What is the meaning of urban liveability for a city in a low-to-middle-income country? Contextualising liveability for Bangkok, Thailand

Background Creating ‘liveable’ cities has become a priority for various sectors, including those tasked with improving population health and reducing inequities. Two-thirds of the world’s population will live in cities by 2050, with the most rapid urbanisation in low- and middle-income countries (LMIC). However, there is limited guidance about what constitutes a liveable city from a LMIC perspective, with most of the evidence relating to high-income countries, such as Australia. Existing liveability frameworks include features such as public transport, affordable housing, and public open space; however, these frameworks may not capture all of the liveability considerations for cities in LMIC contexts. Objectives This case study formed a multi-sectoral partnership between academics, policymakers (Bangkok Metropolitan Administration, Victorian (Australia) Department of Health and Human Services), and a non-government organisation (UN Global Compact – Cities Programme). This study aimed to: 1) conceptualise and prioritise components of urban liveability within the Bangkok, Thailand context; 2) identify alignment to or divergence from other existing liveability tools; and 3) identify potential indicators and data sources for use within a Pilot Bangkok Liveability Framework. Methods The Urban Liveability Workshop involving technical leaders from the Bangkok Metropolitan Administration and a rapid review of liveability literature informed the conceptualisation of liveability for Bangkok. The Bangkok Metropolitan Administration Working Group and key informants in Bangkok provided input into the liveability framework. Indicators identified for Bangkok were mapped onto existing liveability tools, including the UN Global Compact CityScan. Results Findings revealed commonalities with the Australian liveability definition, as well as new potential indicators for Bangkok. The resulting Pilot Bangkok Liveability Framework provides a structure for measuring liveability in Bangkok that can be implemented by the Bangkok Metropolitan Administration immediately, pending appropriate data acquisition and licensing. The Bangkok Metropolitan Administration Working Group and key informants identified core issues for implementation, including limited spatial data available at the district-level or lower. Conclusions This study conceptualised urban liveability for Bangkok, a city in a LMIC context, with potential for adjustment to other cities. Future work should leverage opportunities for using open source data, building local capacity in spatial data expertise, and knowledge sharing between cities. Electronic supplementary material The online version of this article (10.1186/s12992-019-0484-8) contains supplementary material, which is available to authorized users.


Urban liveability and health and wellbeing
In parallel to these global trends, creating 'liveable' cities has become a priority for various sectors, including those tasked with improving population health and reducing inequities [10]. Since the beginning of the Healthy Cities movement, there has been increasing recognition of the role of urban environments in shaping human health and wellbeing, prompting calls for urban planning and public health disciplines to reconnect [6,11]. Urban liveability is closely aligned with the concept of social determinants of health [12] and evidence demonstrates that improving liveability can promote residents' health and wellbeing while simultaneously reducing a city's environmental impact. For example, aspects of urban liveability such as public transport [13], neighbourhood walkability [14,15], and access to quality parks and public open space [16][17][18][19] have been positively associated with health outcomes and behaviours, including increased physical activity and improved mental health. These attributes also mitigate the effects of climate change by alleviating the urban heat island effect [20,21] and reducing car dependence and greenhouse gas emissions [22].
One consideration is that there is limited guidance about what constitutes a liveable city or neighbourhood from a LMIC perspective, with most of the evidence relating to high income country contexts [23,24]. For example, in the Australian context, liveable cities have been conceptualised as 'safe, attractive, socially cohesive and inclusive, and environmentally sustainable, with affordable and diverse housing linked to employment, education, public open space, local shops, health and community services, and leisure and cultural opportunities, via convenient public transport, walking, and cycling infrastructure' [25]. However, there are likely other, and / or different prioritisation of, liveability attributes in LMICs that may not be reflected in frameworks developed for cities in high income countries [26]. For example, some residents in LMICs may live in informal settlements, and / or have limited access to clean drinking water and sanitation [27]. These attributes impact the liveability of a city, yet existing definitions of urban liveability do not capture these nuances [12]. Hence, there is a need to contextualise liveability from a LMIC perspective so that actions to enhance urban liveability are responsive to the diverse contexts and aspirations of cities.
Another consideration is whether cities are delivering liveability for all, particularly as intra-city disparities in infrastructure provision (e.g. access to reliable public transport) are social determinants of health that translate to health inequities [28,29]. Indeed, health inequities observed within cities have been highlighted by the WHO as a pressing global issue [30], and the recent Shanghai Declaration calls for stronger city governance and mechanisms that promote greater equity at the local community and city level [31]. Of the numerous liveability indices available, not all of these have been configured to detect inequities in liveability. Rather, some liveability indices are targeted towards assessing the attractiveness of cities for investors or expatriates' remuneration for relocation; other indices lack the finegrained spatial scales needed to determine how liveability is distributed across a city [32]. Applying evidence-based indicators at spatial scales smaller than a city is therefore required to identify any potential inequity [32].
One mechanism to address both of these considerations is the development of context specific urban liveability indicators that can be used to measure and monitor progress towards urban liveability [28]. Applying such indicators can stimulate discussion between diverse stakeholders and sectors including policymakers, urban planners, and civil society, while providing information about and prioritising certain social determinants of health across diverse urban environments [28,33]. Importantly, these indicators must be appropriate to the setting (e.g. LMIC) and sensitive enough to detect disparities in liveability within cities [32].

