Abstract

Background: The healthy city concept has been widely accepted globally and has been established in all six World Health Organization (WHO) Regions. Community involvement, empowerment, and leadership are embedded core principles in the Healthy Cities initiative and pillars to achieve the health and health-related sustainable development goals. This article aimed to present the findings of the recent evaluation of eleven healthy cities in the WHO Eastern Mediterranean Region (EMR).
 Methods: The descriptive comparative evaluation was based on the WHO/EMRO healthy city 80 indicators. It included eleven cities (Al-Dariyah, Jalajil, Al-Jamoum, Unaiza, Riyadh Alkhubra, Sharoura, Al-Madina, Al-Taif, and Al-Mundaq in Kingdom of Saudi Arabia; Al-Yarmouk in Kuwait, and Manama in Bahrain).
 Results: The findings revealed that eleven cities were peculiar in demonstrating community involvement, empowerment, and leadership in real terms. All had well mechanisms for communities to voice themselves and participate in decision-making, assessing the needs, setting priorities, planning better for their cities, and monitoring. The community engagement was based on voluntarism with a high sense of loyalty. It has been well demonstrated in community organizations like women and youth groups, health volunteers, community-based organizations, and others.
 Conclusion: Although community participation and empowerment remain at the heart of the healthy cities initiative, to be meaningful, the government-related sectors must foresee this as an integral part of long-term strategic development. Moreover, a paradigm shift towards a more integrated approach to promote health, well-being, accelerate the achievement of health-related sustainable development goals, and reduce health inequities in urban settings requires multi-stakeholder collaboration, including public, private, and community civil societies.

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