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Born Thriving: Infant, Toddler, Caregiver Neighborhood Design Guidelines

Born Thriving is a project to mainstream children’s and caregivers’ needs into municipal decision-making, planning, implementation, and maintenance. It is co-authored with civil servants from the Tirana municipality but intended for use by anyone with a stake in making healthy public space.

Born Thriving‘s written guidance consists of three volumes: ITC neighborhood design guidelines (vol. 1); the ITC neighborhood indicator baseline (vol. 2), and a series of case studies of recent comparable projects from around the world (vol. 3).

Eighty-five percent of human brain development happens in the first three years of life. By age five, the neural pathways that we will live with forever are almost totally set. These years are when the capacity for emotional attachment is either attained or not, and chronic diseases are set into motion. Children’s life outcomes very much hinge on care from others. But a caregivers’ ability to nurture is not simply a matter of their personal choices, as much as it is a systemic matter—of what choices their environment affords them.

The Born Thriving design guidelines distill what constitutes a healthy environment for young children and their caregivers. As a matter of governance, building environments that support healthy childhoods requires making the choice to change business as usual: healthy environments don’t just appear—they are the result of choices that have been made about where and how to allocate funds over the course of decades. Over the past six years, the city of Tirana has provided city managers around the world with a city-scale proof of concept of urban transformation that is driven by a commitment to the well-being of children.

Staff from the municipal workers department responsible for the maintenance of school grounds give feedback about typical surface drainage systems
Staff from the municipal workers department responsible for the maintenance of school grounds give feedback about typical surface drainage systems

What Is the Value of Mainstreaming?

Political will is the fastest way to upend business-as-usual planning and bring transformative change to cities. But political will always be fleeting against the timescale of city making. When visionary leadership does exist, we must rapidly build up systems around it that outlast mandates and become absorbed and accepted as broader cultural change—both inside institutions and outside them: or in other words, we need to “mainstream.”

To mainstream is to transform challenging ideas into values, to create an inertia among coordinated professionals pursuing common causes for a sustained period of time. Mainstreaming is a process of replacing an existing set of values and assumptions with a new set.

If training is what someone does to you, and learning is what you do for yourself, mainstreaming represents a shared, mutual reflex.

Defining a Unit of Public Caregiving

Born Thriving frames the neighborhood through the lens of a broad, ubiquitous group: infants, toddlers, and their caregivers, or “ITCs.” ITC refers to a group of at least two people, the youngest of whom is under five years old. That caregiver doesn’t have to be a parent—they could be an older sibling, a grandparent, a neighbor—but ITCs are a diad in public space. Throughout this book we refer to the singular “ITC” and always mean at least two people.

Born Thriving Is a Cycle of Work: First Measure, Then Consult Guidance, Build, and Repeat

The three major phases of work form a cycle of reflection and learning: evaluation and monitoring, design guidelines, and implementation.
The three major phases of work form a cycle of reflection and learning: evaluation and monitoring, design guidelines, and implementation.
The neighborhood design guidelines correspond directly to the neighborhood indicators.
The neighborhood design guidelines correspond directly to the neighborhood indicators.
Design guidelines applied to a hypothetical low-traffic street in a Tirana neighborhood.
Design guidelines applied to a hypothetical low-traffic street in a Tirana neighborhood.

Who Is this Guidance Intended For?

Budget decision-makers
Directors, municipal cabinet-level decision-makers and departments of budgeting.

Planners and designers
The general directorate of urban planning and development and their sub-departments of urban design and urban decor; parks and playground designers within Tirana APR; and the engineers who oversee street geometry in the department of transport.

Implementers
The department of public works and the sub-directorates who carry out small-scale construction work within DPN2.

Maintenance workers
The three key departments DPN1 (responsible for greening, watering, and cleaning of streets and street trees), DPN2 (responsible for repairing sidewalks, roadbed, and signage), and DPN3 (responsible for maintenance of schools and kindergartens).



National regulators and planners
National Territorial Planning Agency overseeing master planning, and agencies in the Ministry of Infrastructure and Energy that prepare and distribute the Road Code and other legal documents governing the way street geometry is standardized.

Educators and care workers
Professionals working in schools, kindergartens, and nurseries, as well as those providing care for young children, the elderly, and other people and groups with different access needs.

Community health advocacy groups
Associations of residents who want to request changes to their streets or schools but might not yet speak the language of planning.

Private sector
Property developers, architects, and urban designers working for private clients, private education providers, and play-oriented businesses including cafés and restaurants.

The Five Objectives of the Infant, Toddler, and Caregiver Neighborhood


Objective 1: Our neighborhood protects us from traffic
❤️ Motorized traffic is the greatest safety hazard to ITCs, in terms of both direct injury and death and the long-term health consequences of air and noise pollution.
❤️ ITC street design is about prioritizing resident well-being over the easy and rapid passage of drivers, creating a public realm that is welcoming to young children and their caregivers.

Objective 2: We are at ease outdoors in our neighborhood
🧡 ITC neighborhoods should be active with people so that ITCs feel secure in the presence and watchful eyes of trusted neighbors.
🧡 ITCs should be able to travel easily on sidewalks and stairs designed with strollers in mind.
🧡 Lighting makes a world of difference improving the safety and comfort of evening socializing for ITCs.

Objective 3: We can play and rest in our neighborhood
💛 In order to nurture healthy brain development in children, neighborhoods should be sensorially stimulating and socially enriching.
💛 Schoolyards should be transformed into green, playful, and well-serviced public neighborhood gathering places.





