Community Care and Catalonia and Spain at a Glance

1. Community Care in Catalonia
and Spain
Josep Vidal-Alaball
Primary Care & Public Health physician

2. What is Community Care?
Community Care
interventions in Catalonia
and in Spain
Final considerations

3. Definition
Can be defined as the health of the individuals
and the groups in a particular community(1).
This is determined by the interaction of
personal, family, cultural and physical factors
and the socio-economic environment
(determinants of health).
(1) Gofin J, Gofin R. Essentials of global community health. Sudbury, MA: Jones & Barlett Learning; 2010: 269

4. 4
A community health intervention is a strategy aimed to
improve the health of a defined community

5. Working Group in Community Oriented Primary
Care (APOC) - 1987
Community Oriented Primary Care (COPC) is a practice
in which the elements of community, family and
individual care are given together (reflecting the spirit of
the International Conference on Primary Health Care held in
Alma-Ata in 1978).
In Catalonia; first working shop in 1987 organized by
the Catalan Society of PC Working group
COPC part of FM training curriculum since 1990

6. 6
COPC methodology integrates the individual (clinical)
and the community (public) approach. Consists in a
cyclic process of planning based on the population
needs.

7. 7
Group. 20 members: PC nurses and doctors, public
health practitioners, social workers
Conducted 30 workshops for more than 1,000
professionals
Helped implement COPC model in several health
centres
http://www.apoc-copc.org/eng/linksE.htm

8. 8
Acting Together for Health network (AUPA)
Network of several health institutions (primary care and
public health) and professional bodies and societies.
To promote Community Care projects in Primary Care:
• Annual grants for funding community projects
• Provide training to professionals and PC trainees
• Publish research and educational material
• Methodological advice to centres
• Promote collaborative research projects
http://www.gencat.cat/salut/ies-aupa/html/ca/Du63/index.html

9. 9
From may 2003  96 Centres

10. 10
Community Health Workers project (ASACO)
Based on health assets and Salutogenesis
Public Health + Primary Care Teams
First phase:
• Identify representative community agents
• Train agents on social determinants, salutogenesis
and assets for health. Same training!
•Blog (training sessions, resources…)
•Video http://youtu.be/NzPSCx9BS6g

12. 12
Second phase:
• Groups in 3 areas created
• Identification health assets. Methodology: ABCD
(Asset based community development)
• What gives you health?
• Video
• Boxes
• Identification problems (COPC methodology)

13. 13
http://projecteasaco.wordpress.com

14. 14
Health in Neighbourhoods – Urban Renewal Plan
2004: Neighbourhoods law includes plan to improve
health in the most disadvantaged neighbourhoods in
Catalonia.
Objective: To introduce health as a major element for
the improvement of the living conditions and welfare of
the neighbourhood.
Analysis and detection needs with the community,
prioritization of actions and implementation.

15. 15
Evaluation of health equity effects
http://www.sophie-project.eu/index.htm

16. 16
http://jech.bmj.com/content/68/9/811.abstract

17. 17
Roquetes Community development Plan
Emanates from a COPC group, uses the Health in
Neighbourhoods programme.
After conducting a community analysis and diagnosis,
prioritize 3 problems:
1. Musculoskeletal disorders
2. Lack of healthy habits
3. Lack of self-care skills

18. 18
Carmel Community Development Plan
Since 2001
Amalgam of individual neighbours, neighbourhood
associations, health professionals and public
administrations
To promote processes of participation among the
community to improve the neighbourhood
Several Community Projects:
• Support group for women who are going through a time of
significant change in their life
http://www.carmelamunt.org/bloc/quequicom/

19. Programme of Community Activities in Primary
Care (PACAP)
Program Spanish Society of PC to stimulate
Community Activities in PC – 1995
Produce a journal: Comunidad
Promote Community Activities Networks
Community Activities Search engine
http://www.pacap.net/pacap/

20. 20

21. 21

22. 22
Health Observatory of Asturias
http://www.obsaludasturias.com Since 2010
Space of knowledge about health information in
Asturias. Generate periodic reports.
Link information on health indicators to various
community health projects developed in Asturias

23. 23
Projecte RIU
Facilitate access to health services for vulnerable
population in Alzira
Training to community health agents (75h)
Health Assets. Mapping http://on.fb.me/1pc7hFJ

24. Future challenges
Aging population. Chronic diseases
Training. Particularly non-health workers
Economic climate: ? Opportunity
Research – Evidence
Involve non-health related agents  Inter-ministerial
Public Health Plan (Health in all policies)

25. Josep Vidal-Alaball
josep.vidal@gmail.com
Twitter: @jvalaball
http://www.slideshare.net/jvalaball