世界卫生组织城市治理促进健康和福祉倡议

City Spotlight: Khulna, Bangladesh “To build a healthy city, we must firstchange public attitudes towardshealth and wellness.” About Khulna City - Md. Firoz Sarker, Divisional Commissioner andAdministrator, Khulna City Corporation Bangladesh is the eighth most populous country in the world,with an estimated population of 175.7 million in 20251. Khulnahas a population of over 980 000 people living within about 45square kilometers in 20252,3. According to the 2022 Bangladeshcensus4, this represents around ten percent of the country’stotal population. The city has experienced unprecedentedgrowth and thus increasing population density – primarily frompeople from southern areas of Bangladesh moving to the city,driven by factors including lack of employment opportunitiesin rural areas, lack of health services and schooling in rural andsmaller urban precincts, and natural disasters.5 under the Ministry of Local Government and RuralDevelopment. It is a self-governing body, primarily responsiblefor collecting taxes and developing city infrastructure,and is comprised of seven departments which include theDepartment of Municipal Affairs, the Conservancy Division,the Health Department, the Parks & Gardens, the RevenueSection, the Road Light Section, and Solid Waste Management.KCC governs 31 wards that manage local services lead bythe mayor. In 2024, Bangladesh experienced unprecedentedpolitical turmoil and civic unrest, leading to the formationof a caretaker government and the removal of all politicalappointees, including Khulna’s Mayor. Bangladesh has a decentralized administrative system withmultiple levels of elected local government entities – eachholding their own responsibilities. Khulna is governed by theKhulna City Corporation (KCC) at the local government level Health and development in Khulna City Bangladesh is experiencing a significant epidemiologicaltransition, particularly in urban areas like Dhaka and Khulna.While communicable diseases previously dominated mortalitytrends, noncommunicable diseases now account of themajority of deaths as of 2021, highlighting the need forchronic disease-focused policies and health services.11Healthservices in Khulna, managed by the same agencies as urbanmanagement, must navigate complex relationships betweenthe Ministry of Health and Family Welfare, the KCC, and theprivate sector. There are only eight public health centers,compared to 72 private and 27 community centers.12Due tolimited public facilities, many rely on private services, thoughlow- and lower-middle-income residents still primarily usepublic options due to their affordability and accessibility. Khulna City is known as an industrial city with main sectorsin agricultural product processing, wood processing andshipbuilding. With its growing economy, demands for realestate and housing have been increasing rapidly. As of 2010,Khulna ranked among the most polluted cities in Bangladesh,with residents facing air pollution levels that were eight timeshigher than the World Health Organization’s recommendedlimit—reducing life expectancy by approximately eight years6,7. Unemployment remained significant, with a rate of around5%, and women frequently encountered fewer employmentopportunities.8In Bangladesh, only 55% of urban residents hadaccess to sanitation facilities in 20229, and in Khulna, about1,134 slum communities, covering 8.14% of the city’s totalarea, had substandard or inaccessible sanitation services.10 Phase 1 (2020–2024) Key Achievements 1The establishment of aHealthy City committee –composed of an Advisory and Technical committees- overseeing and coordinating the implementation ofthe Initiative. 4Six MoU signatory organizations issued formaladministrative orders banning tobacco use withintheir premises and promoting healthy food optionsand active breaks in meetings, training sessions,seminars, and workshops. 2The development of a “Khulna Healthy City ActionPlan”, a 4-year plan to facilitate cross-sectoralcoordination and collaboration. Priorities in the planinclude: 1) Integration of the Health-in-all-policiesapproach; 2) Promotion of healthy lifestyles andprimary health care services; 3) Strengthening goodgovernance and multi-sectoral coordination. 5Two Urbanlead cohort trainings held with 13participants from key government, academic, andcivil society institutions. Khulna City formally joined the South-East AsiaRegional Healthy Cities Network (SEAR-HCN) in 2023. 3A city-wide community-led campaign implementedto promote healthy diets, physical activity, and citycleanliness, through various events and social mediacampaigns, as well as in nine selected schools,involving students, teachers and guardians. The ongoing institutionalization of aHealthy Citymulti-stakeholders coordination platformunder theMemorandum of Understanding (MoU) signed by 11city stakeholders.13 Activities Capacity building & Leadership Community engagement - A community-driven Healthy City campaign reached 15,000 div