Director EPES' International Training Program and member of the educational team, EPES Foundation, Santiago, Chile.
Director of Planning and Evaluation and member of the educational team, EPES Foundation, Santiago, Chile.
Glob Public Health. 2023 Jan;18(1):2236705. doi: 10.1080/17441692.2023.2236705.
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, Educación 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.
结构胜任力被用于培训医疗专业人员,让他们了解社会、政治和经济动态是如何造成不利于人口健康的条件的。在南方国家,这种方法在历史上可以追溯到社会运动、大众教育、社会医学和人权。1982 年,在智利军政府统治下极端贫困、不平等和暴力肆虐的时期,Popular Education in Health(EduSalud)为培训社区卫生促进者制定了一个项目,以解决常见疾病问题,并分析造成健康状况不佳的根本原因。2010 年,EduSalud 开始使用相同的模式来培训国际和智利的医疗专业人员。该方法推进了四项胜任力。评估表明,培训有助于改变医疗专业人员的思维模式,促使他们质疑自己的实践。然而,教育从业者并不能改变造成健康状况不佳的根本结构。本文探讨了 EduSalud 的胜任力与结构胜任力框架之间的交集,突出了 EduSalud 对结构胜任力的两个主要贡献:一种缩小健康社会决定因素的理论分析与实施行动计划之间差距的方法;以及与社会运动的有机长期联系,加强贫困社区的集体行动,推进社会正义。