December 9^th, 2020—The WHO Healthy Cities program continues to drive health-based innovation across cities within the Eastern Mediterranean region, as evidenced by the recent evaluation of the Healthy Cities Program (HCP) in Sahand, Iran. In the wake of COVID-19, the first-ever virtual desk review of the program convened on December 1^st and December 2^nd. Attendees consisted of the WHO evaluation team, representatives from Iran’s Ministry of Health and Medical Education and the Tabriz University of Medical Sciences (as a key partner), in addition to His Excellency the Governor of Sahand, whose active participation throughout both days of the review reflects the high levels of political commitment at the city level.

The virtual desk review of Sahand’s HCP yielded considerable insights concerning the potential of the program as a means of sustainable development and community-wide health protection. Prior to the implementation of Sahand’s HCP in 2015, a baseline survey was performed by HCP focal points—in conjunction with the Tabriz Health Services Management Research center, the Road Traffic Injury Research Center, the Oskou County Governor, and multiple stakeholders—to assess Sahand’s most significant needs and identify the key priorities that would guide HCP implementation. Thorough evidence-based research is among the cornerstones of the Healthy Cities program, and thereby highlights its commitment to stimulating meaningful development.

A slew of measurable outcomes stemmed from priority-guided actions since the implementation of Sahand’s HCP, such as the establishment of additional PHCs, emergency medical service (EMS ) stations, and parks that serve the community of Sahand. These outcomes consolidate the HCP’s role as a source of community engagement and multilateral collaboration among governing bodies, healthcare workers and the local community.

The high levels of observed political support for Sahand’s HCP were reinforced by an evaluation of the HCP’s organizational structure, which brought to light the active involvement and participation of the Ministry of Health & Education, Oskou MPs, the Governor of East Azerbaijan, and the Head of Tabriz University of Medical Sciences. This support enabled the redirection of funding from various sectors to Sahand’s HCP, rather than the allocation of funds. Furthermore, Sahand’s HCP is lauded for its self-sustaining quality, which is made possible by the consistent training of stakeholders to counteract the adverse effect of turnover—8 governors have been installed since the implementation of the HCP in 2015; nevertheless, key milestones were achieved with minimal disruptions.

These milestones consist of, but are not limited to, various community-based accomplishments, such as the mobilization of 1450 active health volunteers, female empowerment, health ambassadors in schools, the formation of social assistance groups, and the involvement of private sector entities (private sector partners provide PHC and rehabilitation services). Notable cross-sectoral activities also consist of a “No Tobacco City” endeavor, and Emergency Preparedness training. Community engagement is the foundation of the HCP; therefore, a Community Participation House was designated as a forum for community members to share their concerns with the governor. It is worth mentioning that Sahand is among the cities in Iran that have observed the lowest number of COVID-19 cases due to the presence of organized and engaged communities along with community-based communications and rigorous public health efforts.

Upon the desk review’s conclusion, Sahand was deemed ready for the final series of evaluation field visits that will take place prior to the determination of the city’s eligibility for the “healthy city” award. The key achievements observed thus far have rendered Sahand as a potential model for HCP implementation for other cities in the Eastern Mediterranean region. Furthermore, the WHO evaluation team praised the diligent documentation and record-keeping of the HCP team, which paves the way for the upcoming evaluation visit to Sahand.