[Towards good governance for health: incorporating the diversity of perceptions around urban health]

Abstract

Objective: To analyse the similarities and differences in the discourse surrounding the conceptualisation of health and the perceived health assets and needs in the neighborhoods and city of Bilbao in a participatory process.

Method: Participatory workshops were held with professionals, neighbors and associated citizens. The differences in perceptions of the three content blocks were analysed on the basis of the health model referred, as well as the typologies -of a more individual or structural nature- of identified health needs and assets.

Results: The conceptualisation of health from a biopsychosocial perspective was clearer among professionals, although both profiles pointed to the importance of its social determinants. The formulation of needs and assets in health by the neighbors was made from the impact on their daily life and from a position of users with respect to a service provider administration. Among the associated citizens and professionals, intermediate and structural determinants were more frequently mentioned, as well as issues related to the administration's scope of action.

Conclusions: The inclusion of the multiplicity and diversity of perceptions in planning is key to good local government for health. To address their contradictions, a commitment by governments to effectively incorporate citizen participation is needed.

Keywords: Diagnóstico de salud; Gobernanza; Governance; Health diagnosis; Percepciones; Perceptions; Salud urbana; Urban health.