Objective 4: Our neighborhood protects us from harsh weather
💚 Protection from harsh weather enables children to spend more time outside, meaning caregivers are encouraged to leave the house as well.
💚 Clean air, proper drainage, and widespread access to shade are essential in any ITC neighborhood.

Objective 5: We are well served in our neighborhood
💙 ITCs need access to public facilities such as washrooms, drinking fountains, and diaper-changing areas in order to feel welcome and well served in public space.
💙 Access to daily needs such as nutritional food, education, childcare, recreation, and healthcare must be clustered close to home to offer maximum convenience and care.
💙 Cities must budget for the high-quality maintenance of services and green spaces.

What Are the Benefits of Building Neighborhoods that Center the Needs of Infants, Toddlers, and Caregivers?

The ITC neighborhood plan addresses the difficulties the public faces with limited green space, social services, and safe access to them. While the research focus of the book is on young children and caregivers, the elements presented herein positively affect everyone. Changing neighborhoods to achieve the five local-scale objectives in this guidance creates benefits at larger scales as well, through chains of effects stemming from a less polluted and more health-supporting environment.

Build a sense of comfort for pedestrians of many abilities
Walking in Tirana often entails navigating several obstructions, whether it be destroyed paving, a tree or a business encroaching on the pedestrian way, or other people who are also struggling to move along in the small space allowed to them. Public ways that can be smoothly wheeled through—whether by stroller or powered wheelchair—provide a foundational layer of access in the city that benefits everyone. Sidewalk widths function conceptually opposite to traffic lanes: the wider they are, the slower people can move.

Counteract decades of car-centric development
Facilitating mode shifts and localizing trips reduces traffic congestion in the long term. On-street car parking is free in most Tirana neighborhoods, leading to congested neighborhoods without adequate room for footpaths. Often, ITCs are forced to walk on the same road as cars. This is especially dangerous when there are almost no traffic-calming elements on the street, and drivers are accustomed to moving at speeds much higher than 20 km/h with no consequences.

Expand and enhance green space
The World Health Organization (WHO) recommends that every city have a minimum of nine square meters of green space per capita, but Tirana has only two square meters per capita, and the existing green space is poorly distributed. These design guidelines encourage the redesigning and repurposing of existing open spaces such as school yards for year-round public access.

Reduce maintenance costs in expanding facilities
Every new park, playground, and green space bears a construction cost, but long-term maintenance costs must also be factored in up front. When street lighting, playgrounds, parks, and public facilities are well designed with appropriate materials and consideration of elements like shade, shelter, trees, and benches, spaces become more inviting to ITCs year-round with less cost to the city. When the public welcomes a new project and assumes ownership over it, damages, replacement, and repair costs will be reduced.





Cools down
Navigating Tirana on foot is tough during hot summer days because the city lacks street shade from large trees and awnings, and other cooling spaces such as swimming pools are scarcely available. Comfort in the public realm during the summer should not come at a cost. Cooler streets and parks allow people to spend more time outside, and even lend cooling to nearby buildings, all of which helps to reduce energy expenditure by both households and public buildings.

Reduce air and noise pollution
Air quality in Tirana has dropped far below WHO standards, and automobile emissions are the primary culprit. Meanwhile, the city has developed a reputation for noise pollution, the health effects of which are seriously underestimated. For infants and toddlers who spend most of their time in the city at the eye-level of exhaust pipes and engines, these stress-inducing elements of the urban environment are only amplified.

Lower costs to the healthcare system
Health-conscious planning reduces the burden on the public health system, especially with chronic, socially transmitted diseases like asthma.

Improve learning outcomes for kids, benefiting all
Safe routes to school are shown to improve learning outcomes by stimulating brain activity (connection to nature at an early age assists in brain development) and social connections outside the classroom. Overall, safe and supportive environments enable a sense of independence that benefits children and their caregivers.

Improve democratic sense of control over neighborhood
Neighborhood planning and investment is a deliberate process of empowering local decision-making that has significant implications for public trust in government. Investing in and giving voice to local institutions like community centers and other social services in annual cycles of participatory budgeting builds long-term community strength, especially when it is intentionally inclusive of children and caregiver voices.

Help retain families
Concern about living standards and the quality of education consistently rank highest among the reasons young people choose to emigrate. What can contribute to a sense of belonging and trust in the possibility of long-term investment in place is neighborhood planning that is focused on the quality of the public realm and the ways in which local institutions like schools are empowered to guide community decision-making.

An Anti-Displacement Approach

Everyone should have access to health-supporting, playable urban environments. However, much of what this book proposes—walkable streets, bike lanes, lush green space, clustered services—are characteristics recognized as valuable neighborhood amenities, which in turn increase the value of nearby land and, correspondingly, rents. This has often led to the displacement of longtime residents and neighborhood businesses in favor of homogenizing upscale redevelopment.

The core commitment of these design guidelines is to improve well-being and reduce stress for children and caregivers. Housing insecurity is among the most stressful of experiences. This is why it is important that design interventions are implemented in combination with anti-displacement policies, so that neighborhoods remain affordable even as they improve. Several cities such as Nantes, France and Portland, Oregon, have implemented such strategies.

For too long, planners and designers have approached street design as isolated from the larger problems of land use and transit planning. In doing so, they have failed to address how their work is implicated in processes of neighborhood gentrification. When urban design best practices are simply used as a pretext to gentrify neighborhoods, the core principle of child-friendly planning is undermined: everyone—and especially every child—deserves to live in a neighborhood that allows them to thrive.