1. Introduction
Over the past few years, a growing number of proposals, policies, projects, practices, and methodologies have been undertaken globally to achieve social, economic, and environmental sustainability in urban areas. This is due to the recent appreciation of human capital development, healthy living standards, and the benefits of safeguarding the ecosystem against eminent threats of pollution [
1]. According to Liu et al. [
2], over 50% of the global population has relocated to urban settlements thus raising concerns about achieving sustainability through urban development. Particularly in Sub-Saharan Africa, it was estimated that the rate of urbanization increased from 30.8% to 38.8% between 2000 and 2017 [
3] and was further projected to reach a total populace of 1 billion before 2020 [
4]. Subsequently, the United Nations has also projected that by 2050 Africa should be recording an urbanization rate of 56% [
5]. Owing to the fast-growing rate of urbanization among African countries, Capuano [
6] revealed that there will be huge ramifications for world energy markets. Meanwhile, a 2018 sustainable development report also revealed that 91% of people living in urban areas were inhaling air that was below the World Health Organization’s air quality threshold; hence, about 4.2 million deaths were associated with air pollution [
7]. Consequently, an increase in urban rates will trigger the demand curve for basic social needs such as food, housing, hospitals, schools, energy, transport systems, and sanitation among urban dwellers (city residents) [
8].
Urbanization is driven by the presence of areas with good infrastructure and amenities. These areas are collectively known as cities and have been identified as a driving force for the realization of sustainable developments through productive measures and innovation if well-managed [
9]. The World Bank [
9] reported that about 4.4 billion people currently reside in cities and by 2050, 7 out of 10 people will be living in cities. Due to the economic significance and populace of cities, their impact is gradually becoming ubiquitous in the 21st century. Although these impacts seem positive, the activities of the cities are contributing over 60% to greenhouse gas emissions due to the large consumption of global energy [
10,
11]. Additionally, other negative impacts revealed to be associated with cities include issues of poor living standards, high birth rates, and environmental degradation due to the depletion of natural resources as well as total environmental quality [
12]. An effective and efficient solution for enhancing the sustainability of urban regions is the requirement to establish cities that prioritize well-being. The World Health Organization, WHO [
13], defines a healthy city as one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and developing to their maximum potential. The creation of these healthy cities falls within one of the international policies known as the Sustainable Development Goals (SDGs) formed by the United Nations [
14].
There are 17 objectives in the SDGs, with 169 targets, and 231 different tracking indicators that create a unique path toward achieving sustainable development [
15]. “Sustainable Cities and Communities” namely SDG 11 of the 17 SDGs aims to foster the growth of cities that are both equitable and environmentally sustainable [
16]. For the first time in the history of the United Nations, SDG-11 adds a distinct urban target, highlighting the indispensable role of cities in achieving global sustainable development [
17]. Zinkernagel et al. [
18] stated that it embodies social inclusion and ecological sustainability under the influence of an integrated approach to achieving urban sustainability. In addition, SDG 11 evaluates the features of an urban ecosystem such as housing, urban design and planning, transport systems, green public spaces, and air quality [
19]. Although the SDGs are transnational in scope, it is becoming apparent they also have a vital local dimension, as they highlight socioeconomic issues such as education, healthcare, urbanization, and sanitation, which are all areas under the purview of local government [
10].
The Local Government Act 2016 (Act 936) of Ghana places the District Assemblies (DAs) at the forefront of planning, executing, and managing policies concerning the districts (i.e., cities, and towns) [
20]. According to the report from the Ghana Statistical Service [
21], the urban population of Ghana is about 17 million. This represents an increase of 50.9% in 2010 to 56.7% in 2021 with most increases occurring in Accra and Kumasi [
21]. Owing to the current pressure on these urbanized areas, there is a tendency to be exposed to adverse effects arising out of the increase in demand for limited resources available within the cities. It is, therefore, expedient that these local authorities become more proactive in drafting action plans that will serve as a framework for sustainable city development [
20]. This places much burden on the DAs to work at ensuring that the SDGs, especially, SDG 11 are achieved. The SDGs have been facing strong headwinds for some time. Despite the significant efforts in some places, national governments on all continents (of which Ghana is part) have fallen short in their integration [
22]. These shortfalls result mainly from societal polarizations, populism, and growing geopolitical conflicts among others. As of 2022, the global SDG index was below 67%, an indication that there is a potential for the world not being able to achieve the set targets by 2030 [
22]. This calls for governments globally to speed up their rates of achieving the targets.
