Abogacía por la salud de la población gitana: capacitación de profesionales del Distrito Sanitario Sevilla

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Abstract

Resumen Se describe la experiencia de un taller cuyo objetivo fue capacitar a profesionales para abogar por la salud de la población gitana. La abogacía por la salud es recomendada por organismos internacionales y expertos en salud pública para superar las inequidades en salud. Participaron 16 profesionales de tres centros de salud de barrios con una alta densidad de población gitana, en riesgo de exclusión social. El taller se organizó en tres sesiones dirigidas a sensibilizar, dar a conocer el marco conceptual y metodológico de la abogacía, y diseñar un plan de abogacía. Se pone de manifiesto la utilidad de este espacio de reflexión y análisis, y la necesidad de abogar por la salud de la población gitana, junto a otros agentes gitanos/as y sectores comunitarios, identificando oportunidades y utilizando los recursos comunitarios. Futuras investigaciones deben profundizar en el desarrollo de planes de abogacía intersectoriales y difundirlos, para facilitar su implementación en otros contextos de características similares.

Translated abstract

Abstract This article describes a workshop whose objective was to build Roma health advocacy capacity among a group of health professionals. Health advocacy is recommended by international organizations and public health experts to overcome the health inequities that Roma populations suffer. Sixteen professionals from three health centres located in neighbourhoods with a high Roma population participated. The workshop was organized in three sessions aimed at raising awareness, sharing an advocacy framework and methodology and designing an advocacy plan. We highlight the utility of spaces for reflection and analysis, the need to advocate for Roma health with Roma leaders and community sectors, identification of opportunities and utilization of community resources. Future research should strengthen the development of intersectoral advocacy plans, disseminate them and facilitate their implementation in other contexts with similar characteristics.

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Advocacy for Health Equity: A Synthesis Review

Linden Farrer, Claudia Marinetti, Yoline KUIPERS Cavaco … (2015)

Context Health inequalities are systematic differences in health among social groups that are caused by unequal exposure to—and distributions of—the social determinants of health (SDH). They are persistent between and within countries despite action to reduce them. Advocacy is a means of promoting policies that improve health equity, but the literature on how to do so effectively is dispersed. The aim of this review is to synthesize the evidence in the academic and gray literature and to provide a body of knowledge for advocates to draw on to inform their efforts. Methods This article is a systematic review of the academic literature and a fixed-length systematic search of the gray literature. After applying our inclusion criteria, we analyzed our findings according to our predefined dimensions of advocacy for health equity. Last, we synthesized our findings and made a critical appraisal of the literature. Findings The policy world is complex, and scientific evidence is unlikely to be conclusive in making decisions. Timely qualitative, interdisciplinary, and mixed-methods research may be valuable in advocacy efforts. The potential impact of evidence can be increased by “packaging” it as part of knowledge transfer and translation. Increased contact between researchers and policymakers could improve the uptake of research in policy processes. Researchers can play a role in advocacy efforts, although health professionals and disadvantaged people, who have direct contact with or experience of hardship, can be particularly persuasive in advocacy efforts. Different types of advocacy messages can accompany evidence, but messages should be tailored to advocacy target. Several barriers hamper advocacy efforts. The most frequently cited in the academic literature are the current political and economic zeitgeist and related public opinion, which tend to blame disadvantaged people for their ill health, even though biomedical approaches to health and political short-termism also act as barriers. These barriers could be tackled through long-term actions to raise public awareness and understanding of the SDH and through training of health professionals in advocacy. Advocates need to take advantage of “windows of opportunity,” which open and close quickly, and demonstrate expertise and credibility. Conclusions This article brings together for the first time evidence from the academic and the gray literature and provides a building block for efforts to advocate for health equity. Evidence regarding many of the dimensions is scant, and additional research is merited, particularly concerning the applicability of findings outside the English-speaking world. Advocacy organizations have a central role in advocating for health equity, given the challenges bridging the worlds of civil society, research, and policy. Policy Points: • Many barriers hamper advocacy for health equity, including the contemporary economic zeitgeist, the biomedical health perspective, and difficulties cooperating across policy sectors on the issue. • Effective advocacy should include persistent efforts to raise awareness and understanding of the social determinants of health. Education on the social determinants as part of medical training should be encouraged, including professional training within disadvantaged communities. • Advocacy organizations have a central role in advocating for health equity given the challenges bridging theworlds of civil society, research, and policy.