ABSTRACT
Participation is a process that requires the involvement of the policy makers, managers, technicians and staff of the institutions, and of citizens, as well as intersectoral and interdisciplinary action. To generate transformative changes, an infrastructure that encourages participation and planned action is required, and that recognises all the actors in the process. It takes time and commitment to ensure continuity through the joint production of actions, hence the importance of consolidating participatory projects that continue beyond political changes making public services sustainable. Training, the appropriate use of participation tools and a horizontal policy of delegated power are essential to ensure participation. Surveys, sociograms, flowcharts, health assets mapping, participatory budgets and participatory evaluation matrices are some of the tools that can be chosen, depending on the type of subjects addressed, the time and resources available, the characteristics of the participating population and territory, as well as determining the use that will be made of the information generated for the next phase. Participation tools are useful for citizens and professionals to analyze, understand, debate and decide collectively how to improve living conditions and environments. Over the past decade, social networks in the virtual environment have generated new trends in mass participation, which are self-managed by citizens.
Subject(s)
Community Participation/methods , Humans , Models, Organizational , Research Report , Societies, Medical , SpainABSTRACT
La participación es un proceso que requiere la implicación de responsables de la política, del personal directivo y técnico de las instituciones, y de la ciudadanía, así como de la acción intersectorial e interdisciplinaria. Para generar cambios transformadores es necesaria una infraestructura que favorezca la participación y la acción planificada, reconociendo a todos los actores del proceso. Se precisan tiempo y compromiso para su continuidad a través de la producción conjunta de acciones, y de ahí la importancia de consolidar proyectos participativos que continúen más allá de los cambios políticos para que los servicios públicos sean sostenibles. La formación, el uso adecuado de las herramientas de participación y una política horizontal de poder delegado son imprescindibles para el desarrollo de la participación. Herramientas como sondeos, sociogramas, flujogramas, mapeos de activos para la salud, presupuestos participativos o matrices de evaluación participativa son algunas de las que pueden elegirse, en función del tipo de materias abordadas, el tiempo y los recursos disponibles, las características de la población participante y del territorio, así como del uso que se va a hacer de la información generada para la siguiente fase. Las herramientas de participación son útiles para que la ciudadanía profesionales analicen, comprendan, debatan y decidan colectivamente con el fin de mejorar las condiciones de vida y los entornos. En la última década, las redes sociales en el entorno virtual han generado nuevas tendencias de participación masiva y autogestionada por la ciudadanía
Participation is a process that requires the involvement of the policy makers, managers, technicians and staff of the institutions, and of citizens, as well as intersectoral and interdisciplinary action. To generate transformative changes, an infrastructure that encourages participation and planned action is required, and that recognises all the actors in the process. It takes time and commitment to ensure continuity through the joint production of actions, hence the importance of consolidating participatory projects that continue beyond political changes making public services sustainable. Training, the appropriate use of participation tools and a horizontal policy of delegated power are essential to ensure participation. Surveys, sociograms, flowcharts, health assets mapping, participatory budgets and participatory evaluation matrices are some of the tools that can be chosen, depending on the type of subjects addressed, the time and resources available, the characteristics of the participating population and territory, as well as determining the use that will be made of the information generated for the next phase. Participation tools are useful for citizens and professionals to analyze, understand, debate and decide collectively how to improve living conditions and environments. Over the past decade, social networks in the virtual environment have generated new trends in mass participation, which are self-managed by citizens
Subject(s)
Humans , Community Health Services/organization & administration , Community Participation , Community Networks/organization & administration , Health Promotion/organization & administration , Participatory Planning , Policy Making , Community-Based Participatory Research/methods , Intersectoral Collaboration , Health Priorities/organization & administrationABSTRACT
Local administration is responsible for health-related areas, and evidence of the health impact of urban policies is available. Barriers and recommendations for the full implementation of health promotion in cities and neighbourhoods have been described. The barriers to the promotion of urban health are broad: the lack of leadership and political will, reflectes the allocation of health outcomes to health services, as well as technical, political and public misconceptions about the root causes of health and wellbeing. Ideologies and prejudices, non-evidence-based policies, narrow sectoral cultures, short political periods, lack of population-based health information and few opportunities for participation limit the opportunities for urban health. Local policies on early childhood, healthy schools, employment, active transport, parks, leisure and community services, housing, urban planning, food protection and environmental health have great positive impacts on health. Key tools include the political prioritisation of health and equity, the commitment to «Health in All Policies¼ and the participation of communities, social movements and civil society. This requires well organised and funded structures and processes, as well as equity-based health information and capacity building in the health sector, other sectors and society. We conclude that local policies have a great potential for maximising health and equity and equity. The recommendations for carrying them out are increasingly solid and feasible.
Subject(s)
Cities , Environmental Health , Health Promotion , Urban Health , Humans , InvestmentsABSTRACT
An asset-based approach could be useful to revitalise health promotion or community health interventions combining work with multiple partnerships, positive health, community engagement, equity and orientation of health determinants. We set some recommendations about how to incorporate the assets model in programmes, projects and interventions in health promotion. Some techniques are described for assets mapping and some experiences with this methodology being developed in different regions are systematised. We propose the term "Asset-based Health Promotion/Community Health" as an operational definition to work at the local level with a community engagement and participatory approach, building alliances between different institutions at the state-regional level and trying to create a framework for action with the generation of evaluations and evidence to work on population interventions from the perspective of positive health.
