From 6 to 8 July 2021 the UNESCO Chair and WHO Collaborating Center on Global Health & Education and EHESP organised the first edition of the Global Community Health Annual Workshop. This year’s course was held online and FREE of charge.
Aim and audience
The main aim of the workshop was to explore the diverse practices of community health worldwide, learn from them, and apply those newly acquired skills and knowledge to current/future projects. We welcomed all those involved in health promotion, prevention, healthcare and social care services:
- Professionals working in public health institutions, NGOs
- Students undertaking a Master or PhD in Public Health or Health Promotion
- Researchers and professionals involved in implementation of community health programs
Day 1 – Community health as a practice
Goof Buijs is the manager of UNESCO Chair / WHO Collaborating Centre Global Health & Education. From 2019 he is director of Global Health & Education Consultancy. His field of expertise is bringing health and education together. He is an experienced networker, expert in creating and leading international projects focused on prevention and youth, innovator, trainer and facilitator of events and conferences. He supports cooperation among people, focusing on everyone’s talents and uniqueness.
Eric Breton, a Canadian, is professor of health promotion at the EHESP School of public health. Before settling in France, he acquired a broad international experience in research in Canada, Australia and the United Arab Emirates. His main research interests focus on policy advocacy strategies in the prevention of NCDs, evaluation of complex community-based interventions, and on local capacity building strategies for health and equity. He is an affiliated researcher of the UNESCO Chair Global Health & Education, an Associated Editor for the journal Health Education and Behavior, he also sits on different national and regional expert groups such as the High Council for Public Health (HCSP). In 2020, he published with three other editors the second edition of the first health promotion handbook in French, a publication that has mobilized contributions from 40 authors from 6 countries.
Didier Jourdan – Chair holder UNESCO Chair and head of the WHO Collaborating Center Global Health & Education, France
Laurent Chambaud – Dean of EHESP School of public health, Rennes, France
Liane Comeau – Executive Director International Union for Health Promotion and Education (IUHPE)
Community health as a field of practices
Didier Jourdan is the chair holder of the UNESCO chair “Global Health & Education” and head of the WHO collaborating center for “Research in Education & Health”. He is full Professor, former Dean of the Faculty of Education and Vice-President of Clermont-Auvergne University in France. Website of the UNESCO chair and WHO collaborating Centre https://unescochair-ghe.org/ Personal website: http://didier-jourdan.com/
Empower communities to effectively control and prevent child malaria in Sub-Saharan Africa
David Houeto, Medical Doctor, holds a Masters degree in Public Nutrition and Health System Organization and a PhD in Health Promotion. He is currently Associate Professor in Health Promotion and Social Determinants of Health (School of Public Health, University of Parakou, Benin), where he launched the first regional Francophone Africa Masters course in Health Promotion in 2013 with an online version since 2019 in collaboration with AUF (Agence Universitaire Francophone), UQAM (Université du Québec à Montréal) and UniGe (University of Geneva). He is the current President of the International Francophone Network for Health Promotion (REFIPS, www.refips.org). His main research interests include community development/engagement including health literacy, health in all policies, healthy settings programs and health system strengthening with health promotion approach. He is author of many books and book chapters all focusing on the Health Promotion development in Africa.
Summary: Malaria remains a vital concern of child survival in sub-Saharan Africa despite the existence of effective curative and preventive measures. It is known that child malaria is underpinned by factors such as socioeconomic, cultural, environmental etc. that must be considered simultaneously in order to effectively control it. This study applied to a rural community in Benin (West Africa) the Health Promotion concept (community participation and empowerment, contextualism, intersectorality, multistrategy, equity, and sustainability) to develop a programme in order to control child malaria and closing the gap of unsuccessfully programmes. The study design was a quasi-experimental pre-post conducted over a period of 27 months. As results, 80% of the community members participated in six of the seven sub-projects planned. The prevalence of fever (malaria) was significantly reduced after the intervention (P= 0,008). The recourse to adequate health care has significantly increased after the intervention (²= 48.07, P< 0.001). All these contributed to a statistically significant reduction of children deaths due to malaria (P= 0,001) in the village. Health Promotion strategies are likely to contribute to sustainable malaria programmes’ implementation that reduce malaria incidence and deaths in children under five.
