33

Introduction: Thinking about health at the local level by involving local stakeholders makes it possible to move beyond the traditional sectoral boundaries to build meaningful interventions. This requires creating a supportive environment for collaboration. Les Semeurs de Santé seeks to address these challenges through a cooperative methodology that includes human support, training in cooperation, and a range of health-related actions. Methodology: Based on a case study approach combining different sources of qualitative data, this study (2018–2022) aims to document 1) the rollout of the intervention; 2) the contribution of each component to the creation of collaborative dynamics; and 3) the factors that influenced its implementation. Results: In each of the municipalities involved, groups of people got together to take action on the problems they themselves had identified. Each component of the intervention played a specific role in this mobilization. Two categories of factors were identified: 1) factors related to the implementation of the intervention itself and its ability to create a supportive environment for collective action; and 2) contextual factors related to the local context and the specific features of each municipality. Conclusion: Les Semeurs de Santé challenge the conditions of engagement and power relations within health systems. This experience shows that the collective dimension and citizen participation are intrinsically linked to encountering and recognizing others. It highlights the importance of learning processes as well as the need for continued investment.