Urban liveability frameworks and indicators in LMICs
The Sustainable Development Goals (SDGs) and many aligned tools provide high-level frameworks to guide aspirations for cities globally [10,34]. The SDGs provide an overarching global framework for enabling and delivering sustainable development [10], and internationally define the scope for the 2030 Agenda for Sustainable Development, which has been ratified by all 193 UN member states. SDG 11 specifically targets urban sustainability, aiming "to make cities safe, resilient and sustainable" [1].
Developed in alignment with the ten universal principles of the United Nations Global Compact in the areas of human rights, labour, environment and anticorruption, the CityScan diagnostic tool, developed by the Global Compact's Cities Programme, helps cities identify and rank 157 pressing urban issues in 22 topic areas across the city's social development, environmental sustainability and governance [35]. Through the UN Global Compact -Cities Programme's cross-sectoral approach, responses to these challenges are encouraged through a governance framework of municipal government, the private sector, civil society and community [34,35]. This tool is being further refined to align with the SDGs.
Alongside these global initiatives are the suite of Healthy Liveable Cities Group Liveability Indicators that draw on conceptually derived and empirically tested urban liveability indicators that respond to numerous domains of urban liveability [29,[36][37][38][39][40][41]. These indicators were developed from a health and wellbeing perspective, with an aim to identify the elements of urban planning and policy that are associated with health (and health inequities) [12,32].
These tools provide helpful starting points for cities looking to improve health and wellbeing outcomes.
Alongside these frameworks, there is a need to understand how urban liveability: is conceptualised in diverse contexts; can be operationalised to track progress towards these aspirations; local definitions and operationalisations align with or diverge from global frameworks.

Research context: Bangkok, Thailand
Bangkok is the capital of Thailand and has experienced rapid growth and economic development in the past forty years, similar to other cities in LMICs. Bangkok is increasingly home to migrants from other Thai provinces and other Association of Southeast Asian Nations (ASEAN) member countries, with many newcomers drawn to Bangkok's denser, inner-city areas. This growth has been accompanied by expanding infrastructure and investment in education, health, and technology, yet challenges remain in ensuring equitable access to these key resources and infrastructure. For example, major issues facing the city include concerns about heavy traffic, unhealthy environments and unequal access to highquality schools. These issues are accompanied by increasing concern about social inequalities, unemployment and insecure work.
There is strong political commitment in Bangkok to increase the city's liveability and improve residents' wellbeing, as laid out in strategic planning documents such as the recent 20-year Development Plan for the Bangkok Metropolis. Bangkok's 20-year Development Plan aims to improve liveability across the city, with special focus on the elderly, residents with disabilities, and those facing disadvantage. The Bangkok Metropolitan Administration has been a key leader in promoting the urban liveability and sustainability agenda in Bangkok, with a focus on how these aspirations can improve the health and wellbeing of all residents.

