The Close Relationship between Health Actions and Peacebuilding for «Bien-Vivir» of Communities Affected by Armed Conflict in Colombia

Abstract

Background: The aim of this study is to present the design of a proposal for the implementation of the Comprehensive Health Care Routes (RIAS, by its Spanish acronym) in the municipality of Vista Hermosa (Meta, Colombia). We are trying to get a real and broad view of the health context in the municipality; identify the health assets, problems, and needs, as well as the enablers and barriers for the implementation of the RIAS; and draft a series of recommendations for the implementation of the RIAS. The fieldwork was developed with people living in the urban area of Vista Hermosa and in the rural settlement of Santo Domingo. Methods: This is a quasi-experimental with quantitative and qualitative methods developed in four phases. In the first, we identified the area and worked on the bases. In the second, we conducted community-based research to characterize the population; identify health beliefs, values, and needs, as well as enablers and barriers to accessing the health system; and evaluate the implementation of the RIAS for Health Promotion and Maintenance and the RIAS for Maternal-Perinatal Health in the municipality. In the third, we designed a methodology for implementing the RIAS, and developed six health interventions with their respective deliverables. In the fourth, we transferred the constructed knowledge to the local community, the Health Care Talent (HCT) and the government authorities in Vista Hermosa. Results: We made a diagnosis of the health of the residents of Vista Hermosa and specifically, of the study participants, based on the RIAS for Health Promotion and Maintenance, and the RIAS for Maternal-Perinatal Health. We also developed a compendium of their values and beliefs about health, grouped into five categories: health and disease processes; health, body, and territory; health care; care networks; and barriers to access. Finally, we mapped the municipality's capacity to implement the RIAS. We divided it into three categories: key actors, resources, and facilitators. Discussion: This study made important contributions in three areas: a) the communities located in the urban areas of Vista Hermosa and Santo Domingo; b) the ongoing implementation of the RIAS in Vista Hermosa; and c) the field of research on peacebuilding health interventions. Finally, we identified challenges and limitations that may affect the implementation of the RIAS, as well as some recommendations to address the latter.