In French Guiana, a significant proportion of the population is isolated from the health care system. Accessing health care is difficult and challenging for a number of reasons, including the transport network, intercultural context, and professional turnover. An experimental scheme to support and train health mediators has been set up and piloted by a consortium of community groups and hospitals, with the aim of improving access to health care for people living in the country's interior region.

Twenty mediators received three years of coaching in their professional stances and practices. Training modules, individual interviews, and focus groups were held throughout the pilot. These activities made it possible to collect qualitative data on three aspects: the training, network support, and relations with employers. These data were cross-referenced with the literature in the fields of mediation, interculturality, and public health. The aim was to assess the impact of such a scheme on the practice of health mediators.

The program has enabled mediators to gain a better understanding of their profession, acquire the skills they need to practice it, and be recognized as professionals, notably through graduation. The creation and consolidation of a network and a shared professional culture have fostered their empowerment and their ability to offer better care adapted to the needs of the population.

Establishing a regional and local presence would help to consolidate the profession. It would energize the network and the professional culture, which represent two clear assets for community health action. Finally, it would encourage the empowerment of mediators and, ultimately, of individuals and communities to act on the determinants of health.