Origins of the research partnership
This project is underpinned by a partnership between the Bangkok Metropolitan Administration, the UN Global Compact -Cities Programme, the Victorian (Australia) Department of Health and Human Services, and urban scholars at RMIT University (Melbourne, Australia). In May 2017, a group of technical leaders from the Bangkok Metropolitan Administration participated in the Urban Liveability and Resilience Program, a capacity development and training program run by the UN Global Compact -Cities Programme in Melbourne, Australia. This served as an initial catalyst for the development of a partnership between the Bangkok Metropolitan Administration, UN Global Compact -Cities Programme, and Melbourne-based urban scholars and policymakers from RMIT University and the Department of Health and Human Services. It was anticipated that this project would facilitate two-way knowledge sharing between Melbourne-and Bangkokbased partners, whose cities face similar challenges and share common policy goals (e.g. both Melbourne and Bangkok are 100 Resilient Cities member cities).

Aims and objectives
The aims of this project were to: 1) conceptualise and prioritise components of urban liveability within the Bangkok, Thailand context; 2) identify alignment to or divergence from other existing urban liveability tools, including those used in Melbourne and Australia; and 3) identify potential indicators and data sources for use within a Pilot Bangkok Liveability Framework.
In partnership with the Bangkok Metropolitan Administration, this project sought to accomplish the following objectives: to develop a definition of urban liveability suitable for use in the Bangkok context, and potentially other LMICs; to establish a Bangkok Metropolitan Administration Liveability Working Group to provide contextspecific advice and guidance; to identify and prioritise potential liveability indicators aligned to the SDGs and spatial data sources for inclusion in a Pilot Bangkok Liveability Framework; to identify core issues for the Bangkok Metropolitan Administration to populate and implement the Pilot Bangkok Liveability Indicator Framework.
This project was executed in six stages (Fig. 1). It was purposefully designed as an iterative process to maximise opportunities for Bangkok Metropolitan Administration guidance in terms of maximising relevance to Bangkok's context and reflecting the Bangkok Metropolitan Administration's strategic priorities. These methods provide a useful example that can be used by other cities around the world to identify liveability issues and develop indicators. Each stage is discussed in greater detail in the following sections.

Stage 1: urban liveability workshop
As part of the Urban Liveability and Resilience Program, technical leaders from the Bangkok Metropolitan Administration (Table 1) participated in an urban liveability workshop led by the Cities Programme's urban scholars and authors of this paper (Badland, Davern) [41]. Themes from the Urban Liveability Workshop formed the foundation for the conceptualisation of liveability in Bangkok's context. In this workshop the Bangkok Metropolitan Administration technical leaders provided insight into similarities and differences in urban liveability for Bangkok compared with Australia, as well as Bangkok's strategic and priority areas for action. Capacity building and training in using indicators to inform urban planning practice was also embedded in the

Stage 2: literature review
A rapid review of international urban liveability literature was undertaken in August 2017 to identify key considerations that may be applicable to the Bangkok context. The scope of the rapid review was defined by the concepts and issues of urban liveability identified by Bangkok Metropolitan Administration leaders, as well as additional considerations for cities in a LMIC context. For example, while drinking water quality was not identified as a salient theme in the Urban Liveability Workshop, the international literature highlights equitable access to high quality, safe drinking water as a key determinant of liveability and health and wellbeing in a LMIC context [10,[42][43][44].
Combinations of key words capturing the concepts of liveability and LMICs were used in the database Scopus, which was chosen for its multidisciplinary coverage (see Additional File 1 for full search strategy). Qualitative and quantitative empirical literature, theoretical literature, and grey literature were included. The literature search in Scopus yielded 269 results. Screening of titles and abstracts was undertaken to identify potentially relevant articles. Hand searching of relevant articles' reference lists and of authoritative sources of grey literature (e.g. WHO) was also conducted. Articles were included based on the following inclusion criteria: included some discussion, definition, or investigation of liveability in the context of LMICs available in full text (online) available in English.
Data were extracted from the literature that related to the definitions of liveability, considerations for liveability, and measures or indicators of liveability. These definitions, considerations and measures were grouped into major themes or 'domains' of liveability, which were informed by the findings from Stage 1. Together, the findings from Stage 1 and 2 were used to create a draft list of urban liveability indicators for the Bangkok Metropolitan Administration's consideration. This captured key domains of urban liveability for Bangkok, as well as specific indicators and potential measures that could be used to monitor progress. For example, transport was identified as a key domain of liveability for Bangkok, both in the Urban Liveability Workshop and through the literature review. Within the transport domain, vehicles per kilometre of city roads was a specific indicator that has been used to measure and monitor car congestion in an urban setting [45]. Additional measures were proposed for some indicators based on the project team's experience in indicator development for Australian cities.

