Shifting the paradigm from illness to wellbeing: development of a Municipal Health Strategy

ISSUE: Portugal is undergoing a health promotion and healthcare competency transferring process to local governments, requiring the development and implementation of Municipal (local) Health Strategies (MHS). Planning an MHS remains a challenge as no guidelines have been established, being imperative to involve citizens and local stakeholders. DESCRIPTION OF THE PROBLEM: The MHS contemplates, at the municipal level and in the field of health, the priority lines of intervention and respective targets, indicators, activities, resources, and timeframes. This communication will describe the participatory mixed-methods design created for the development of one of the largest municipalities of Portugal: Almada. A technical panel was formed to act as a think tank throughout the development of the MHS, involving different public and private local social actors (Almada city hall, parishes councils, schools, faculties, sports clubs, healthcare units, social service organizations, etc.). The world café method was selected for collaborative thinking, involving also public health and health promotions experts and Almada citizens. A population-based survey complemented public registries as a data source for building up a municipal health profile (a diagnostic tool for supporting the MHS definition). What are the vision and values of Almada's MHS, how to involve the community, and what are Almada's MHS strategic axes, these are some of the questions discussed in the world cafés. RESULTS: From March to May 2023, six world cafés were conducted, plus one population-based survey focused on municipalities’ health and well-being indicators. The preliminary data point to an MHS “shifting the paradigm from illness prevention to wellbeing promotion”. LESSONS: Collaborative models are pivotal to building up effective intersectoral municipal policies, reflecting real-world health problems, and tackling real-world solutions. KEY MESSAGES: • The definition of local health strategies require collaborative, co-construction oriented models, with challenging methodological processes. • A multi-sectorial stakeholder panel set out positive health and wellbeing indicators and goals (instead of disease prevention goals) as priority for a Municipality Health Strategy.