Community action plays a vital role in shaping the health and well-being of individuals and populations. When communities are actively engaged in identifying their needs and driving local initiatives, the outcomes are not only more relevant but also more sustainable. Across OECD countries, we see growing recognition that health is deeply influenced by social, economic, and environmental factors – many of which lie beyond the reach of healthcare systems. Strengthening community action is therefore essential for addressing health inequalities, fostering resilience, and promoting healthier, more inclusive societies.
The concept of community action was first mentioned by the World Health Organisation (WHO) at the Alma Ata Conference in 1978 as an important part of primary health care and it gained further prominence when it was included in the Ottawa Charter for Health Promotion (WHO, 1986[1]). In line with the Charter, which notably emphasises the importance of building healthy public policies, creating supportive environments, and strengthening community action, many countries have reinforced the role of community engagement in their health promotion strategies. Over the past decade, community action gained momentum, not only propelled by initiatives led by the WHO, but also thanks to the practical guidance and advice of institutes like the National Institute for Health and Care Excellence (NICE) in the United Kingdom (NICE, 2016[2]) and the Center for Disease Control and Prevention (CDC) in the United States (Center for Disease Control and Prevention, 2011[3]). In 2020, the WHO published a guide on how to use community action to help achieve the health goals and targets of the Sustainable Development Goals (SDGs) as part of the Universal Health Care Coverage Goal of the United Nations (WHO, 2020[4]). Building on existing work on community action, Box 1 defines the key terminology used in this policy paper.
This policy paper presents a curated collection of examples from a diverse range of settings that demonstrate how communities have come together to improve health and well-being. The examples highlight the power of collaboration between residents, health professionals, public institutions, and civil society organisations, and showcase practical strategies such as strategic planning, participatory process, local networks, and monitoring and evaluation efforts. Each example offers valuable insights into what works in practice and provides inspiration for other countries seeking to promote community-driven change. While the contexts vary, all initiatives share a common foundation: meaningful community engagement, shared leadership, and a commitment to equity and inclusion.
The examples presented in this policy paper were selected based on their relevance for community action, quality of available information, and geographical variation – each highlighting different aspects relevant for community action. Five out of the six examples have been evaluated by researchers, demonstrating their positive impact on community action while highlighting possible areas for improvement. The examples are presented in the following four sections:
Building a strategy for community action. A strategy for community action helps to provide a clear, co‑ordinated framework that empowers communities while ensuring their efforts align with broader public health and social goals. Section 2 presents an example from Austria, a country that recently has successfully organised a consultation process to develop a roadmap for health promotion, which identifies and prioritises measures for more health and quality of life for all residents. The example details each step in the participatory process, demonstrating how community input was gathered, synthesised, and incorporated into action plans.
Boosting community action by central and regional governments. Most community action initiatives target local population groups and are led by local actors. However, such local focus does not prevent higher-level authorities from participating in community projects beyond merely providing funding. Section 3 includes two examples, one from the Valencian Community in Spain and one from the Canton of Zurich in Switzerland, of how central authorities establish and co‑ordinate collaboration with local authorities and support them to facilitate community action.
Creating local networks. Local networks are key for the success of community action initiatives. Section 4 presents two initiatives to demonstrate the diverse ways in which local networks can be established and the results they can achieve. The first example is an initiative by the regional government in Aragon, Spain, while the second example is led by the non-profit organisation that closely co‑operates with the central governments in France and the Netherlands.
Evaluating community action initiatives. Monitoring and evaluation protocols are crucial for assessing the effectiveness of programmes and initiatives. Strategies and action plans should include a discussion on the evaluation of proposed policies. Section 5 provides an example of a successful project in Germany, whose core design was based on situation assessment, monitoring and evaluation of the initiated activities.
For each example, the paper briefly describes the context and key elements of the initiative and extracts relevant policy lessons from the evaluations that have been undertaken, with the aim to support policy makers, practitioners, and community leaders in introducing or adapting their approaches to community action. Not only is strengthening community participation critical to the effectiveness of public health initiatives, it is also a pathway toward greater social cohesion. The examples in this policy paper can encourage and inform efforts to place communities at the heart of health and well-being strategies, ensuring that change is rooted in the lived realities and aspirations of the people it seeks to serve.
Effective community action should be based on a clear legal framework, while resources and mechanisms of intervention should be embedded in participatory governance systems at national and local levels. Taken individually, the initiatives mentioned in this paper illustrate the diverse ways in which community action can act as a catalyst in advancing the public health agenda in their respective countries. Taken together, the selected examples demonstrate a concrete pathway for promoting community action and empowerment because they are part of broader national strategies, require the involvement of multiple policy areas, and are part of participatory processes. They highlight how individuals and communities can be enabled to take greater control over their health and well-being.