Charting a Route to Better Urban Health

Designing policies and programs to improve the lives of people living in cities is often a long and arduous process. Where are the best places to invest limited funds and what do residents need most are complicated questions, but a good systems map can help answer them. Building Healthy Cities (BHC) has used the systems mapping technique to show the ways that various sectors affect health in three cities. Systems mapping helps city officials draw linkages between health and other sectors, identify ways to create change in the current system, and mobilize opportunities and resources to overcome challenges. Through the process, BHC solicits input from a variety of stakeholders, including and most importantly residents of each city. 

In Da Nang, Vietnam, the BHC team began the systems mapping process in July 2019, with support from partner Engaging Inquiry, which trained academicians from the University of Da Nang. After learning the process, the academicians created a map detailing the dynamics that inform and influence decision-making and resource allocation in Da Nang. To ensure the map’s accuracy, BHC organized workshops and focus group discussions with participants including government officials; association, local nongovernmental organization, and private sector representatives; and community members.

Recently, BHC project coordinator Le Van Phong and program communication assistant Trang Vu shared insights and information from the systems mapping process, reporting that people were eager to participate.

They are enthusiastic to give opinions and express their viewpoints to contribute to the finalization of the map—toward the common goal of improving and developing Da Nang city,” notes Vu.

Phong finds the multi-step process logical. The team has completed the first step—establishing an understanding of the situation in the city and identifying supporting and challenging factors—and is moving on to the second: synthesizing opportunities for change within the current system. This second step will produce a theory of leverage, which identifies points in the system where change can be most effective. For the third and final step, the team will strategize how to work within the system and develop an action plan containing recommendations for stakeholders to improve health. 

This process has given Phong and Vu a broader view of city development and deepened their understanding of the need for adaptability and flexibility in BHC’s implementation. They have also gotten to know more about their community. One former city leader established a club for retired people that for the past 20 years has allowed many older people to apply their experience and talent to support city development efforts. Phong and Vu also learned that women’s engagement in the political system continues to increase and has benefitted the city in myriad ways, including improved waste management, increased access to health care, and reduced gender inequity.

The system maps will reside on Kumu, an online platform that is free and easy to access. While the Da Nang map is not yet available online, we encourage you to look at the system maps from our other cities, Indore and Makassar. 

Applying local knowledge and expertise is essential to creating sustainable change. Through approaches like systems mapping, BHC is working to ensure community engagement and ownership of a multi-sector approach to improving urban health.

Written by: Vu Xuan Cam Trang & Karin Christianson