期刊
GLOBAL PUBLIC HEALTH
卷 18, 期 1, 页码 -出版社
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD
DOI: 10.1080/17441692.2023.2236705
关键词
Popular education; structural competency; social determinants of health; gender; community health promoters; >
Structural competency is a training approach for health professionals that addresses how social, political, and economic factors affect population health. EPES, developed in Chile during the military dictatorship, pioneered the use of this approach to train community health promoters to tackle common illnesses and analyze underlying causes of poor health. Evaluations show that the training transforms professionals' mindsets but doesn't address the underlying structural issues.
Structural competency is used to train health professionals on how social, political, and economic dynamics create conditions that negatively impact a population's health. In the Global South, this approach has historical roots in social movements, popular education, social medicine, and human rights. In 1982, during a time of extreme poverty, inequality, and violence under the Chilean military dictatorship, Educacion Popular en Salud (EPES), developed a programme for training community health promoters to address common illnesses and analyse the underlying causes of poor health. In 2010, EPES began using the same model to train international and Chilean health professionals. The approach advanced four competencies. Evaluations show that training contributes to transforming health professionals' mindsets and leads them to question their practices. However, educating practitioners does not change the underlying structures that generate poor health. This article examines the intersection between EPES' competencies and the structural competency framework, highlighting two major contributions of EPES to structural competency: a methodology that narrows the gap between a theoretical analysis of social determinants of health and implementing action plans; and organic long-term links with social movements that strengthen collective action in poor neighbourhoods to advance social justice.
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