Subject(s)
Health Promotion/methods , Humans , SpainABSTRACT
OBJETIVO: Describir los cambios percibidos por la población y los profesionales en relación con la salud y el uso de servicios tras la intervención RIU con agentes comunitarios en un barrio vulnerable. DISEÑO: Estudio descriptivo cualitativo con entrevistas individuales y grupales y observación participante de octubre de 2008 a julio de 2009. Emplazamiento: Barrio Raval (Algemesí-Valencia). Participantes: Selección por muestreo opinático de 7 mujeres agentes de salud, todas las que finalizaron la intervención, y 10 profesionales implicados en la misma. MÉTODO: Con las mujeres se mantuvo una entrevista grupal a los 6 meses, y una entrevista grupal y 7 individuales a los 9 meses de intervención. Se realizó un análisis temático de tipo descriptivo desde el modelo de promoción de salud. Con los profesionales se utilizó observación participante en una reunión a los 9 meses, analizándose las notas de campo según: valoración del proyecto, cambios detectados, dificultades y recomendaciones. RESULTADOS: Las mujeres adquirieron información sobre salud, anticoncepción, embarazo y servicios sanitarios; señalaron cambios en autocuidados y habilidades sociales y liderazgo; interiorizaron el rol de agente de salud difundiendo lo aprendido y manifestando mejor autoestima y reconocimiento social. Provocaron cambios en su entorno relativos al cuidado de la salud y el acceso a los servicios. Los profesionales no incorporaron a su trabajo la perspectiva comunitaria; valoraron el proyecto, coincidieron con las mujeres en la mejora del acceso y uso de servicios y en el acercamiento población-profesionales. CONCLUSIONES: RIU aumenta las capacidades de las personas participantes, su reconocimiento social y mejora el acceso y uso de servicios sanitarios
OBJECTIVE: To describe how health agents and professionals working in a community project perceive the changes related to the population health status and their use of health-care services after the RIU intervention in an urban area of socioeconomic disadvantage. DESIGN: A qualitative descriptive study based on individual and group interviews and participant observation conducted between October 2008-July 2009. Location: Raval (Algemesí-Valencia) Participants: We selected by purposive sample 7 women health agents, all persons who completed the intervention, and 10 professionals for their involvement in the intervention. METHOD: We conducted a group interview with the women at 6 months and a group and 7 individuals interviews both at 9 months of intervention. We realized a thematic descriptive analysis from health promotion framework. We used participant observation in a meeting with professionals at 9 months and analyzed field notes as: appraisal project, detected changes, challenges and recommendations. RESULTS: Women acquired information about health, contraception, pregnancy and heath services; they noted changes in self-care and social skills and leadership; they internalized the role of health worker disseminating what they learned and showed improvement in self-esteem and social recognition. They caused changes in the people related on health care and access to services. Professionals didn't incorporate at their work the community perspective; they valued positively the project; professionals and women agreed on improving access and use of services and closeness population-professionals. CONCLUSIONS: RIU increases the capabilities of the participants, their social recognition and improves access and use of health services
Subject(s)
Humans , Health Vulnerability , Health Status Disparities , Community Health Services/organization & administration , 34658 , Risk Groups , Evaluation of the Efficacy-Effectiveness of Interventions , Health Promotion , Community Participation , Gender and HealthABSTRACT
OBJECTIVE: To describe how health agents and professionals working in a community project perceive the changes related to the population health status and their use of health-care services after the RIU intervention in an urban area of socioeconomic disadvantage. DESIGN: A qualitative descriptive study based on individual and group interviews and participant observation conducted between October 2008-July 2009. LOCATION: Raval (Algemesí-Valencia) PARTICIPANTS: We selected by purposive sample 7 women health agents, all persons who completed the intervention, and 10 professionals for their involvement in the intervention. METHOD: We conducted a group interview with the women at 6 months and a group and 7 individuals interviews both at 9 months of intervention. We realized a thematic descriptive analysis from health promotion framework. We used participant observation in a meeting with professionals at 9 months and analyzed field notes as: appraisal project, detected changes, challenges and recommendations. RESULTS: Women acquired information about health, contraception, pregnancy and heath services; they noted changes in self-care and social skills and leadership; they internalized the role of health worker disseminating what they learned and showed improvement in self-esteem and social recognition. They caused changes in the people related on health care and access to services. Professionals didn't incorporate at their work the community perspective; they valued positively the project; professionals and women agreed on improving access and use of services and closeness population-professionals. CONCLUSIONS: RIU increases the capabilities of the participants, their social recognition and improves access and use of health services.
Subject(s)
Attitude of Health Personnel , Community Health Services/statistics & numerical data , Health Promotion , Urban Health , Adolescent , Adult , Community Health Workers , Evaluation Studies as Topic , Female , Humans , Socioeconomic Factors , Spain , Surveys and Questionnaires , Young AdultABSTRACT
The aim of this study is to map the awareness of gender, socioeconomic, immigrant and ethnic health inequalities in health at schools, maternal health and traffic injury health prevention programs. The study was conducted in the 19 health descentralized areas in Spain, 17 autonomous community (ACs) and the 2 autonomous cities (ACities). The data were collected from May 2008 to January 2009. The unit of analysis was the collection of policy documents setting out the programs mentioned above and the related support material in each AC. A reading guide was used to analyze the awareness of inequalities. With regard to health at schools, 2 of 10 programs show a high awareness of inequalities and include many specific proposals to be implemented at the local level. Regarding maternal health, 13 ACs have prepared support material with high awareness of inequalities to be implemented. A traffic injury program has been created in two ACs. We map the whole situation in Spain regarding the health programs that we have used as examples and their awareness of inequalities. We can conclude that there are differences between the regions studied in Spain and in general, the awareness of inequalities is low.
