La toma de decisiones en salud comunitaria a través del mapeo de activos en salud / Community health decision-making through the assets mapping

Se presenta la experiencia de redefinición de la metodología de mapeo de activos en salud, que tuvo como objetivo hacer posible el análisis según desigualdades de salud, así como su utilización como herramienta en procesos participativos de toma de decisiones en el ámbito de la Administración local. Para ello se diseñó un procedimiento replicable y apto para todas las edades y todos los colectivos. A su vez, se estableció una extensa clasificación de los activos no solo en el plano geográfico, sino también según el perfil de la persona y las características de los activos. El volcado de los datos en un sistema de información geográfica y la gran cantidad de activos recogidos permitieron ampliar la interpretación habitual de los datos obtenidos y presentar la información de forma dinámica. (AU)

This is a report about the experience on redefining the health asset mapping methodology. The aim of this experience consisted of making an analysis on health inequalities, as well as of using it as a tool in decision-making participative processes in the local administration area. Thus, a replicable procedure for all ages and groups was designed. Besides this, assets have been widely classified, in accordance with the territorial distribution, people's profiles and asset features. Both the upload of data to a geographical information system and the large amount of data gathered allowed us to enlarge the common interpretation of data and present the information in a dynamic way. (AU)

Supporting community participation in a pandemic / Apoyar la participación comunitaria en la pandemia

The invariable governmental approach to the impact of the COVID-19 pandemic has been to effect the White Knight stance of Don Quixote, defending the population from the “Virus Dragon” and dedicating its knight-errantry to the damsel Dulcinea. Though essential, new therapeutics, vaccines, physical distancing, rigorous hygiene standards and efficient health systems are not sufficient to counter the effects of the virus. Individual compliance to public health guidelines also matters, while remaining similarly insufficient to diminish the threat. Earthier, citizen-led, community participation strategies, however, lead to innovative, tailored solutions that better fulfil the needs of diverse neighbourhoods and assures greater virus resistance and increase in population health compared to a top-down, knightly approach or isolated individual efforts. The challenge of COVID-19 offers communities a moment to build more resilient, antifragile communities that not only survive the current crisis, but that thrive after it, and that are better equipped for the next challenge. This is not the time for the singular heroics of the White Knight, or the antics of Don Quixote, tilting at windmills. It is the time of Sancho Panza, which is to say of regular non-credentialed citizens, and their collective efforts, who up to now have largely been considered pawns in this contest. Asset-based community development (ABCD) rejects both the individual as an island and the institutional, knightly emphasis on assessing needs and deficits within communities. It favours identifying and mobilising available and latent assets within a community to forge closer connections among all people, the better to collectivise problem-solving efforts. Community-driven initiatives are assisted in this by localised not-for-profit agencies that practice subsidiarity. (AU)

Los gobiernos, sin variación, han respondido al impacto de la COVID-19 como caballeros blancos al estilo de Don Quijote cuando defendió a la población del virus-dragón y dedicó la caballería andante a la defensa de su dama Dulcinea. Aunque esenciales, los nuevos tratamientos, las vacunas, el distanciamiento físico, los estándares rigurosos de higiene y unos servicios sanitarios eficientes no bastan para contrarrestar el efecto del virus. El cumplimiento individual de las medidas de salud pública también importa, pero igualmente resulta insuficiente para disminuir la amenaza. Estrategias más terrenales, lideradas por ciudadanos y con participación comunitaria, conducen a medidas innovadoras en cuanto a que se ajustan mejor a las necesidades de la diversidad de entornos y aseguran una mayor resistencia al virus y una mejor salud que los caballerosos esfuerzos aislados. El reto de la COVID-19 ofrece a las comunidades la posibilidad de hacerse más resilientes y menos frágiles, y no solo sobrevivir a esta crisis, sino florecer tras ella y estar mejor equipadas para los próximos retos. No son tiempos para caballeros andantes ni para las payasadas de Don Quijote enfrentándose a las aspas de un molino. Estamos en tiempos de Sancho Panza, o lo que es lo mismo, de ciudadanos normales no acreditados y sus esfuerzos colectivos, que hasta ahora han sido considerados meros peones. El desarrollo comunitario basado en activos rechaza tanto a los individuos aislados como al caballeroso énfasis institucional al valorar las necesidades y los déficits en las comunidades. Favorece la identificación y la movilización de los activos disponibles y latentes en las comunidades para forjar conexiones más próximas entre individuos, que es lo mejor para colectivizar los esfuerzos y solucionar los problemas. Las iniciativas lideradas por las comunidades se ven apoyadas por agencias locales sin ánimo de lucro. (AU)

[Community health decision-making through the assets mapping]. / La toma de decisiones en salud comunitaria a través del mapeo de activos en salud.

This is a report about the experience on redefining the health asset mapping methodology. The aim of this experience consisted of making an analysis on health inequalities, as well as of using it as a tool in decision-making participative processes in the local administration area. Thus, a replicable procedure for all ages and groups was designed. Besides this, assets have been widely classified, in accordance with the territorial distribution, people's profiles and asset features. Both the upload of data to a geographical information system and the large amount of data gathered allowed us to enlarge the common interpretation of data and present the information in a dynamic way.

Supporting community participation in a pandemic.

The invariable governmental approach to the impact of the COVID-19 pandemic has been to effect the White Knight stance of Don Quixote, defending the population from the "Virus Dragon" and dedicating its knight-errantry to the damsel Dulcinea. Though essential, new therapeutics, vaccines, physical distancing, rigorous hygiene standards and efficient health systems are not sufficient to counter the effects of the virus. Individual compliance to public health guidelines also matters, while remaining similarly insufficient to diminish the threat. Earthier, citizen-led, community participation strategies, however, lead to innovative, tailored solutions that better fulfil the needs of diverse neighbourhoods and assures greater virus resistance and increase in population health compared to a top-down, knightly approach or isolated individual efforts. The challenge of COVID-19 offers communities a moment to build more resilient, antifragile communities that not only survive the current crisis, but that thrive after it, and that are better equipped for the next challenge. This is not the time for the singular heroics of the White Knight, or the antics of Don Quixote, tilting at windmills. It is the time of Sancho Panza, which is to say of regular non-credentialed citizens, and their collective efforts, who up to now have largely been considered pawns in this contest. Asset-based community development (ABCD) rejects both the individual as an island and the institutional, knightly emphasis on assessing needs and deficits within communities. It favours identifying and mobilising available and latent assets within a community to forge closer connections among all people, the better to collectivise problem-solving efforts. Community-driven initiatives are assisted in this by localised not-for-profit agencies that practice subsidiarity.

[Health promotion based on assets: how to work with this perspective in local interventions?] / Promoción de la salud basada en activos: ¿cómo trabajar con esta perspectiva en intervenciones locales?

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.