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By 2050, 6.30 B people, or 65% of the world population
will live in urban area
Source: WHO (2016:2)
Source: WHO (2016:3)
2025
Source: WHO Kobe Centre, Japan (2005)
Healthier people in healthier environments
Source: WHO Kobe Centre, Japan (2005)
Healthier people in healthier environments
• City-wide approaches to improve the whole urban environment are essential to improving health and quality of life of vulnerable populationso Integration of environment and development
concerns• Intersectoral collaboration between local and
national agencies/authorities• Environmental impact assessment and health
impact assessment support policy and decision-making processes
o Participatory decision makingo Right issues are being addressedo Promotes local ownershipo Engenders the sustainability of interventionso Support broader agenda of community development and empowerment
o Public-private partnershipo Build infrastructure and provide health-related serviceso Invest in activities that advance health promotiono Donate to support public health initiatives
o Coordinated policies and actions across multiple sectors are needed to achieve desired outcomes for health equityo Health in All Policies (HiAP)
Source: WHO (2016:18)
• High population density• Inadequate housing• Absence of a safe and reliable water
Factors influencing the increase of incidence of tropical diseases in
urban areas
• WHO advocates:• Integration of disease control programs into primary
health care system• Move from narrow vector control management
strategies to a broader, more decentralized integrated approach
What can be done?
1. Human behavioral changes2. Health messages3. Sustainable vector-borne disease control4. Mobilizing resources5. Community vector control experiences6. Vector-hygiene as a by-product of urban development
Source: Knudsen & Slooff (1992:4-5)
What can be done?
1. Human behavioral changeso Reduce “ruralization” of the
citieso Need trained social workers to
assist individuals, families and communities as well as primary health care personnel to drop traditional rural concepts and adopt better standards of environmental hygiene in and around the home
Source: Knudsen & Slooff (1992:4)
• Policy changes Public Health
• Environmental changes• Systems changes• Professional behavior change• Individual behavior change Primary
Care
Implement change – what changes?
Public health programmes: what needs to change and who changes it?
Source: Hill, A., Griffiths, S. & Gillam, S. (2007:59)
What can be done?
2. Health messageso Appropriate health education
messages for people in various social settings
o Mechanisms for action between communities local agencies, countries and regional authorities in the area of communications and health education
o Methods for assessing community responses to health messages
Source: Knudsen & Slooff (1992:4)
Campaigns to improve public knowledge in urban areas
• Symptoms of infectious diseases When to seek healthcare When it is safe to treat oneself
6. Vector hygiene as a by-product of urban development (Cont’d)
o Urban authorities should be aware of municipal planning
o Support practical information network• Vector control leaders can exchange
their experiences, management ideas and tools etc. with others
• Ways to integrate vector control methodologies and make partners for health
o Integrate bio-environmental control and community involvement
• Role of local belief systems, social settings and cultural understandings
Source: Knudsen & Slooff (1992:4)
• Capacity improvement for surveillance , control programs and prevention programs (Local and Global)• Monitor the burden of diseases• Assist local authorities and global
community for a quick response to public health threats
Source: Neiderud (2015:7)
Improve the infectious disease surveillance system
Source: Tong et. al (2015:11027-11028)
o Strengthened disease surveillance infrastructure• Information network for disease surveillance
system (Comprehensive web-based real time)
• Financial support from local governmentso Better trained health workers
• Doctor→ Infectious disease detection, diagnosis, reporting, treatment and cooperation with CDC staff
• Systematic and regular training for health care workforce in CDCs, hospitals and relevant health departments, especially in rural and remote areas
o Better report system• Effective communication and information
sharing between local hospitals and CDCs
Bangkok Health Profile
ทมา: ศรวรรณ ตงจตกมล และคณะ (2559: หนา 6)
ก�รแบงกลมพนทเขตกรงเทพมห�นคร
23
Bangkok
Gulf of Thailand
Chao Praya River
Registered Population 5,686,252 personsMale = 2,694,922Female = 2,991,331
From population and housing census = 9.1 million
Estimated Population 12 millionTourists 18.24 million/year
Area 1,568 Km2
Bangkok : Demography
Population densityPomprab District 25,940 people/ square kilometerJatujak District 5,251 people/ square kilometerNhong joak District 677 people/ square kilometer
ของประชาชนในพนท โดยอาจนำาแนวทางและหลกการของ Health in All Policies มาดำาเนนการ• เรงสนบสนนก�รมสวนรวมของชมชน โดยเฉพาะอยางยงก�รพฒน�นวตกรรมและก�รพฒน�กำ�ลงคนเพอสขภ�พ สำาหรบคนในชมชน เชน อาสาสมครสาธารณสข ในการทำางานแกไขปญหาในชมชน
ขายควบคมโรคไมตดตอ กรงเทพมหานคร• Hill, A., Griffiths, S. & Gillam, S. 2007 Public Health and Primary Care: Partners in Population Health, Oxford
University Press, Oxford.• Knudsen, A. B. & Slooff, R. 1992 Vector-borne disease problems in rapid urbanization: new approaches to
vector control, Bulletin of the World Health Organization, 70 (1): 1-6.• Leon, D. A. 2008 Cities, urbanization and health, International Journal of Epidemiology, 37: 4-8.• Neiderud, C. 2015 How urbanization affects the epidemiology of emerging infectious diseases, Infection
Han, G., Williams, C & Bi, P. 2015 Infectious diseases, urbanization and climate change: challenges in future China, International Journal of Environmental Research and Public Health, 12: 11025-11036.
• WHO 2016 The WHO-UN Habitat Global Report on Urban Health: equitable, healthier cities for sustainable development, Centre for Health Development (WHO Kobe Centre), Kobe, Japan.
• WHO Kobe Centre 2005 A Billion Voices: Listening and responding to the health needs of slum dwellers and informal settlers in new urban settings, Healthier people in healthier environments, Centre for Health Development (WHO Kobe Centre), Kobe, Japan.