Health and territory policies: discussing the Portuguese context in light of programmatic instruments and decision-makers' perspectives

Abstract

This study focuses on the role that the territory plays in health policy-making. It is argued that the territorial context enables the decision making processes concerning the improvement of health and the equity/efficiency trade-off, hence the importance of increasing collaboration between health policies and spatial planning. In reality, however, few things are known about how and in which circumstances the territory dimensions are taken into account in decision-making processes. Focused on the Portuguese case, this study debates this issue by listening to those who are or have been involved in health policy-making. A set of 23 interviews was conducted with actors who work in the health area, whose line of thought allowed the understanding of how health policies are developed and which institutional collaborations are established during the process. In addition, programmatic instruments of health policies were analysed to improve qualitative evidence about the spatial dimension of health policies. Findings show that there is still a long path ahead to integrate in a comprehensive manner the spatial dimension in health policy-making processes.