Day 2 – Mobilizing communities
Exploring the complexity of asset-based approaches as a key strategy to mobilise communities
Viola Cassetti is a public health researcher and anthropologist, specialised in community health promotion initiatives, in particular with a focus on qualitative and participatory methodologies. She has worked in community development in Latin America and in applied research in primary care and public health in the UK and Spain. She recently completed her PhD in Public Health at the University of Sheffield (UK) on asset-based approaches in communities. She currently works in a project to evaluate the implementation of community engagement guidelines in Spain and collaborates with local authorities to promote community action in health from a participatory and interdisciplinary approach.
Summary: In recent years, asset-based approaches have been increasingly adopted by health promotion workers and researchers as the underpinning paradigm of community-based initiatives. However, asset-based approaches draw on various theories on community health and their implementation can take up a variety of forms. This lecture will introduce the major theories underpinning asset-based approaches and explore how they are translated into practice when designing a community-based initiative, with a specific focus on the role of assets when identifying and tackling health needs.
Experience of Health Promoters in local communities in South Africa
George Arrey is the chief executive officer of Health Promotion South Africa Trust in South Africa. He is a certified senior health promotor. Has a BA in Health Sciences and Social services (Community and Health Psychology) and a BA Hons (Community and health Psychology). He has worked as general trader, as community development coordinator and health educator.
Summary: The Health Promoters Logic Model of Health Education has been developed and implemented for the last 15 years plus. It is based on the practical optimization of community resources and assets to create awareness and conscientize the local community about the endemic health issues of their context, and through participatory action, plan, implement and evaluate, together with the target community, an intervention project suitable to alleviate and/or manage these health issues. It’s main area of focus is primary prevention. The latter is crucial to lighten the burden on secondary and tertiary prevention. The following key aspects are involved in the process: Situational analysis of the target community; Needs assessment of the target community; Identification of local resources and assets; Identification of role players and their inputs; Assessment of throughputs and timeline; Implementation; Evaluation of short-term and long -term outcomes; and, Creation of impact.
Providing sense to diversity in health settings. An experience from Argentina
Raul Mercer, Coordinator of the Program of Social Sciences and Health at FLACSO (Latin American School of Social Sciences), Buenos Aires, Argentina. He graduated as a medical doctor from the National University of La Plata, Argentina. Specialist in Paediatrics and Child Care and has a Master of Science (Epidemiology),University of Madison, USA. Consultant for different international agencies and government bodies on child, adolescent and women’s health issues. Researcher in projects on maternal mortality, infant malnutrition, health care practices during the perinatal period, reproductive health policies. Member of the Social Sciences and Health Programme of FLACSO, Argentina, where he develops teaching activities in Health Promotion.
Summary: When we refer to the differences that occur in a society, in a didactic way we could infer two types of differences: 1. Those that are the product of the constitutive diversity of a population, 2. Those that are the result of injustices generated by the humankind and that adopt different forms of expression such as inequities, inequalities, injustices, discrimination and social exclusion, among others. In turn, the two types of differences can interact with each other through its intersectionalities, an expression of the heterogeneous behavior of social determinants when considering contexts and population groups. We will address the following questions:
- How do we understand diversity in the field of health?
- Why do we give importance to diversity as the axis of development of professional practices?
- How to make the concept of diversity tangible through research, extension and teaching activities?
Day 3 – Promoting / advancing health and well-being
Access to health care for the worst-off: strengths and limitations of action research in West Africa
Valéry Ridde is Director of Research at CEPED (http://www.ceped.org), a Joint Research Unit involving the University of Paris and the Institut de Recherche pour le Développement (IRD). He was Associate Professor at the School of Public Health at the University of Montreal. He is currently hosting the Institute of Health and Development at the Cheikh Anta Diop University of Dakar (Senegal). His research work focuses on universal health coverage, health service financing, program evaluation, public health policies and health promotion.
