Community participatory processes focused on equity in health at the local level

The Basque Country has a long-standing tradition of community action for health and well-being, reflected in numerous local initiatives ranging from promoting active ageing through community walks to improving school playgrounds. Yet, important opportunities remain to strengthen these efforts. Only one in five initiatives are co-managed, with communities engaged as equal partners throughout the process. Moreover, fragmentation and limited coordination among stakeholders hinder the full potential of these actions.

Addressing these challenges requires a more structured, community-centred approach to enhance participation, coherence, and sustainability — an objective that the new strategy seeks to achieve in alignment with broader regional health goals.

The 25-month project, funded by the European Union and led by the Basque Department of Health with technical support from the OECD, aimed to strengthen community action for health and well-being in the Basque Country. It focused on improving coordination, enhancing institutional preparedness, and engaging policymakers and stakeholders to ensure long-term sustainability. Key outputs included a recommendation for the strategy, an action plan outlining implementation steps, and recommendations to improve institutional capacity. Activities such as expert workshops and training sessions supported knowledge exchange, while a pilot tested selected strategy components.

The project provides the Basque Department of Health with concrete tools to implement a structured approach to community action. The strategy proposal and action plan provide a clear framework, while targeted recommendations strengthen institutional capacity. Expert workshops and training sessions have improved stakeholder engagement and collaboration, supporting best practice exchange. The pilot phase tested a key element of the strategy, an institutional coordination mechanism, to ensure feasibility before implementation.