Public health work you can defend in a council meeting or a licensing process.

A municipal health strategy in four phases, each with its own deliverables: the Municipal Health Profile, the strategy, support while it is put into practice, and a platform that monitors it. If you already have a strategy, you can contract the last two phases on their own.

Decreto-Lei n.º 23/2019 transferred health competences to municipalities. A strategy gives those competences a plan, with objectives the council can measure and report on. Every priority in it can be traced back to the data and the consultation behind it.

Under each phase: what you receive, then how we do the work.

Phase 1. Municipal Health Profile

Health indicators by parish, on an interactive digital platform, with its maintenance. The profile shows where the municipality starts, and where the differences between parishes lie.

How we work:

• A starting meeting. We agree the scope, a contact in each service and the calendar, and hand over a written information request, organised by topic and by the service that holds the data.
• Health and what shapes it. The profile covers population, mortality and illness, and also the determinants of health: income and deprivation, housing, environment and heat, mobility, lifestyles, and access to care. Results are read by parish, sex and age wherever the data allow.
• Groups in greater vulnerability. Groups such as people who are homeless, migrants, older people living alone and people with disabilities are each read in their own right, not only as statistics, through the teams and organisations that work with them and, where possible, the people themselves.
• Indicators you can check. Each indicator is chosen against stated criteria and has its own sheet: definition, source, year, the finest level at which it is reliable, and its limitations. Gaps in the data are listed, each with a proposed fix.

Phase 2. Strategy elaboration

Consultation with the people and organisations the strategy depends on, then the strategy itself: priority areas, axes and measurable objectives. The strategy is published digitally, and we present it in dissemination sessions.

How we work:

• Health in All Policies (HiAP). Most of what shapes health is decided outside the health department. We assess how far each municipal area takes health into account (a maturity assessment) and map the municipal policies with an impact on health, so that the strategy can give each area its share of the work.
• Participation inside and outside the council. Municipal services and companies, the local health units, parish councils, residents and associations. Groups that rarely take part are reached through mediators, and participants are told how their input was used.
• Priorities by stated criteria. Needs are scored on health impact, equity, feasibility, cost and acceptability. The weights come from the participation, and we test whether the ranking holds when they change.
• A governance model. Who coordinates, who decides, which service answers for each objective, and how a problem moves up when it cannot be solved where it starts.

Phase 3. Implementation support

Technical support and follow-up while the strategy is put into practice: an implementation guide, technical meetings and an annual progress report.

How we work:

• Action sheets. For each priority action: the need it answers, who is responsible, partners, calendar, estimated cost, possible funding sources, and indicators for delivery and for results.
• Capacity building. Training for heads of service and technical staff, shaped by the needs found in the diagnosis, with all materials handed over in editable form.
• Follow-up. Regular meetings, a look at what is holding actions back, proposed corrections, and a plan for the council to run the strategy on its own.

Phase 4. Monitoring and evaluation platform

An interactive platform on the strategy’s indicators: dashboards, alerts when an indicator moves away from its target, and automated reports. Maintained and updated.

How we work:

• Two levels. The strategy’s indicators, and the progress of each action.
• Progress against a path. Each indicator is rated against the expected path from its baseline to its target, so a slipping indicator shows up early.
• Views for each reader. A strategic view for elected members, an action view for heads of service, the full detail for technical staff, and a public view. Maps and comparisons by parish, filters by sex, age group, territory and period, and exports.
• Your platform. Built with open-source software or PowerBI, as the project needs, with a data dictionary and documentation handed over.

Phases 3 and 4 can also be contracted on their own.

Across all four phases

• One chain from data to action. A single matrix links each need to its priority, axis, objective, target, indicator and action. It reads both ways, and needs that are not taken forward are recorded with the reason.
• Evidence standards. Official sources, epidemiological methods suited to small populations, each need confirmed by data, participation and the services, and actions backed by published evidence.
• Quality and risk. Every deliverable is reviewed by someone who did not write it before it reaches you. Risks are tracked from the start, with an owner and a warning sign for each.
• Data protection. We work with aggregated, anonymised data. Interviews and focus groups run with consent, small counts are suppressed or grouped, and data protection roles are set before any personal data are handled.