According to the 2023 Sustainable Development Report, based on the pace of progress since 2015, none of the SDGs is on track to be achieved by the deadline of 2030 [
22]. Although, currently, the world has made some progress towards achieving SDG 6 (clean water and sanitation), SDG 7 (affordable and clean energy), and SDG 9 (industry, innovation, and infrastructure) [
22], this progress varies extensively across countries. Overall, European countries (Denmark, Czechia, Estonia, Latvia, and Slovak Republic) top the SDG index. Notwithstanding these statistics, it is revealed that even the highest-performing countries on the SDG index still face major challenges in achieving the SDGs that relate to climate, biodiversity, sustainable cities, etc. In the 2023 SDG global index, Ghana is ranked 122 out of 166 with a score of 61.8% [
22]. Based on the current 2023 SDG dashboard for sub-Saharan Africa, Ghana is on track to achieving only one (i.e., SDG 12 responsible consumption and production) out of the 17 SDGs. For the remaining 16 SDGs Ghana is either facing a significant challenge or a major challenge in achieving them. These statistics leave Ghana much to be desired when it comes to achieving the SDGs. However, this study is only focused on SDG 11 because of its significance. Cities and other urban areas are home to around 55% of humanity and account for 70% of global economic output [
23]. It is established that by 2050, these figures will increase to 70 and 80%, respectively [
23]. Goal 11 focuses on the creation of inclusive, secure, resilient, and environmentally sustainable urban environments. Cities are at the forefront of global living. As of 2022, the world’s population reached 8 billion, with over half residing in urban regions. This trend is expected to continue, with a projected 70 percent of the global population living in cities by 2050 [
15,
16,
22]. Currently, approximately 1.1 billion people live in slums or conditions resembling slums within urban areas, and this number is anticipated to grow by 2 billion over the next three decades. Nevertheless, many cities are unprepared for this rapid urbanization, as it outpaces the development of housing, infrastructure, and essential services [
9,
22]. This situation has resulted in the proliferation of slums and slum-like living conditions. Issues such as urban sprawl, air pollution, and a lack of accessible public spaces persist in urban areas [
15,
16].
While progress has been made since the adoption of the Sustainable Development Goals (SDGs) in 2015, the number of countries with national and local disaster risk reduction strategies has doubled. However, challenges persist. In 2022, only half of the urban population had convenient access to public transportation [
10,
13,
22]. Achieving sustainable development necessitates a significant transformation in how urban spaces are planned and managed and Ghana is not an exception to this transformation. In the Ghanaian context, achieving healthy city development has faced several challenges.
Current studies surrounding the concept of healthy city development revolve around adoption factors [
24], drivers [
25], and integration with technology [
24,
26]. According to the findings of Wang et al. [
27] it was discovered that studies related to healthy cities were focused on their conceptual connotation, development practices, impact effects and measurement and evaluation [
27]. Despite the growing responsiveness in creating eco-friendly cities with reference to SDG 11, literature is lacking on the role of local authorities such as the district assemblies in attaining sustainability, especially in developing countries such as Ghana. Through a comparative analysis of the notion of healthy cities and smart cities, Alves [
28] concluded that the materialization of the concept of healthy cities depends strongly on policies and efforts from authorities, sectors, and institutions. It is, therefore, the aim of this study to bring to light the role of district assemblies in attaining healthy cities with respect to SDG 11 within the Ghanaian context. The study is posited to bridge the knowledge gap by assessing the awareness of DAs concerning healthy city development and SDG 11, their contributions towards the two, and the challenges encountered.
