In brief

281 municipalities (big & small) in Flanders (Belgium) engaged themselves in the project ‘Healthy Municipality’ (Gezonde Gemeente) which was launched in April 2013. The Flanders Institute for Healthy Living (NPO) and the Local Health Platforms (The ‘Logo’s’, these are organisations who coach the municipalities on the field) strongly believe in subsidiarity and reach with this project 94% (281/300) of all municipalities in Flanders. The goal of Healthy Municipality is helping local municipalities to work at their own pace and according to their own needs towards a more sustainable preventive health policy.

With this project we contribute to the realization of the sustainable development goals (SDG’s), Flemish and local health goals, but above all to a better health for all Flemish people.

A short movie (in Dutch) can be viewed here.

Some history

The contours of this project were laid from 2006 in the Meetjesland region (a region between Ghent and Bruges). Together with 6 municipalities (Assenede, Lovendegem, Nevele, Aalter, Knesselare and Merelbeke), consideration was given to the stronger linking of preventive actions to structural policy initiatives. Based on clear criteria, progress could be monitored and rewarded in each municipality. These criteria were later reworked into a growthmeter (see further). Preventive health care thus became part of regular municipal policy.

In 2012, the Flemish Government asked to rework this project and the materials so that it could be used by all Flemish municipalities. Insights from another project 'Fool of Health' also came in handy. At that time, the Flanders Institute for Healthy Living became project holder with the support of the Local Health Networks and the Organ.

The basic principles

Local autonomy: The Flanders Institute for Healthy Living developed Healthy Municipalities with attention for the administrative relationships between Flanders and the municipalities. This means that participation in the project happens voluntarily. There are no planning nor reporting burdens and demand-driven work is as important than supply-oriented work. Additionally there’s a strong attention on communication and branding.

Attention to both action and policy: ‘Healthy Municipality’ supports local actions which already have a long tradition, and tries to stimulate project work to guarantee a sustainable preventive health policy.

Integrated policy: A successful sustainable preventive health policy with equal health opportunities for all is a policy that’s supported by all political leaders and officials. The Flanders Institute for Healthy Living, the Local Health Platforms and the Healthy Municipalities try to raise enthusiasm for this broad approach. The local policy and management cycle (BBC) which is applicable to all Flemish local municipalities, offers many opportunities. The strength of the collaborative effort and mutual benefit gained by all partners fortifies Healthy Municipalities. By focusing on professional development and networking new partnerships arise. Partners of these networks are active in different sectors (sport, mobility, security ...) and are invited to join because they can contribute to the health in all policies philosophy.

With Healthy Municipality we mainly try to have an impact on the organizational determinants for an integral policy. Questions are:

How do we increase the political and administrative support for an integral health policy?

How do we strengthen or change the vision of local politicians and civil servants on health?

How is the municipality administration organized around health and health related topics?

What events and challenges are there in the municipality that give us a good starting point for an integrated approach?

Coaching & materials

Municipalities who engage themselves in the project Healthy Municipalities sign a charter and are coached by their Local Health Platform (there are 15 Local Health Platforms in Flanders and Brussels) and the Flanders Institute Healthy Living. They use the growthmeter as a compass with 35 quality criteria grouped in 7 process components (e.g. citizen participation...) and a health matrix to come to a mix of actions. To promote these actions and activities they use personalized promotional materials.

To promote integrated working, we also have a health matrix for integrated policy and a model for network analysis. And with the choice template we help cities and municipalities to make more conscious, discussed and substantiated choices.

With our ‘settingprofiel’ in Dutch we help the Local Health Platforms with getting a global overview of each municipality so that they can discover the opportunities and threats. In these document coaches get an overview of all the local policymakers, the most import councils and forums, the most important policy documents and data.

Health in all policies

The Belgian and Flemish context

Belgium is a federal country with 3 different regions. Flanders is one of the three regions, alongside Brussels and Wallonia. The organization of and the control over the local municipalities, health promotion and disease prevention are three examples of regional jurisdiction.

Flanders has 300 municipalities which are very diverse (in terms of size, in terms of socio-economic characteristics, in terms of capacity ...). The smallest municipality (Herstappe) has less dan 90 inhabitants, the largest (Antwerp) more than 500.000. The median size is 14.000 inhabitants, the median capacity in the local administration to work on health promotion and disease prevention is seven hours weekly; which is rather low.

Flemish municipalities are not obliged to work on health promotion and disease prevention and fund their local health promotion activities and campaigns with their own funds. Flemish municipalities may well appeal to the Local Health Platforms for substantive and logistical support.