Gobernanza territorial para la salud en Medellín y el cuidado comunitario frente a la COVID-19

Gobernanza territorial para la salud en Medellín y el cuidado comunitario frente a la COVID-19

Introduction. There are enormous challenges for the measurement of governance due to the diversity of poorly recognized approaches among stakeholders and adjustments in health policies. Objective. To identify territorial health care governance actions managed by community leaders during the second wave of the COVID-19 pandemic for community building and resilience. Materials and methods. A questionnaire, with five dimensions and 43 questions, was applied to 139 leaders from the communes of Castilla, Belén and Guayabal. Pearson's chi-square test was used to measure differences by commune and a multiple correspondence analysis was performed to explore spatial and relational aspects. Results. Avoiding meetings (p=0.002), keeping informed (p=0.034), participating in support networks (p=0.051), carrying out information campaigns (p=0.017), encouraging activities to recover the economy (p=0.027), participation in virtual spaces (p=0.004), support to low-income families (p=0.009) and to the most vulnerable (p=0.002) were some of the actions measured, finding a differentiated management by the leaders of each commune. In the MCA, a high level of correspondence was found regarding the care and self-care actions motivated by the leader, a medium level regarding the characteristics of the environments and the actions managed by the leader and a low level in the collective actions. Conclusion. There is evidence of actions oriented towards territorial governance for health in health promotion to address COVID-19 in the community leaders of the communities studied.