Social Prescribing in the Portuguese Context: Challenges and Strategies to Implement and Evaluate a Complex Intervention

Addressing the population’s ageing and the increased burden of non-communicable diseases, while tackling social determinants of health, have been major challenges for health services worldwide. Social Prescribing (SP) is an innovative approach of integrated care to respond to these challenges. This chapter presents the experience of implementing and evaluating SP in Portugal. After a brief contextualization of the national health system, an overview of the SP intervention in the Portuguese context is provided. The SP started in a Family Health Unit in Lisbon, with a local bottom-up pilot project. Since then, interest in SP has been growing at local authority and policy levels, with SP interventions being implemented in different regions of the country. The implementation of the SP pilot was assisted from the beginning by a monitoring and evaluation academic team. This chapter explores barriers and facilitators in implementing SP as identified by stakeholders and discusses key challenges in evaluating the project. A participatory mixed-methods evaluation study is being conducted to obtain insights on SP implementation and assess its impact at patients, health system, and health–social sector intersection levels. This experience can contribute to national and international knowledge on SP implementation and evaluation to inform evidence-based practice and policy.