Stage 3: Bangkok metropolitan administration working group
Scholars from the UN Global Compact -Cities Programme and RMIT University worked with key informants in Bangkok to coordinate and establish a Bangkok Metropolitan Administration Working Group. This working group comprised selected Bangkok Metropolitan Administration technical leaders, including several who had participated in Stage 1 (Urban Liveability and Resilience Program). One of the tasks for the Bangkok Metropolitan Administration Working Group was to review the liveability indicators (generated as part of Stage 3) to ensure the indicators and measures were relevant to the context of Bangkok. The Bangkok Metropolitan Administration Working Group also took an informal inventory of spatial data sources that could potentially be used to measure and monitor liveability in Bangkok.

Stage 4: City scan strengthening
The urban liveability indicators identified for Bangkok through Stages 1 and 4 were mapped against three existing urban liveability tools: the SDGs [10], the UN CityScan [34], and the Healthy Liveable Cities Group Liveability Indicators. These tools were chosen for their alignment with the social determinants of health and their abilities to influence international and local (Australian) policy. This process took into account the agreement (or disagreement) between high-level indicators, rather than specific measures. For example, the indicator 'food quality' that was identified for Bangkok was mapped to the CityScan's 'food security' and the Healthy Liveable Cities Group's 'food environment' indicator. While each of these encompasses a slightly different concept, all three share a common strategic focus on ensuring access to quality food for all residents and achieving at least one target under SDG 2: 'zero hunger.'

Stage 5: key informant review
The list of liveability indicators and measures identified in Stage 3 was further refined by Bangkok Metropolitan Administration key informants. The key informants were selected by one of the authors (Nitvimol) who was based in the Bangkok Metropolitan Administration. Key informants were Bangkok-based civil servants with a high level of experience and representing a range of government departments involved in the delivery of at least one domain of liveability. The key informants: 1) prioritised liveability indicators and measures for immediate, medium-term, and long-term action by the Bangkok Metropolitan Administration; 2) identified priority measures for each indicator that best captured liveability in Bangkok, taking into account available data sources (where known); and 3) identified data custodians for the priority measures (where known).
The process of prioritising liveability indicators for immediate, medium-term, and long-term action by the Bangkok Metropolitan Administration (Aim 1) considered two main criteria. First, the level of importance of each indicator (as determined by the Bangkok Metropolitan Administration Working Group) was considered. Second, key informants considered the feasibility of measuring each indicator with existing data sources and the timeframes within which these data are/would become available. It was anticipated that this would involve some negotiation in terms of which indicators were determined to be most important; however, in practice, the availability of readily usable spatial data largely determined which indicators were immediately actionable. Hence, there was a high level of consensus during this prioritisation process.
Stage 6: spatial data sourcing Where possible, district-level data (or data captured in units smaller than city-level) were identified and incorporated into the framework. The purpose of this was to enable better measurement and monitoring of progress to capture differences and disparities in access to key 'liveability' infrastructure within the city of Bangkok, as well as providing a tool to monitor precinct-level developments. Where no spatial data were available in Bangkok for a given indicator identified in Stage 4, alternative potential spatial data sources were suggested for inclusion in the Pilot Bangkok Liveability Framework. These alternative data sources were identified through a desktop review.

