Community Action to Strengthen Health Equity in the Spanish Basque Country

The Basque Country has a rich tradition of community action, with many initiatives taking place across regions and involving a wide range of actors. Local and institutional networks provide important opportunities for collaboration, but efforts remain fragmented and unequal across different provinces and municipalities, as there is no overarching structure to coordinate activities at the Basque level. Limited public funding and staffing constrain the reach of community action, while approaches to monitoring and evaluation vary greatly between sectors. This report examines how community action is evolving in the Basque Country, focusing on health equity. It reviews the role of the Department of Health, maps ongoing participatory initiatives at the local level, and highlights strengths as well as gaps in current practices. The report also outlines recommendations for a strategy to strengthen community engagement, ensuring that community-led efforts are better supported and more sustainable. Strengthening these processes can help advance equity, improve well-being, and make health systems more responsive to the people they serve.