Scaling up the WHO Healthy Cities programme in Bahrain 

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ahrain has experienced rapid urbanization and a rising burden of noncommunicable diseases, which accounts for 75% of deaths in the country.¹ In response, Bahrain adopted the World Health Organization (WHO) Healthy Cities programme to create sustainable urban environments that promote health and well-being. ² This initiative fosters intersectoral collaboration, integrating Health in All Policies to improve overall well-being beyond the health sector. WHO Bahrain, in coordination with the WHO Regional Office for the Eastern Mediterranean, provided technical support to launch, implement and scale up the programme at the governorate level. As of January 2025, Bahrain has four recognized Healthy Cities. Additionally, the initiative has been expanded beyond cities to include two governorates, reflecting the nation’s commitment to health and sustainability.^3,4

The WHO Healthy Cities programme

The WHO Healthy Cities programme was introduced in the WHO Eastern Mediterranean Region in 1990 to advance public health in urban settings. ⁵ Participating cities must sign a letter of collaboration, committing to enhancing health, well-being and equity in urban environments while joining the Regional Healthy City Network. They must then complete a self-assessment based on 80 indicators targeting social determinants of health and the Sustainable Development Goals. The final step is an external assessment by WHO’s regional and country evaluation teams, leading to official recognition as a Healthy City and the awarding of a certificate from the WHO Regional Office for the Eastern Mediterranean. Cities are re-evaluated every three years.⁶

With WHO’s technical support, Bahrain was among the first countries in the Region to implement the programme. Umm Al-Hassam became Bahrain’s first recognized Healthy City in 2018, followed by Manama in 2021, making it the first capital in the Region to receive this designation. In 2022, Busaiteen/Al-Sayah in the Muharraq Governorate and A’ali in the Northern Governorate joined the network, bringing the total to four recognized Healthy Cities.³

In 2023, the programme gained further momentum as three governors signed letters of collaboration with the WHO Representative in Bahrain to expand implementation of the initiative beyond individual cities to entire governorates.⁴ This commitment is a testament to political will and the nationwide dedication to the Healthy Cities programme as a strategic vehicle for improving the health and well-being of its population. Dr Tasnim Atatrah, WHO Representative in Bahrain, commended the governorates and Ministry of Interior for their commitment to the programme, and the Ministry of Health (MoH) for its support in facilitating this key initiative nationally, stating:

Following this commitment, governorates began scaling up implementation, with the MoH’s Health Promotion Directorate overseeing the initiative nationally and the Healthy City Coordinator’s Office leading local implementation.

WHO Bahrain also facilitated the exchange of experiences related to healthy settings in both national and regional settings. Through collaboration with the MoH and governorates, WHO Bahrain provided a platform for the existing Healthy Cities to showcase their best practices and share lessons learned, strengthening national capacities and promoting programme sustainability.

In 2024, WHO Bahrain provided technical support to the Capital and Northern Governorates during the self-assessment phase. It also facilitated two key missions in August and November 2024 as part of the Healthy City evaluation process. The assessment teams, comprising representatives from the MoH, WHO Bahrain and the WHO Regional Office for the Eastern Mediterranean, conducted field visits to selected sites in Bahrain’s Capital and Northern Governorates.^7,8 These sites were selected based on a comprehensive assessment of the nine domains and 80 indicators addressing social determinants of health.

Since its establishment in 2021, WHO Bahrain has been instrumental in scaling the Healthy Cities programme, transforming urban health governance and promoting sustainable, health-focused environments. By extending the programme from cities to entire governorates, Bahrain is setting a regional precedent for integrating health across all levels of urban planning. As urbanization intensifies across the Eastern Mediterranean Region, Bahrain’s experience offers a model for other nations striving to improve health outcomes, equity and sustainability. WHO Bahrain’s continued support and leadership will ensure the long-term success of this initiative, contributing to more resilient communities within Bahrain and across the Region.