Advances in an integrated evaluation of Community health in Medellín (Colombia) during 2014-2019

Abstract

Abstract Background In accordance with the “Health in All Policies” approach, since 2014 the city of Medellín (Colombia) has implemented a community-based urban health model based on knowledge and action to strengthen community participation, social cohesion, and health equity. Methods A mix method design was carried out to effectively monitor planning actions, as well as specific socio-environmental interventions in two thirds of the communes of Medellín. A standardized operating procedure was built up: toolkit for diagnostic validation were developed; priorities and health needs identified; assets of social, community, institutional and social capital of the intervened communes analyzed and mapped; community capacities and social leadership in health strengthened; governance and intersectoral communication for change and social mobilization increased. Results 45.07 (SD 19.77) was a measurement baseline of Community Social Capital in Health. The interrelation between community health assets was especially relevant in some communes. For example: In the Commune 1 Popular, women's leadership allowed the implementation of relevant salutogenic actions. The intersectoral actions of the Commune 15 Guayabal for child care were evaluated as a case of territorial governance. In the Commune 12 La América, social mobilization actions were evaluated as a case for social communication. By other side, the learning process of a community training program in social participation in health has generated relevant evidence to continue jointly reinforcing citizen empowerment in health decision-making. Conclusions There was a large overlap between the community health interests and the technical decisions for health planning designed by the city health authority, in that sense, assessing social participation in health as a process involves not only planning common actions but also designing and applying participatory knowledge with the community. Key messages Social interactions for social health transformations requires longitudinal process of observation. Implementation evaluation is useful 'just on time' for decision making process.