Page - 421 - in Biodiversity and Health in the Face of Climate Change

421 being compromised under climate change, they themselves are also (partially) accountable for the climate-health problems, and, therefore, should be included in resolving them. In addition to knowledge co-creation, policy co-design and imple- mentation and actions to respond to urban climate-health challenges based on the three- dimensional principles of nature-based solutions, governing knowledge- action systems, also requires collective learning. The outcomes of nature-based interventions need to be monitored and observed by stakeholders as feedback to the knowledge pool of climate change, urban ecosystems and health, thereby enabling knowledge- action systems governance, also known as resilience management for urban health, to co-evolve with the changing complexity of urban systems resulting from further impacts of climate change. 18.5 Conclusions Urban health and well-being outcomes are the product of systems that function to produce services of value to humans. The degree to which urban system functions deliver services for human health and well-being depends on the human capability to manage complexity and create healthy urban environments. Institutions, under- stood as being made up of rules enabling and constraining interactions, provide the space and freedom for action as well as the organisational constraints. As human dominance of ecosystems spreads across the globe, humankind must become more proactive not only in trying to preserve components of earlier ecosys- tems and services that they displace, but also in imagining and building new kinds of ecosystems and nature-based hybrid solutions that allow for a reconciliation between human development, functioning ecosystems and biodiversity. To address this, we offer the following five approaches: 1. Resilience management for healthy cities in the context of climate change must be based on a deep understanding of the complexity of urban systems and the functions they provide. 2. Climate change affects all urban system functions directly or indirectly, and thereby also human health and well-being. Urban green areas and greening of other types of infrastructure need to be planned and managed to respond to the increasing health risks of climate change in cities. 3. Nature-based solutions have been developed as an action response to increase resilience to environmental stresses and can be used to help reduce health risks of climate change in cities. 4. Managing resilience in urban systems requires adaptive and flexible governance styles on several scales in order to enhance multi-functionality of systems and functions that support urban health and well-being. 5. Our knowledge of urban system complexity and urban system functions needs to be translated into actions that are not only nature-based, but also governed by knowledge-action systems that recognize all urban inhabitants as stakeholders and enable collective learning for urban health under climate change. 18 Resilience Management for  Healthy Cities in  a  Changing Climate