XarxaSalut, network of municipalities for health, Valencia Region (Spain): policy process evaluation

Abstract

Abstract “XarxaSalut” started in 2017, with the municipalities that have taken the commitment to boost the Promotion of Health (HP) at the local level through community participation, intersectorality and equity perspective. The objective is to present a policy process evaluation (2'5 years) of the implementation of XarxaSalut. Different approaches have been used; a questionnaire addressed to the municipalities at the time of adhesion including data on intersectorality, participation, HP actions and open questions; description of instruments that Regional Public Health Authorities (RPHA) has mobilized and an analysis of barriers and strengths made by the coordination office. In 2017, 17 municipalities were joined, being 197 in February 2020 (70% of the population). 65% are in a process of an organizational change through the intersectoral, decision making and participative working group. 35% are doing analysis of determinants and /or health situation, assets maps and a prioritization of HP actions. The main barriers identified by municipalities are lack of economic and personal resources, and difficulties in achieve citizen participation. The main benefits were the optimization of resources, the exchange of experiences, training, or economic support from the RPHA. Some support instruments develop for RPHA are a collection of guides for community development, funds that the municipalities can apply to support actions related with training, HP action on vulnerable population, on asset maps, participation processes, vulnerable neighborhoods, etc.; Community actions have been included in the “Health Observatory” to give visibility and social support to XarxaSalut. Interdisciplinary training processes with health and municipal professionals have been made in order to develop a common language and strength the competences for HP. Lesson learned: The need to improve coordination and a common language between different types of participants and professionals Key messages The decision makers and professionals in the municipalities understand the impact in health of the policies developed at local level but needs guide and support to deal with it. The coordination between different administrations and primary health at local level and the misunderstandings about health and their determinants are the main aspect to reinforce.