Summary: Most health systems in Francophone West Africa still require user fees from patients. As a result, the worst-off are excluded from access to care. Several action-research have been organized in Burkina Faso and Mali to show that community-based and participatory approaches are socially acceptable and relevant for selecting indigents to benefit from free healthcare. But these processes have shown their limitations as they do not work well in urban areas and in rural areas, user fees exemption is not enough for these socially and geographically excluded people. Thus, health navigation interventions are now urgently needed to be deployed and tested to ensure that the poorest can benefit from their rights in the context of universal health coverage.
Home, School, and Community Collaboration in Health Service Delivery for Children: Practices of PROC Cohort
Yifei Hu, is full professor at the Department of Child and Adolescent Health and Maternal Care at Capital Medical University, China. Dr. Hu conducted postdoctoral research at the Vanderbilt University, USA, from October 2009-July 2011. Dr. Hu received a CIRA International Visiting Fellow Program 2018 (CIRA) from the Center for Interdisciplinary Research on AIDS at Yale University. Dr. Hu was formerly associate research professor at NCAIDS from 2003-2015 as well as the National Technical Officer for the WHO China Representative Office from 2005-2008. At present, Dr. Hu’s research focuses on Child, adolescent health and maternal care and is running two registered clinical trials: Beijing child growth and health cohort a population-based study and a multi-center longitudinal study on infant feeding behavior and growth in China. She is currently principal investigator of the 3 research supported by National Natural Science Foundation of China.
Summary: We want to share experience on how to link research-based PROC study to Home, School, and Community Collaboration in Health Service Delivery for Children. PROC study is a prospective cohort study established in 2018 in Beijing, China to study obesity and cardiovascular risk among the kids before onset of puberty, who are expected to be followed up till adulthood. With close follow up with their anthropometry, blood pressure, body composition, and urinalysis and their daytime-activity pattern, echocardiological imaging of heart and major vessels, ultrasonic examination of liver and hearing loss, we provide timely medical service to the kids and their parents. We have supported the schools to modify their physical education curriculums to better address high prevalence of obesity and overweight of the children via safely increasing interests and intensity of the physical activity. Along the research, we keep routinely briefing to local education commission and inform individual report to the parents and provide free registration, consultation, and access to hospitals with good academic reputation. With such efforts, we achieve a home, school and community collaboration in service delivery for school kids.
Local intersectoral action: what does it do and how?
Louise Potvin is a professor at the Department of Social and Preventive Medicine, School of Public Health (ESPUM), Université de Montréal. She is the Scientific Director of the Centre de recherche en santé publique. She holds the Canada Research Chair in Community Approaches and Health Inequalities. She is known as a founder and pioneer of Population Health Intervention Research, a domain of scientific domain that seeks to develop a cumulative body of knowledge on public health interventions, their planning, implementation, scaling up and sustainability. She is also a leading figure in health promotion research, more specifically through her work on the role of local environments in health inequality and local intersectoral action. In addition to having edited and co-edited 8 books and 12 supplements in major scientific journals, she has published more than 300 peer-reviewed articles, book chapters, editorials and comments. She has served on numerous research organization’s scientific boards in Canada and in Europe. She is the Editor-in-Chief of the Canadian Journal of Public Health. She is a Fellow of the Canadian Academy of Health Sciences. She received the 2017 Pierre-Dansereau Award from the Association canadienne française pour l’avancement des sciences (ACFAS), the 2019 Canadian Institute of Health Research – Institute of Public and Population Health, Trailblazer Award and the 2021 R.D. Defries Award from the Canadian Public Health Association for outstanding contributions in the field of public health.
Summary: Health and well-being are produced in everyday life through the use and transformation of accessible resources that range from housing to food to greenery to safe public spaces and so on. Those resources are controlled mostly by actors outside the health system. Therefore, promoting health and well-being in communities require that actors from a variety of sectors together with citizens develop a shared understanding of the local challenges and assets, create common goals and coordinate their action. This is generally known as local intersectoral action. Based on a 15-year research program that studied l’Initiative montréalaise de développement local, this presentation will explore three functions operated by local intersectoral coalitions and through which they produce observable transformations in people’s living environments.