5. Conclusions
The 2023 Sustainable Development Report ranks Ghana 122 out of 166 with a score of 61.8% in terms of countries making efforts to achieve the SDGs. Based on the current 2023 SDG dashboard for sub-Saharan Africa, Ghana is on track to achieving only one (i.e., SDG 12 responsible consumption and production) out of the 17 SDGs. For the remaining 16 SDGs Ghana is either facing a significant challenge or a major challenge in achieving them. With the role played by SDG 11 in achieving the SDGs, this study was conducted to assess the achievement of healthy city development (HCD) in Ghana. After reviewing several pieces of literature on the study, 10 targets were identified under Sustainable Development Goal 11. These targets include Target 11.1—Safe and affordable housing, Target 11.2—Affordable and sustainable transport systems, Target 11.3—Inclusive and sustainable urbanization, Target 11.4—Protecting the world’s cultural and natural heritage, Target 11.5—Reducing the adverse effects of natural disasters, Target 11.6—Reducing the environmental impacts of cities, Target 11.7—Providing access to safe and inclusive green and public spaces, Target 11.a—Strong national and regional development planning, Target 11.b—Implement policies for inclusion, resource efficiency and disaster risk reduction, and Target 11.c—Support least developed countries in sustainable and resilient building.
The study employed a quantitative research approach to enable the researchers to conclude their findings among a larger population. Thus, a survey was conducted among the key personnel within the District Assembly to ascertain their level of awareness of healthy city development and the current achievement levels from their perspective through the SDG 11 targets and the challenges they encounter in achieving HCD. Personnel with the DAs were involved in this study because per the structure of the government of Ghana, the DAs are responsible for the development of cities. The District Assemblies in Ghana are pivotal in the localization and implementation of the SDGs at the local level. Their responsibilities encompass a wide range of development areas, and their actions are crucial for ensuring that progress is made toward achieving these global goals within their districts. This made it appropriate to involve them in this study. Descriptive and inferential analysis was used to analyze the responses from the respondents. The results of the analysis revealed that the local authorities were averagely aware of the SDG 11 targets causing a ripple effect in the awareness of HCD. Correspondingly, the outcome of the analysis also showed that there was a low level of achievement of the healthy city status according to the views of the local authorities. Following this, a normalized technique was used to ascertain the critical challenges encountered by the local authorities to achieve HCD. Out of the 10 factors identified from several studies, only four were critical challenges to the outcome of the study. These challenges were a lack of financial resources for implementing healthy city policies, poor implementation of healthy city policies, lack of public education on HCD, and poor monitoring of the implementation process on HCD. Therefore, the need for local actors to focus attention on sustainable development goals within the local community is crucial for the achievement of healthy cities.
Furthermore, the scientific novelty of these findings was implied in two ways. Primarily, from a theoretical point of view, this study has established the awareness and current achievement level of healthy city development referenced from SDG 11 among the local authorities in Ghana. The study has also recognized the challenges encountered by the local authorities to achieve healthy city development, which needs to be defined in the present literature. In practice, the establishment of this study informs development planning stakeholders, design stakeholders, educational institutions, government agencies, and researchers in Ghana to facilitate processes and procedures that ensure sustainability within the local communities and cities. For planning stakeholders such as the National Development Planning Commission (NDPC) and the Ghana Institute of Planners (GIP), these findings will divert their focus on the need to support and enhance the institutional capacity of the local actors toward the implementation of sustainable policies to facilitate HCD. These findings will also inform design stakeholders such as the Ghana Institute of Engineers (GhIE) and the Ghana Institute of Architects (GIA) to develop standards that will ensure the sustainability of designs earmarked for urban areas. Educational institutions will be able to identify the target areas needed for driving the awareness of the populace toward the development of healthy cities from the findings of this research. For government agencies such as the Ministry of Local Government, Decentralization and Rural Development (MLGRD) and the Metropolitan, Municipal, and District Assemblies (MMDAs), these findings will inform them of the critical challenges encountered in achieving HCD in Ghana. Hence, sparking strategic actions they are to take toward resolving these challenges. Similarly, the findings of this study will enable researchers to identify knowledge gaps for further empirical studies.
Although this study achieved its intended aim, there were limitations along its path. These limitations were encountered due to the quantitative approach of the study. Thus, respondents were unable to express their diverse opinions verbatim on the subject matter. Again, the inability of authors to conduct spatial analysis and employ the use of data visualization and Geographic Information System (GIS) techniques is noted as a major limitation of the study. In addition, the choice of research participants was limited to the local authorities who had jurisdiction over developmental projects within the local communities and cities. Therefore, further studies should consider the qualitative approach of research that creates an opportunity for respondents to address their concerns regarding the achievement of healthy city development.