Designing a Health Strategy at Local Level: A Conceptual Framework for Local Governments

Gonçalo Santinha (), Alexandre Fernandes, Rafaela Oliveira and Nelson Pacheco Rocha
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Gonçalo Santinha: GOVCOPP, Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
Alexandre Fernandes: GOVCOPP, Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
Rafaela Oliveira: GOVCOPP, Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
Nelson Pacheco Rocha: IEETA, Department of Medical Sciences, University of Aveiro, 3810-193 Aveiro, Portugal

IJERPH, 2023, vol. 20, issue 13, 1-22

Abstract: This article addresses a gap in the literature regarding the design and implementation of health and well-being strategies by local governments. It presents a conceptual framework that can help local governments to include health and well-being among their political priorities by promoting the participation of local stakeholders and the community in general. The article also highlights the important role that local governments play in public health, especially in times of crisis, such as the COVID-19 pandemic. To demonstrate the approach, the manuscript explores the recent shift toward decentralization in Portugal and the resulting emphasis on local governments leading new approaches to health governance. The planning process for Arouca’s Health Strategy, an inland municipality, is used as a case study to demonstrate the approach, which emphasizes the meaningful participation of the entire local community. The article concludes by noting that there is still significant room for improvement in all areas related to health and well-being and a need to adopt new multistakeholder governance arrangements to sustain the institutional capacity for upcoming strategies.

Keywords: decentralization; health system; healthcare governance; local government; health strategy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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