Experts about community health
Gwendolijn Boonekamp, Senior Lecturer Health Promotion, HAN University of Applied Sciences, the Netherlands
- Community health can be more effective if an asset approach is taken
- A balance with what professionals think and what the community wants
- Translate resources into assets, including salutogenesis and agency
- Health not as a goal in itself but as a means for people to pursue life
Jennie Popay, Distinguished Professor of Sociology & Public Health, Lancaster University, United Kingdom
- Health inequalities and social justice
- Concept of Community Health, a different perspective from a sociologist
- Covid-19 pandemic made the existing health inequalities more visible
Myriam Dufay (video in French), Professional intermediary, Association L’Effet Morpho, French Guiana
- Action de L’Effet Morpho pour la communauté. La lutte contre le paludisme (Malaria), L’accès à l’eau potable.
- L’importance des médiateurs de santé dans l’accompagnement des communautés.
- Valoriser les petites victoires
Nina Wallerstein, Professor of Public Health, College of Population Health, Director, Center for Participatory Research, University of New Mexico USA
- Community-based participatory research for many decades
- Assisting communities with health and healing practices
- Health is linked to economics and politics
- Community knowledge
- Listening as key skill
Rebecca Rae, Research Lecturer III, University of New Mexico, College of Population Health, USA
- Implement community based participatory research in tribal nations in New Mexico
- Family listening project curriculum
- Community health is holistic: physical, spiritual, mental, social, ways of knowing, grounded in our cultural ways that are in place since millenials,
- Have passion and really enjoy the work that you do
- Mentorship and learning from people who have been working in this field
Satarupa Dasgupta, Assistant Professor of Applied Communication, Ramapo College of New Jersey, USA
- The intersectorality of Community Health: healthcare component, economics involved and the social interaction of community members
- Contribution of Community Health Workers to better health and equity
- Impact of covid-19 on transgender communities in India
Our participants contribution
Community health for me is…
Saloua Abouchadi, is a public health medical doctor, researcher and, lecturer at the National School of Public Health, Rabat, Morocco since 2013. She has a professional experience of 22 years including 7 years as a medical officer in a rural district, and 5 years as a program health manager in the direction of hospitals & ambulatory Care (Ministry of Health, Morocco). She was involved in the implementation of many health programs at the ministry of health: the action plan to reduce maternal and neonatal mortality 2008-2012, the maternal deaths surveillance system (as member of the national committee for confidential inquiries into maternal deaths), primary health care information system for family practice, improving medical certification of cause of death. Her main field of research interest is the health care system, with a focus on maternal and neonatal health and primary health care. As a lecturer, she is involved in different training programs, mainly in basic concepts in public health and health promotion. Currently, she is expecting to broaden her research field in health promotion.
Camila Ait-Yala, is the project leader of the “IEC Santé” team at GRAS (Unité de Recherche en Anthropologie de la Santé), located at the University of Oran 2 (Algeria). She holds a doctorate in language science from the University of Oran 2 and specialises in the analysis of verbal interactions in professional situations, particularly in hospitals. Camila is the Algerian coordinator of the UNESCO Chair in Education and Health.
Camila Ait-Yala, est chef de projet de l’équipe « IEC en Santé » au GRAS (Unité de Recherche en Anthropologie de la Santé), située à l’Université d’Oran 2 (Algérie). Elle est titulaire d’un doctorat en sciences du langage de l’Université d’Oran 2 et s’est spécialisée dans l’analyse des interactions verbales en situations professionnelles, notamment en milieu hospitalier. Camila est coordinatrice pour l’Algérie de la Chaire UNESCO EducationS & Santè.
Ashfaaque Bhunnoo, a MPH candidate at Ecole des Hautes Etudes en Santé Publique (EHESP). He is a registered medical practitioner in Mauritius with over 5 years of clinical experience. He completed his MBBS from Dalian Medical University, China, in 2015 and since, has been trying to promote healthy behavior at a local level.
