Health and quality of life development plan: from theory to practice

In 2019, a decentralization process in Portugal transferred health governance competencies and autonomy from central to municipal level. Despite empowering local authorities to shape health policies and strategic partnerships, municipalities turned to academia for public health planning expertise. This work depicts how the National School of Public Health devised a Health and Quality of Life Development Plan for one such municipality. A two-stage approach was used. Firstly, a comprehensive overview of population health status and determinants was produced. It involved analysing local and national legal frameworks and worldwide strategic literature; assessing sociodemographic, economic, environmental and health indicators; questioning residents and key stakeholders; and city council and local health authorities working sessions. Secondly, detailed strategies were laid out to address specific health needs and determinants. It involved analysing similar municipal plans; selecting priority health actions; and designing evidence-based interventions with target, timeline, estimated resources and outcomes measures. The authors built and applied a public health planning methodology, resulting in a profound health diagnosis. Public and stakeholder scrutiny ensured prioritization of key action areas and effective working pathways in strategic planning were introduced. Furthermore, evidence-based actions adapted to local capacity, budget and resources were presented. Outputs range from health literacy sessions in schools to contingency plans for public health emergencies. Health governance responsibilities’ redefinition evidenced a knowledge gap and drove the need to consult academia to develop evidence-based health policies. By creating this methodology, the authors defined strategic pillars and tailored operational recommendations for municipalities, which rely on ongoing indicator monitoring and, ultimately aim to improve population health through concerted efforts. KEY MESSAGES: • The decentralization of health competencies granted local autonomy in shaping health policies. To support decision and policy-making, a comprehensive tool for health diagnosis assessment was designed. • The need for a concerted local action with definition of territorialized development strategies, highlights the value of a deep connection between decision-makers and academia as a consulting entity.