SALT as a bottom-up approach - Study of Kasper Moes

[Autry Haynes]

Is SALT truly a 'bottom-up approach?

Read this study of an intern [Kasper Moes] who did a study in the health sector within Holland. The assessment of how GGD employees working with communities view CLCP/SALT. The aim was to explore whether CLCP / SALT may be beneficial additions to Dutch health promotion in order to improve public health, and whether the method is suitable.

This was done using the following research question: ‘’What are the potential arguments in favor and against implementing CLCP/SALT in a Dutch community health service context according to GGD experts?’’  The participants of the study included "[..] employees working for the division of health promotion and epidemiology are experts on both public health and working with the community."

There were five arguments in favor of and three general arguments against the hypothesis. The five arguments in favor included:

[1]  [...] provide a broader, more complete vision on community health ...];

[2] Increase ownership of citizens;

[3] [...] straight forward methodology to comprehend ...[....] implying that utilizing it would be an unhampered task in theory.

[4] CLCP/SALT is not restricted to formalities. The threshold for testing the methodology in a hands-on practical way would be low.

[5] CLCP / SALT can be related to the natural way of working of many. These employees [ working in public health and working with the community] already possessed a fundamental understanding of the CLCP/SALT principles, making it less complex for them to understand.

The negative arguments include:

[1] Difficulty in linking goals of the health programme with those that emerge during the engagement with communities.

[2] Difficultly to constantly keep all actors up to date, as well  as justify and quantify progress made by the project. CLCP is an organic process, making it unpredictable what courses of action are to be taken and what outcomes are to be measured.

[3] CLCP / SALT can take up a lot of time, making it difficult to acquire and retain involvement aligned to the different priorities of the top-down approach of the organization implementing the interventions.

The full story is Report_Kasper.pdf

What are your thoughts? Please share here (^_^)

[Autry Haynes]

Aye Luc, are you referring to number 2 of arguments against, in our number statement?

[Luc Barriere-Constantin]

WRT the negative arguments, I think they are inherent to the approach: 

1) Depending on the question asked by the facilitators, you can always focus the attention and the interest of a group or community on a specific area or theme; it's a facilitating skill. 

2) I am not sure to understand that argument: as long as an Action plan has been designed by the project (following the dream), you can perfectly follow the course of the actions within a given time-frame.

3) It is true that there is uncertainty with regard to the outputs level of a project: as we move upstream to outcomes and impact of the same project, then the SALT/CLCP expected results can be perfectly in line with the "organizational expected results". However, the purpose of the SALT/CLCP is to give voice to the groups and communities; it's for them to decide the course of the actions they want to undertake to reach a given result. It's therefore very true that it may not please organisations which intend to dictate that course of actions. It depends at which level the organisation is setting its priorities...   

[Serge Mouthuy]

Great to have a concrete assessment of pro's & con's of the SALT methodology.   The first negative argument emphasizes the needs to integrate community perceptions before setting up the goals of a program and also to train or educate all actors about health perspectives.