Community capacity building on the social determinants of health: a local initiative in France
Abstract
Reducing social health inequalities is a major challenge and requires intervening on the social determinants of health and a better repartition of power and wealth. Those requirements highlight the importance of community capacity building. Although the public health literature features a number of contributions on the conceptualization of community capacity building, we found few studies on strategies to reinforce them. In this presentation we report on an initiative aiming at reinforcing community capacity building for equity in health.
This study is a part of an intervention research project in France (2012-2015). “Ensemble la santé pour tous en Pays de Redon-Bretagne Sud” is based on the construction and facilitation of an intersectoral committee including local elected officials, professionals and civil society members. We conceptualized community capacity building according to nine comprehensive domains (Liberato, 2004): sense of community, leadership, partnership/linkages/networking, communication, participatory decision making, development pathway, assets-based approach, resources mobilization, learning opportunities and skills development. Data collection was carried out through 3 focus groups to which members of the committee were invited to attend (n = 12). We conducted a qualitative content analysis.
The analysis of the nine comprehensive domains reveals that after 2 years of existence the committee is building its capacity. The intervention does not seem to have had impacts on participatory decision making, resources mobilization or learning opportunities, but it seems to have developed the sense of community (especially in building aims), and the leadership (the necessity of committee’s coordination).
Capacity building is a lengthy process. It seems to start by developing the sense of community and the leadership. Reinforcing community capacity building involves reconciling the aspirations of individuals, organisations and those of community