3.2. Integrated knowledge for intersectoral, equity-driven PHC
Conventional PHC approaches often lack the means to adequately analyze and inform measures to address the root causes of inequities in relation to population health needs. By embedding SDH into localized data systems, primary health care systems can more effectively meet the health needs of individuals, families and communities; allocate resources; prioritize populations in conditions of vulnerability and foster community trust. This area focuses on developing comprehensive, localized knowledge and data systems that integrate social determinants of health into local practice and decision-making processes. It emphasizes using holistic, community-informed analyses to understand inequities and power dynamics, supporting actionable frameworks.
Examples from SIMASHE
Community mapping in Lao People’s Democratic Republic: The CONNECT Initiative utilizes an asset-based, positive approach to empower communities to collectively identify local resources. For example, community stakeholders have carried out participatory mapping. using local knowledge to prioritize issues and identify solutions. This approach involves developing local authorities’ capacity for respectful communication to engage with the community and gain a genuine understanding of the village from residents’ perspectives.
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Multisectoral small area diagnostics, planning and accountability mechanisms in Tolosa, Philippines: After analysis of data in order to prioritize health programmes (e.g. on noncommunicable diseases), comprehensive planning exercises at the barangay (district) level incorporating the social determinants of health were carried out by the Tolosa SDH Technical Working Group and barangay leaders. This built on the expansion of the Local Health Board, to include the Departments of Agriculture, Education, Social Welfare, civil society organizations and academia. The process also included the maximization of the “healthy settings” approach.
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Geoportal development in SIMASHE pioneer municipalities, Chile: The municipalities involved in the country’s reform for universal primary health care have begun mapping community assets and identifying families with social and health vulnerabilities, through geographic information systems. These efforts are helping establish a baseline at the local, regional and national levels, to target social determinants of health and assess equity in health programme investments.
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Transformation of the Health Observatory to focus on the social determinants of health in Huila, Colombia: With the support of SIMASHE, the Huila region is shifting the focus of its observatory from isolated health issues to the social determinants of health (SDH). The aim is to have a subnational clear profile about SDH and health, and to provide support and data to municipalities within the region to enhance SDH monitoring at the local level.
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Key intervention activities
SIMASHE is continuously seeking examples related to this area of work, including activities for:
- participatory mapping of needs and resources for equity-based PHC planning (e.g. community health analysis of PHC needs).
- design and application of tools for collecting and analyzing SDH-related data across the PHC continuum.
- encouraging the analysis and interpretation of SDH-related data by PHC teams and communities.
- integrating local mapping and community input in PHC services and solutions.
- community-informed decision-making for PHC policy and service improvements.
- use of monitoring frameworks for governance, trust, and health equity within PHC in coordination with other government sectors (link with strategic entry point No. 6).