Facilitators and challenges of community action for health. Comparative analysis of four case studies in neighbourhoods of Barcelona

In a context of welfare austerity and growing inequalities many citizens ask for public sector reforms in the health sector and for community action as a relevant practice. However, analyses of community action for health are still limited to single actions. For this reason, this article analyzes community action for health as a whole process of a public intervention in the neighbourhood context, including multiple actors and actions. Based on research on four disadvantaged districts in Barcelona, we develop and apply an analytical tool that allows to identify facilitators and challenges of community action for health on three dimensions of policy: symbolic (why), substantive (what) and operational (how). In this regard, several factors emerge as key ones: generating a shared discourse on health and its assets, developing a common and integral agenda (health promotion, prevention and treatment), ensuring institutional recognition and improving participation and involvement at all times of the different agents.