Building Healthy Cities (BHC) is a three-year (2017–2020) learning project, funded by the United States Agency for International Development, and conducted in three cities including Makassar, Indonesia. BHC is designed to increase understanding of the best routes for improving the social determinants of health in urban contexts.
To inform this approach, several exploratory data collection activities were completed in Makassar in the first year of the project. These included a political economy analysis, an assessment of data use and access, and a comprehensive health needs assessment. Data from a representative survey on non-communicable disease risk factors was also analyzed.
In September 2018, key stakeholders from government, civil society, the private sector, academia, communities, and donor organizations gathered to discuss and validate these data. Participants were also given an introduction to systems analysis, followed by an exercise aimed at eliciting community understanding of various causal relationships at play within the system.
The result was a working map which holds the key dynamics – the patterns underneath the problems – highlighted by the combined stories of these workshop participants. It represents an initial “theory of context” that lays the groundwork for practical next steps to find places of leverage for addressing social and environmental determinants of health.