Integrated Health and Social Practices at the Municipal Level: The Case of Vila Pouca de Aguiar

Background: The decentralization policy in Portugal has enabled municipalities to address public health and social challenges more effectively. Vila Pouca de Aguiar embraced this opportunity to tackle issues such as population aging, social isolation, child protection, health resources inequality and rural depopulation. By integrating health, social and environmental policies, the municipality has fostered resilience, ensured more equitable access to services, people settlement and quality of life.

Approach: Vila Pouca de Aguiar adopted a collaborative model involving local government, health units, public health authorities, social organizations, and residents. Key initiatives include:

Health Services Enhancement

• SNS24 Desks and MyCHTMAD kiosks to improve telemedicine access and support R&D projects.
• Automated external defibrillators installed in public places and community training.
• A Convalescence Unit, in partnership with ULS-TMAD, ensuring continuity of care.
• Health promotion programs
• Equine therapy and hydrotherapy
• Addictions and oncology support initiatives

Health Literacy and Innovation

• The Social Prescription program, in partnership with ENSP, local pharmacies and health units, addresses social determinants of health by linking individuals to community resources.
• Health awareness campaigns with partners, the National Coordination of Mental Health Policies and the Directorate-General of Health

Sustainability and Health Innovation

• Electric vehicles for healthcare services
• Adherence to CPSA.

 

 

 

Domestic Violence Intervention

• Participation and implementation of local Integrated Domestic Violence Network, ensuring coordinated and psychological assistance for victims.

Social Protection and Inclusion

• SAAS and RSI responsibilities, enhancing social support delivery.
• Social Radar Project, (identifies and monitors vulnerable individuals for timely intervention).
• 5th Generation Local Social Development Contract
• “Inclusion Desk” (facilitates service access for people with disabilities).
• Expansion of the Local Council for Social Action partnership network, including organizations like ACAPO, enhancing social support and patient representation.

Child Protection and Advocacy

• The Child Advocacy and Protection Unit protects children’s rights and supports at-risk families.
• Specialists such as speech therapists were hired to improve educational outcomes.

Elderly Protection and Active Aging

• The Municipal Senior Commission focuses on health education, cognitive stimulation, elder abuse prevention, and sociocultural activities.
• Physical activity programs, including home-based initiatives, enhancing mobility.
• Home-visiting programs and teleassistence
• Caregiver support programs and substitutes providing relief for families.

Housing Policy and Volunteer Programs

• Housing policy and volunteer initiatives (Just a Change) to improve housing conditions and accessibility, ensuring dignity and health for residents.

Community Engagement and Social Literacy

• Intercultural mediation projects promoting inclusivity for Roma and migrant communities, fostering cohesion.

Strategic Planning and Networking

• Approval of the municipal Social Charter and participation in the WHO Healthy Cities Project reinforce long-term planning and community development.

Results: These initiatives have improved healthcare access, strengthened social protection, promoted active aging, safeguarded children’s rights, and fostered inclusivity. The municipality has also advanced housing conditions, environmental sustainability, and intergenerational connections.

Implications: Vila Pouca de Aguiar exemplifies how decentralization can address health and social challenges through collaboration and innovation. Future plans include expanding initiatives, deepening child and elderly protection, and further integrating health and social strategies.