Moving forward health equity: implementation research on governance for health equity at local level.

286 p. ; BACKGROUND: Urbanization is one of the leading sociodemographic trends of the 21st century, which makes urban areas one the most important settings for tackling current and new global challenges. In fact, the importance urban health has been increasingly recognised for its central role shaping public health globally. In this context, an equity-promoting urban governance offers a window of opportunity not only to face these challenges, but also to be part of the solution. Policy coherence, accountability and social participation have been identified both as drivers of health equity and key dimensions of governance for health equity.OBJECTIVE: The fundamental question that underlies this research is how local health strategies can drive forward an equity-promoting urban governance for health. This thesis aims to describe the urban governance for health context in three urban case studies, and to appraise and comparatively analyse how the key dimensions of governance for health equity have been incorporated within local health strategies. Moreover, the thesis assesses the main barriers and facilitators of the implementation of equity-promoting local health strategies. ,METHODS: This is a qualitative-based implementation research, which employs a multiple case study method to in-depth examine the local health strategies of Bilbao, Barcelona and Liverpool. Participant observation, document analysis and 27 in-depth semi-structured interviews among technicians, managers, decision-makers and other local actors were conducted. The key dimensions of governance for health equity were assessed: 1. Policy coherence was analysed using an adaptation of the Storm's Maturity Model for HiAP; 2. Accountability was assessed using the Ebrahim and Weisband¿s proposal and the corresponding domain of the PAHO Equity Commission's rubric for accountability; 3. Social participation was analysed using the Health Canada¿s Public Involvement Continuum model. To assess the barriers and facilitators of the implementation processes the ...