Metropolitan and regional health planning: dilemmas of the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil

This paper focuses on the relationship between metropolitan and regional health planning based on the processes of regionalization and the Pact for Health in the Baixada Santista Metropolitan Area, Sao Paulo State, Brazil. The method used was a case study in two stages, namely during initial implementation of the Pact for Health (2007) and the Regional Administration Committees (CGR) and in 2010. Municipal and regional health systems managers and the director of the Metropolitan Agency were interviewed, and records were analyzed from ten years of meetings of the Regional Inter-Administration Committee and the Regional Development Council. Four issues emerged: financing and infrastructure; health services utilization; inefficiency of the Regional Health Administration's instruments and decision-making levels; and the relationship between different levels in the Administration. Metropolitan health management remained as an underlying issue, appearing only incidentally or tangentially to regional management. Despite some limitations, the CGR has been legitimized as a space for regional health management.

Quality assessment of a landslide inventory map and its application to land‐use planning. A case study in the Northern Apennines (Emilia‐Romagna region, Italy)

Landslide hazard and risk are growing as a consequence of climate change and demographic pressure. Land‐use planning represents a powerful tool to manage this socio‐economic problem and build sustainable and landslide resilient communities. Landslide inventory maps are a cornerstone of land‐use planning and, consequently, their quality assessment represents a burning issue. This work aimed to define the quality parameters of a landslide inventory and assess its spatial and temporal accuracy with regard to its possible applications to land‐use planning. In this sense, I proceeded according to a two‐steps approach. An overall assessment of the accuracy of data geographic positioning was performed on four case study sites located in the Italian Northern Apennines. The quantification of the overall spatial and temporal accuracy, instead, focused on the Dorgola Valley (Province of Reggio Emilia). The assessment of spatial accuracy involved a comparison between remotely sensed and field survey data, as well as an innovative fuzzylike analysis of a multi‐temporal landslide inventory map. Conversely, long‐ and short‐term landslide temporal persistence was appraised over a period of 60 years with the aid of 18 remotely sensed image sets. These results were eventually compared with the current Territorial Plan for Provincial Coordination (PTCP) of the Province of Reggio Emilia. The outcome of this work suggested that geomorphologically detected and mapped landslides are a significant approximation of a more complex reality. In order to convey to the end‐users this intrinsic uncertainty, a new form of cartographic representation is needed. In this sense, a fuzzy raster landslide map may be an option. With regard to land‐use planning, landslide inventory maps, if appropriately updated, confirmed to be essential decision‐support tools. This research, however, proved that their spatial and temporal uncertainty discourages any direct use as zoning maps, especially when zoning itself is associated to statutory or advisory regulations.