Results
Aim 1: conceptualise and prioritise components of urban liveability within the Bangkok, Thailand context Key themes from the workshop revealed strong motives around the SDGs and promoting health and wellbeing for the residents of Bangkok (Table 2). Findings from the workshop also revealed commonalities with the Australian urban liveability definition, as well as some key differences. While the general domains of liveability were similar in the Bangkok and the Australian contexts, the specific indicators and measures for housing differed. For example, housing was identified an important domain in both the Australian and Bangkok contexts. However, in Australia, a major concern is housing stock affordability. In Bangkok, indicators and measures for housing needed to capture informal housing and the impact of flooding on informal housing settlements. The workshop findings also revealed some new indicators of liveability specific to Bangkok's context. For example, Bangkok Metropolitan Administration technical leaders emphasised the importance of access to temples and cultural opportunities as a core element of social infrastructure in Bangkok, whereas cultural and religious opportunities were not regarded as being as central to social infrastructure in the Australian context. Aim 3: potential indicators and data sources for use within the pilot Bangkok Liveability framework Table 4 shows the Pilot Bangkok Liveability Framework, which was informed by Stages 1-5. The Pilot Bangkok Liveability Framework provides a potential structure for measuring and monitoring liveability in Bangkok that can be implemented by the Bangkok Metropolitan Administration immediately, pending appropriate data acquisition and licensing. The Bangkok Metropolitan Administration Liveability Working Group and key informants identified spatial data issues for populating the indicators. While some promising spatial data were available, limited spatial data available at the district-level or lower were currently available in Bangkok, with most data only available at the city-level or higher. Data custodians were identified for all indicators and measures within the framework. However, feedback from the Bangkok Metropolitan Administration Working Group suggested that further capacity building around the issue of data custodianship and licensing may be required (e.g. building relationships with local data custodians, understanding each custodian's data processing procedures). Other issues identified included challenges of sourcing or knowledge of available spatial data; including accessing and applying open source data; spatial database architecture and maintenance; and effectively utilising urban liveability indicators to inform evidence-based urban governance and policy decisions.

Discussion
This research (re)conceptualised urban liveability in the context of Bangkok, a city in a LMIC, using a multisectoral partnership. The method provides a great example of how liveability indicators can be used to develop partnerships and build conversations around the multifaceted approaches needed to deal with complex liveability issues across cities. The study was designed to investigate urban liveability using local knowledge alongside the emergent liveability evidence and tools, while ground-testing the pilot framework with various stakeholders through ongoing indicator development, data sourcing, and capacity building. Such an approach enabled the urban liveability framework to reflect the strategic priorities and lived experiences specific to the Bangkok context, which in turn increases the likelihood of translating the framework into policy and practice.
Overall, findings from this study demonstrated points of similarities between the framework developed for Bangkok and other existing liveability tools, while also identifying some key liveability considerations specific to Bangkok's context. These similarities and differences are discussed in the following section. In the subsequent sections of our discussion, we reflect on future opportunities for Bangkok and other cities, as well as areas for future capacity building in Bangkok.

Liveability across diverse contexts
The Pilot Bangkok Liveability Framework revealed some similarities between the conceptualisation of urban liveability in Bangkok and in the Australian context. Features such as housing, public transport, public open space, and the quality of the local food environment were conceptualised as being important to urban liveability in both contexts. However, additional considerations for urban liveability were identified for Bangkok, notably: sewerage and solid waste management, quality drinking water, household fuel, informal housing, flooding, and labour rights. Interestingly, these considerations did not feature prominently in a recent liveability index developed for the Khon Kaen district in Thailand [56]; however these differences across the studies may reflect city contexts, stakeholder priorities, and / or project scope. More broadly, the liveability considerations for Bangkok align with those identified in recent liveability frameworks for other cities  [59], all of which reflect the SDGs [10]. In addition, in this study, relationships between several domains of liveability were observed. For example, housing and environmental management domains were both viewed as critical urban liveability domains for mitigating the effects of flooding (health domain). Similar to what others have advocated [6], these findings highlight the complexity of the city as a system and reinforce the need to consider how aspects of urban liveability interact to shape residents' health and wellbeing and minimise any unintended consequences.
Implementing the pilot Bangkok Liveability framework: spatial data needs and opportunities for capacity building This project revealed substantial knowledge of and commitments to the urban liveability agenda and action on the social determinants of health, alongside a willingness to use spatial data in Bangkok. The Pilot Bangkok Liveability Framework represents a significant milestone in the measurement and monitoring of urban liveability in Bangkok, and potentially other cities in LMICs. For Bangkok, it is suggested that measurement of the full suite of liveability indicators (i.e. including those prioritised for medium-and long-term action) is gradually introduced as additional data and resources are sourced. However, some spatial data challenges likely need overcoming if the proposed framework is to be fully implemented. Spatial data issues that need addressing in future initiatives include generating usable spatial data at scales smaller than a city (e.g. district-level data); others have also pointed to the need for investment in finergrained data to monitor urban health and wellbeing in LMIC contexts [23,24]. Open source data, as well as expertise in sourcing and applying such data, could enable the immediate population and measurement of liveability indicators at units smaller than city-level. This would provide a resource-efficient approach to directly measuring implementation of key infrastructure (e.g. public transport) and allow for the monitoring of any disparities in delivery within Bangkok. In addition, Prasad and colleagues have suggested that remote sensing may offer additional opportunities to collect open-source spatial data, while building capacity within LMICs [23]. Other issues that may need addressing prior to implementing the proposed framework include skill development in maintaining spatial databases, negotiating access to spatial data, and developing and applying spatial indicators to support urban planning decision-making.
In light of these core issues, future directions for this work include using an iterative 'continuous delivery' approach to sourcing spatial datasets, obtaining the relevant permissions to use these data, calculating and applying the indicators, and building capacity in applying and translating the findings. This process will likely result in further refining the liveability framework presented here.

