“Healthy Cities, Environments and Rurality” Policy: experiences in its implementation in four Colombian municipalities, 2023

Abstract

Introduction: The Colombian health promotion policy “Ciudades, Entornos y Ruralidad Saludable” (CERS), aims to contribute to improving the health conditions of populations by transforming their social determinants through intersectoral collaboration and participation. Objective: To understand the implementation of CERS in four municipalities in Colombia. Methodology: A qualitative, descriptive and cross-sectional design, through the study of multiple cases. Seventeen semi-structured interviews were carried out, transcribed, coded and categorized with representatives and leaders linked to this policy in each municipality. Results: Five categories were generated that address aspects such as the integration of CERS into territorial planning, the experiences of intersectoral collaboration, policies and multisectoral goals, the actors absent from this policy and the value that is given to them. Discussion: The implementation of CERS reflects elements related to its possibility of incorporating cross-sectorally into territorial planning instruments, the role that plays in other sectors was explicit in some cases, but not in others, as well as the meaning given to the policy. There are still sectors that need to be linked to the policy initiative. Conclusions: CERS is a policy that is implemented according to the leadership and interests of local health authorities and their capabilities to build collaborations with other sectors. Adequate territorial planning for its strengthening is fundamental, as is the understanding of the policy from health actors. It is important to continue conducting studies in other municipalities, especially in those with scarce resources and capabilities.