The evaluation of healthy city projects in developing countries

In international public health and other disciplines there is a debate about the use of process versus impact (sometimes referred to as outcome) indicators in project evaluations. With growing international and national support for Healthy City Projects in developing countries it is timely to address the issue of how to evaluate such projects. This paper briefly describes process and impact indicators, considers the importance of process indicators given the role of institutional strengthening and capacity building in Healthy City Projects and discusses the balance between locally and internationally generated indicators. A case study of the first Healthy City Project in a developing country in Asia (Chittagong, Bangladesh) illustrates how the project is linked with urban management and can enhance co-operation, co-ordination, motivation, internal organisation, decentralisation and community participation. Finally, some institutional indicators for evaluation are suggested.