Developing assessment and reporting system for sustainability performance in municipalities of megacitiesCase Study: Health performance of Tehran municipality

Introduction: The responsibility of achieving sustainable development goals in most megacities and subsequently in Tehran megacity are in charge of the municipalities. Since, the goal of municipalities in environmental-friendly activities is to protect the physical and mental health of citizens. Therefore, the sustainability assessment of health performance in municipalities is one of the most significant issues in the field of municipal sustainable development of megacities. The Objective of this study was to develop a tool for assessing the sustainability performance of Tehran municipality in the field of health- related activities and services. Material and Method: In this research the main sustainability indicators in the field of health performance were extracted and localized by providing an indicator-based tool for Tehran municipality as a case study. To determine the initial set of effective indicators, guidelines and standards related to health sustainability issues were surveyed, and an initial set of indicators were extracted. Afterward, a two-round Delphi method was applied by 12 qualified experts to select the most robust indicators of Health performance and assign the importance of the inclusion for each proposed indicator on a seven-point Likert scale. The mean value set to 70% and the standard deviation less than 1 were considered as the cut value. Result: The findings resulted in extracting 11 main categories and 28 sustainability indicators of health performance. The set of indicators related to the "green space" and "waste" categories with slight differences gained the first and second position in the health sustainability field respectively, whereas "urban planning", "active and healthy life" and "health and hygienic services" located in the bottom of the list with the relatively close scores. Conclusion: The results of this study showed that due to little difference between the score of the main selected categories (less than 1 point difference between the highest and lowest categories) and also due to the fact that the expert panel reached a consensus on the total 11 categories, therefore in order to achieve municipal sustainable development and improving the health level of citizens in the future, it is essential to have a robust consideration toward applying engineering and management measures against all 11 selected categories.