National Network Status

The Healthy Municipalities initiative began in Peru in 1996 when the Ministry of Health publicized its motto "Healthy Communities for Sustainable Human Development in Peru" that emphasized health promotion at the local level. In 1997, the Ministry of Women and Human Development was designated to implement and actively participate in the initiative. Strategic objectives of the program are to incorporate health and sustainable human development in local government agendas, stimulate the formation and implementation of healthy public policies, increase community participation and empowerment, promote healthy environments and lifestyles, and create a minimal governing structure that facilitates the management of sustainable projects.

During 1996, activities emphasizing local empowerment in addressing community health issues were initiated in Miraflores, Tacna, Puno, Tumbes (on the Peru/Ecuador border), Villa el Salvador, Cerro San Cosme and San Cristóbal. Based on the Planning Methodology promoted by the Ministry of Health, these communities are actively participating with local government, public sectors, and NGOs in the identification of local problems, causes and consequences, and appropriate actions to address the problems.

Activities

Miraflores

The municipality of Miraflores is developing a proposal that emphasizes comprehensive health promotion. Specific objectives are to strengthen local health services, promote environmental health, and popularize healthy lifestyles. One issue facing Miraflores is the demand for health and social services from individuals over 60, who represent 20% of the municipal population (compared to the national level of 6%). As a result of the Healthy Municipality activities in Miraflores, the Office of Senior Citizens has changed its focus to enhancing client participation: the older population now identifies issues of concern and proposes acceptable and feasible solutions.

Tacna

Local government and the community members of Tacna are committed to ensuring the sustainable use of natural resources and a healthy environment. Because of this dedication, Tacna was selected to participate in the Project for Integrated Management of Environmental and Health Actions, administrated by PAHO's Pan American Center for Sanitary Engineering and Environmental Sciences (CEPIS). Within the Healthy Municipalities framework, the project's principal objective is to promote a healthy environment through the involvement of policy-makers, local government and the community. Specifically, the project focuses on the development of Tacna's capacity to manage its environmental problems through the process of environmental and health assessment, identification of alternative solutions to environmental and health problems, and the development of alternative implementation strategies.

The comprehensive project addresses environmental health conditions through increasing access to potable water, promoting responsible use of pesticides, and controlling zoonotic (animal-to-man) disease transmission. In the social and economic environment, the project addresses traffic accidents, urban violence, alcohol and drug addiction, healthy workplaces, nutrition and food safety, improvement in housing and social assistance infrastructure, and the promotion of small business. An important component of the project is management with continuous evaluation and epidemiological monitoring. Coordination and overall management of the project is handled by the Committee on Environment and Health which is headed by the municipal mayor with the participation of local authorities, representatives from local businesses and the community, as well as a technical team. The implementation of project activities takes place through intersectoral working groups.

Other Projects

The municipalities of Villa el Salvador and Independencia have highlighted as problems adolescent pregnancy, child abuse, and poor access to potable water and is currently developing a Perinatal Maternal Health program. In Tumbes and Puno, multisectoral involvement in the Healthy Municipalities initiative has resulted in the mobilization of limited financial resources.

There has been national and international support of the Healthy Municipality movement in Peru. The national newspaper, The Sun, has agreed to include regularly a "Quality of Life" page devoted to the promotion of healthy lifestyles. Additionally, the Japanese government has donated millions of dollars to the municipality of Puno for the cleanup of Lake Titicaca.

Materials

Ministry of Health, Division of Pomotion of Women and Human Development (PROMUDEH). Marco de Referencia para su Implementación en el País.

Pan American Health Organization. Procesos de Municipios Comunidades Saludables en Peru. 1996.

World Health Organization. Partnership for Healthy Cities in Peru. WHO Environmental Health Newsletter. November, 1996.

Contact

Dra. Miriam Cruz Olave, PAHO/WHO Representation in Peru, Los Cedros 269, San Isidro, Lima 27, Peru, Tel:421-3030, Fax: 442-4634.