Strategies and Implementing Steps
In order for Kinmen County to achieve the goal of becoming a city with established and comprehensive institutions, Kinmen County applied to join the Alliance for Healthy Cities, Taiwan in 2012. We have since been promoting Kinmen County as one of the advocates of Healthy City. The history, geography and population status of Kinmen County are different from the Taiwan main island. Therefore when promoting the Healthy City project, a Healthy City profile must first be established according to the available databases in order to understand the county and consider its policies, social-economic situation, environmental concerns, and health conditions of the population. The needs and expectations of the public must also be taken into account.
With the current city status as foundation, the Healthy City profile is constructed under the 8 principles provided by the WHO. The 8 principles are as follow: population, health status, lifestyle, social-economic status, living environment, physical environment, physical and social infrastructure, physical and public health policies and health care services provided. The 8 principles are then incorporated into the three aspects of the Healthy City. The details of the 8 principles are as follow:
2. Health status: lifespan calculation and integrated screening statistics.
3. Lifestyle: smoking, drinking, drug abuse, exercise habit, and daily diet.
4. Social-economic situation: educational background, occupation, income, crimes and violence, and cultural involvement.
5. Living environment: number of derelict, the architectural features of average households, and density of occupancy.
6. Physical environment: air quality, water quality, and water resource and sewage disposal.
7. Physical and social infrastructure: build a barrier-free environment.
8. Public health policies and healthcare services: disease preventive policies and measures, educational policies and services, and environmental protection.
To better understand the needs and expectations of the general public, community meetings were held and the people attended were asked to fill in a “Questionnaire of the needs of Community Members”, further specific goals and concrete action plans were consummated in reference to the results of the questionnaire. Three community meetings have taken place, the meeting locations were on the east, west side of Kinmen County respectively, also in the Lieyu Township as well. The meetings were to find out about the needs of the different communities in Kinmen County, and to understand what the expectations are. Community organizations that have been promoting community health were also invited to the meetings to share their thoughts on the three aspects of Healthy City: Healthy Living, Ecological Environmental and Social Security, in order to clarify the needs and challenges the communities are facing and city future developments. The questionnaire included 71 questions, based on the three aspects discussed in the community meetings, and fully investigated the needs of the public in terms of the Healthy City project, the opinions and expectations as well. 800 questionnaires were handed out, with 602 valid returns. According to the result of the questionnaire, the public is now satisfied with the policies such as: inclusive social welfare system, benefits for the elderly, benefits for women, a sense of security of living in Kinmen County. However, the areas that are not satisfying are as follow: tourism promotion of Kinmen County has caused the locals difficulty in booking an airline seat, waste disposal and environmental maintenance challenges due to tourism, the impact of BOT plans on daily lives, and the stability of water quality from the water company.
The Kinmen Healthy City indicators were constructed according to the 32 international indicators provided by the WHO Healthy City project. The indicators measured Kinmen County with local features taken into consideration, and were formed with tangible qualitative measurements. Other local indicators of other Healthy Cities also provided consultation in the process of creating Kinmen indicators.
As of today the local indicators is in its initial implementing stage. Abortion rate index was among one of the international indicators but was omitted due to its unsuitableness to Kinmen County needs. Currently there are 31 international indicators collected and in use to implement the Kinmen Healthy City indicators. Also, the “Healthy Living” aspect can be further divided into three developmental dimensions: education, culture and healthcare. The education dimension includes educational learning, and sports and exercise; the culture dimension includes reading culture promotion, and cultural awareness; the healthcare dimension includes patient care, health care, disease prevention and food safety, above indicators are among the 12 local indicators of this category. The “Ecological Environment” aspect includes four dimensions: the industry, green transportation, tourism and environmental protection. The industry dimension includes industrial development; the green transportation dimension includes public transportation infrastructures; the tourism dimension includes township scenery, feature sightseeing, and business opportunities from China tourists; the environmental protection dimension includes ecological environment, quality living, and water resources, above indicators are among the 20 local indicators of this category. In the “Social Security” aspect, four dimensions were included, such as infrastructure, social benefits, police administration, and natural disaster prevention. The infrastructure dimension includes public infrastructures; the social benefit dimension includes reconciliation of labor and capital, social benefits, social involvement, and care for socially disadvantaged groups; the police administration dimension includes public safety and crime rate reduction’ the natural disaster prevention dimension includes community disaster prevention, above indicators are among the 12 local indicators of this category.
The total sum of indicators in the three aspects of Healthy City project amounts to 75(including international indicators). Local indicators formulated through the cross-bureau meeting sessions were then being examined by the Promotion Committee to see if the members of the committee agree on the results. Currently the assessing mechanism of the action plan and the demonstration plan has been installed. There will be quarterly assessment and yearly assessment, reviewing the results of each level and examine if the set goals were met. On the indicators that have not achieved expected results, reasons as to why the goal was not attainable and solutions would be required. In the future the city progress indicators would always be open to amendment in accord to the public needs, in order to develop a set of indicators that can best suit the needs and reflect the special local features of Kinmen County. The installment of Kinmen Healthy City local indicators is as shown in figure 2.
Figure1. The Operating Mechanism of Kinmen Healthy City
Figure 2. The Installment of Kinmen Healthy City Indicators