health days and health weeks, peer teaching related to drug prevention, the eradication of ragweed and cleaning of the environment, as well as the elaboration of health plans and health profiles. The new programmes introduced in 2000 include research projects on health promotion, competitions on health organised for schoolchildren, and training programmes for teachers in the field of institutional health education as components of top priority.

The priorities set by the Hungarian Association of Healthy Cities for the year 2000 were also taken into consideration in the organisation of new programmes, especially communication activities related to health, while some others (e.g. local health planning activities and the priorities of political sustainability) were not prominent, probably because the relevant activities started in the former years and appear now as on-going programmes.

The analysis of local, national and international networking revealed that member towns are mainly engaged in local relationships. National level relationships are found to be restricted to two types of institutions, ministries working in related fields and member towns of the association. At the same time, the national association makes it possible for the local projects to establish contacts with national and international partners as well. In spite of this, however, it is important for the member towns to develop and maintain their own networks, because at present international relations are realised at a relatively low level in the majority of the member towns. The reason for that is to be found in the already mentioned problem caused by the lack of language skills and can also be considered as a direct indicator of this situation.