Opportunities for reciprocal learning
Cities in high-and low-income country contexts face similar broad challenges as a result of population growth, urbanisation, and climate change; hence, the SDGs call for diverse, multi-stakeholder partnerships, both across sectors and between countries [10]. (Re)conceptualising liveability for a city in a LMIC sets the foundation for future collaborations and reciprocal learning between cities. For example, working through options for measurement and monitoring that are low-cost, sustainable, and require limited ongoing maintenance (such as open source data) required the research team to be agile, creative, and outward-looking. Further, this study and the (re)conceptualisation of liveability for Bangkok also prompted additional insight about existing liveability tools created for Australia or for global purposes, and a work program run in tandem with this study (CI Butterworth) identified areas for CityScan strengthening (unpublished observations). Finally, the partnership with the Bangkok Metropolitan Administration revealed strong enthusiasm in  Bangkok for intersectoral collaboration and working across government departments. Given the calls for more joined-up policy in Australia, continued collaboration with the Bangkok Metropolitan Administration could involve further knowledge sharing around these issues in both contexts.
As these reflections illustrate, there are substantial opportunities for reciprocal learning between diverse cities. Mechanisms and collaborations that encourage further knowledge sharing between diverse cities and contexts are needed to further the progress towards the SDGs. Indeed, the success of achieving the SDGs relies on active and meaningful local, national, and international collaborations [10].

Limitations
This project should be viewed in the light of its limitations. First, liveability was contextualised from the perspective of Bangkok Metropolitan Administration technical leaders. There may be additional considerations for liveability in Bangkok's context that should be explored further with a wider range of stakeholders, including civil society, non-government organisations, and advocacy groups. Nevertheless, engagement with the Bangkok Metropolitan Administration, who are the stakeholders that develop and deliver urban planning policy, was also a key strength of this project. Second, as this framework was developed specifically for Bangkok's context, the results of this project may not be directly replicable or generalisable to other cities. However, this framework and the methods used provide a useful starting point for other cities in LMICs, and could be adjusted for use with input from local stakeholders. Third, while a Pilot Bangkok Liveability Framework has been proposed through this research, it has not been populated and tested. This was beyond the scope of this project. It is likely additional refinements will need to be made to the Framework prior to implementation.

Conclusion
This project conceptualised urban liveability in the context of Bangkok, a city in a LMIC, with potential for adjustment to other cities. The Pilot Bangkok Liveability Framework provides a future agenda and map for measuring and monitoring liveability in Bangkok with close alignment to the SDGs and social determinants of Access to liquefied petroleum gas a [44] Liquefied petroleum gas connections per household

Ministry of Energy
NB: Within each category (immediate, medium-term, and long-term), indicators are not listed in any particular order. All indicators in this table were first identified by the BMA working group as relevant to Bangkok's context, then reviewed by BMA key informants for prioritisation into immediate, medium-term, and long-term action. Prioritisation was based on indicator importance for the BMA and the timeframes within which data would become available a Indicator was not a salient theme of the Urban Liveability Workshop, but was identified as an important aspect of liveability in the international literature