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Elisabeth Jansson NHPRC2013
 

Elisabeth Jansson NHPRC2013

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Municipalities’ setting approaches in local health promotion – A Swedish case study

Municipalities’ setting approaches in local health promotion – A Swedish case study

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    Elisabeth Jansson NHPRC2013 Elisabeth Jansson NHPRC2013 Presentation Transcript

    • Municipalities’ setting approaches in local health promotion – A Swedish case study Vestfold, June 19th , 2013 Elisabeth Jansson, PhD student Co-authors: Elisabeth Fosse, Per Tillgren
    • Study background The results of this study are secondary findings from the doctoral studies I conduct at Mälardalen University in Västerås, Sweden *Jansson, Tillgren (2010) **Jansson, Fosse, Tillgren (2011)
    • Objectives E Fagersta Strängnäs Sala Oxelösund 4 municipalities’ setting approaches in their local health promotion
    • Methods A multiple case study Content analysis Key person interviews – politicians, executives & officials Documents – annual reports, policies & plans etc. Data collected in 2006 & 2012 E
    • Analysing procedure in 2006 & 2012 1 Single Case D Sala Single Case C Fagersta Single Case B Oxelösund Single Case A Strängnäs Cross-case analysis A, B, C, D5 432
    • Results Public health policies Target groups Settings ●Alcohol, tobacco & Children & youths School drug prevention 4/4 Adults Health care Municipality employed Workplace ●Rehabilitation 3/4 Municipality employed Workplace Primary health care centre ●Equality 4/4 Municipality employed Workplace ●Public health 1/4Whole society School Workplace Library Primary health care centre New venues
    • Results Strategies ●Schools & workplaces are mainly used as location for ad hoc health promotion interventions & programs ●Family centres are the settings where intersectoral collaboration, multiple strategies & a holistic view of health were common (3/4) Advantages ●Entrance & access channel for vulnerable groups ●Enables easier communication between municipal organization & population
    • Results “The municipality’s power source, that's really the three F's [forces], associations & churches & businesses. From organizing a health week per year to more of this everyday, in general. Then these venues, as I can see as an extremely important public health issue, whether they play bridge or read the hymn book, or whatever they do.” (C-Politician)
    • Results ”The library has been this kind of activity location. Where we held a health day e.g. with the theme heart. We have done it together with the pharmacy & primary health care centre. [… ] We have turned us into the public & the program consisted of activities & you can try out & you can get information.” (A-Executive)
    • Results The municipalities doesn’t explicitly express health promotion or settings as an objective or strategy Politicians saw intersectoral collaboration as a strategy to improve the municipality public health in different settings Executives & officials expressed both opportunities & obstacles in intersectoral collaboration in setting based local interventions The municipality organizational structure in horizontal or vertical management affected setting approaches more than political governance profile
    • Conclusions The setting approach is consistent with the municipalities’ views & possibilities to handle complex public health issues Locally prioritized health issues based on local needs & prerequisites are preferably performed in traditional settings The development & sustainability is seen as possible & achievable by intersectoral collaborations with engaged & committed actors in established settings Challenges in the municipalities’ setting approaches are related to factors like sectorial pipe-line organizations & e.g. confidentiality regulations in collaborations between the municipality & health care sector
    • Finally, a quot on the road… “I believe very strongly in this structural stuff when it comes to children & youths. I mean you look, yes I can keep long lectures, but ... then, what saves many children, it's the school, the school is one of the biggest health factors.” (A-Official)
    • Thank you! Elisabeth Jansson Mälardalen University School of Health, Care and Social Welfare Västerås, Sweden elisabeth.jansson@mdh.se Västerås Stockholm
    • References Jansson, Fosse & Tillgren (2011) National public health policy in a local context: implementation in two Swedish municipalities. Health Policy 103(2-3):219-27 Jansson & Tillgren (2010) Health promotion at local level: a case study of content, organization and development in four Swedish municipalities. BMC Public Health 3;10:455