4.A. Skills building seminar: Waves of community health engagement and governance: innovating through a design-as-policy approach
Authors:   Organised by: EUPHA-PHPP, European Observatory on Health Systems and Policies, Portuguese National Health Council (Portugal),   Chair persons: Marleen Bekker (EUPHA-PHPP), Dheepa Rajan (Belgium)
Published: October 2024

In this workshop we will engage our participants in a practice oriented exercise to experiment with a collaborative design-as-policy approach for a community health action plan. The exercise will be based on the lessons learned in two large evaluation projects: 1) an 8-year evaluation of the Dutch All about Health (AaH) platform of social health initiatives on the local, regional and national level; and 2) a comparative multiple case study, including Portugal, building a framework for sustainable citizen engagement, published in the WHO Handbook ‘Voice, Agency, Empowerment: The Handbook on Social Participation for UHC’. Both projects show striking similarities in findings, and developed guidance for devising collaborative action through (a) the use of community platforms, (b) concrete engagement mechanisms and (c) mediating civil society organizations. These will be brought together in a Guidance Tool that participants will work with in the exercise. The aim of the tool is to support initiatives to bring together both top-down participatory efforts and bottom-up grassroots movements in order to anchor community and minority voices into policy decision-making for a more level playing field for policy influence. The aim of the workshop is to let participants experiment with the Guidance Tool and develop collaborative design-as-policy skills.

The outline of the skills building exercise: 1. Group introductions using Mentimeter and invitation to pick a particular complex health issue from participants’ own work or community setting (5 mins). 2. Three pitches on the projects, the Portugal case and the Guidance Tool (10 mins). 3. Exercise instructions (5 mins). 4. Exercise (35 mins) a. Upon room entrance participants receive a colored badge based on their professional background: public health professional/practitioner, community resident, researcher or policymaker; b. Form small sub groups of 6-8 participants with different backgrounds (2 mins); c. Introduce with key words on paper their respective complex community health issues and sub group jointly selects one issue for which most information and experience is present (6 mins); d. First round in duos within sub group: participants work through the guidance steps to an initial idea for the collaborative action approach consisting of a community platform, engagement mechanisms, and mediating civil society organizations, drawn out on paper (10 mins); e. Second round in duos within the sub group: duos review another duos initial design idea and conduct an intuitive SWOT analysis of feasibility, acceptability, and practicability (8 mins); f. Third round in sub group: compare the three proposals in SWOT perspective, select the most salient one, and improve with strong elements from other proposals (8 mins); g. Summarize in key words the final proposal and enter into Mentimeter. 5. Plenary wrap up using Mentimeter: select the winning proposal, and evaluate the exercise (5 mins).

Key messages

• Collaborative action is enhanced considerably through (a) the use of community platforms, (b) concrete engagement mechanisms and (c) mediating civil society organizations.

• The Guidance Tool offers concrete steps for designing a reflexive and adaptive structure and process for community collaborative action and self-governance.

Speakers/Panelists

Marleen Bekker

Wageningen University & Research, Wageningen, Netherlands

Dheepa Rajan

WHO, Brussels, Belgium

Goncalo Figueiredo Augusto

National Health Council, Lisbon, Portugal