Article information
Abstract
Designing and implementing equitable health policies requires the involvement of all stakeholders. However, disadvantaged groups are under-represented in European health participatory mechanisms. Migrants and ethnic minorities (MEMs), for example, are consistently left out of policy-making fora. Additionally, MEMs lack a voice on the programmes that are intended to benefit them. This can jeopardize the responsiveness of health policies to MEM needs and undermine the development of diversity sensitive care, making way for increased inequities in health. It is necessary therefore to investigate innovative strategies capable of fostering MEMs’ participation. Community psychology is particularly promising in this respect as it aims to mobilize the resources that communities possess, rather than simply teaching people to use services developed by others. Moreover, it highlights collaborative/participatory research approaches, which privilege the involvement of all stakeholders. By employing a community psychology approach, this paper looks at three European countries –the Netherlands, Norway and Spain– and summarizes lessons learnt from their experiences with migrant user involvement. The cases reported address different aspects of involvement, including: community mobilization, sociopolitical development, and creation of community alliances and coalitions. Its analysis offers several insights that can transform policy-making into a more inclusive process.
Keywords:
User involvement
Health policy
Health equity
Migration
Community psychology
Resumen
Diseñar y poner en práctica políticas sanitarias justas precisa de la participación de todos los interesados. No obstante, los grupos desfavorecidos están infrarrepresentados en los mecanismos europeos de participación sanitaria. Por ejemplo, los inmigrantes y minorías étnicas quedan sistemáticamente apartados de los foros de diseño de políticas. Además, estos grupos carecen de opinión sobre los programas pensados en su beneficio, lo cual impide una respuesta de las políticas sanitarias a sus necesidades a la par que frena el desarrollo de una asistencia que tenga en cuenta la diversidad, dando origen a mayores injusticias en sanidad. Es necesario pues investigar en estrategias innovadoras que impulsen la participación de los inmigrantes y minorías étnicas. La psicología comunitaria es especialmente prometedora al respecto ya que busca movilizar los recursos propios de las comunidades más que enseñar a la gente a utilizar los servicios desarrollados por terceros. Además, recalca los enfoques de investigación colaboradores/participativos que privilegian la implicación de los interesados. A través de un enfoque de psicología comunitaria, este trabajo contempla tres países europeos –Holanda, Noruega y España– y resume las lecciones aprendidas de su experiencia con la participación de los usuarios inmigrantes. Los casos aportados abordan diversos aspectos de la participación, como la movilización comunitaria, el desarrollo sociopolítico y la creación de alianzas y coaliciones comunitarias. El análisis ofrece algunas ideas que pueden transformar el diseño de las políticas en un proceso más integrador.
Palabras clave:
Implicación de los usuarios
Política sanitaria
Equidad sanitaria
Inmigración
Psicología comunitaria
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