Emmanuel Courmaire, is a director of a primary school in France. He has a long working experience with active participation with children and young people. He is currently doing a Health Promotion study at the Clermont-Ferrand University UCA. He currently is an intern at the UNESCO Chair Global Health & Education
Sonia López Villar, works in the General Directorate of Public Health of Asturias, specifically in the Health Observatory in Asturias, belonging to the Population Health Service. Part of her professional work is linked to community action, coordinating Asturias Actúa, a technical support project for various community participation structures in Asturian municipalities. Likewise, she has participated in several guides linked to the community action, both at the regional and at the national level, being one of the authors of the recent Guide of Community Action to Gain Health from the Spanish Ministry of Health of Spain
Silvia de Ruiter, project officer at the UNESCO Chair Global Health & Education. She has a Master’s degree in Communication Sciences from the University of Twente (Netherlands). She has worked on several European health promotion programmes, including the Schools for Health in Europe (SHE network). She has also been involved in the development and implementation of the health promoting school in the Netherlands.
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Boonekamp, G. M., Dierx, J. A., & Jansen, E. (2020). Motivating students for physical activity: What can we learn from student perspectives?. European Physical Education Review. DOI: https://doi.org/10.1177/1356336X20970215
Boonekamp, G. M., Jansen, E., O’Sullivan, T., Dierx, J. A., Lindström, B., Pérez-Wilson, P., & Álvarez-Dardet Díaz, C. (2021). The need for adolescents’ agency in salutogenic approaches shaping physical activity in schools. Health Promotion International. DOI: https://doi.org/10.1093/heapro/daab073
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A Beijing child growth and health cohort (”PROC”): a population-based study, clinical trial registration information: http://www.chictr.org.cn/showproj.aspx?proj=122175
Didier Jourdan, 2021. Action communautaire en santé.
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Estrategia Europea para la Salud y Desarrollo de la Infancia y la Adolescencia. https://www.mscbs.gob.es/organizacion/sns/planCalidadSNS/pdf/equidad/herramGeneroEstratInfanAdolesc.pdf
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Bilodeau, A., Parent A-A, & Potvin, L. Les collaborations intersectorielles et l’action en partenariat, comment ça marche ? Available from : https://chairecacis.org/fichiers/intersectorialite_partenariat_2019.pdf
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Seaton, C. L., Holm, N., Bottorff, J. L., Jones-Bricker, M., Errey, S., Caperchione, C. M et al. (2017). Factors That Impact the Success of Interorganizational Health Promotion Collaborations: A Scoping Review. American Journal of Health Promotion, 32(4), 1095-1109. doi: 10.1177/0890117117710875
Shankardass, K., Solar, O., Murphy, K., Greaves, L., O’Campo P. (2012). A scoping review of intersectoral action for health equity involving governments. International Journal of Public Health, 57, 25-33
Stolp, S., Bottorff, J. L., Seaton, C. L., Jones-Bricker, M., Oliffe, J. L., Johnson, S.T. Lamont, S. (2017). Measurement and evaluation practices of factors that contribute to effective health promotion collaboration functioning: A scoping review. Evaluation and Program Planning, 61, 38-44. doi:10.1016/j.evalprogplan.2016.11.013
Louart, S., Bonnet, E., Kadio, K., & Ridde, V. (2021). How could patient navigation help promote health equity in sub-Saharan Africa? A qualitative study among public health experts. Global Health Promotion, 28(1_suppl), 75–85. https://doi.org/10.1177/1757975920980723
Valéry Ridde, Emmanuel Bonnet, Kadidiatou Kadio, Sarah Louart, Manuela De Allegri, “Demographics in the service of Universal Health Coverage: examples in West Africa”, Humanitarian Alternatives, n°12, November 2019, p.33-48, http://alternatives-humanitaires.org/en/2019/11/13/demographics-in-the-service-of-universal-health-coverageexamples-in-west-africa/ ISBN of the article (PDF): 978-2-37704-583-9
Valéry Ridde, Emmanuel Bonnet, Kadidiatou Kadio, Sarah Louart, Manuela De Allegri, « La démographie au secours de la couverture santé universelle : exemples en Afrique de l’Ouest », Alternatives Humanitaires, n°12, novembre 2019, p. 33-48, http://alternatives-humanitaires.org/fr/2019/11/13/la-demographie-au-secours-de-la-couverture-sante-universelleexemples-en-afrique-de-louest/ ISBN de l’article (PDF) : 978-2-37704-581-5
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