[Strategies as a vehicle to improve coordination. SESPAS Report 2026]

Healthcare coordination is an essential element in ensuring comprehensive, equitable, and high-quality care in the National Health System (NHS). This article analyzes the role of health strategies as technical and political tools aimed at improving coordination between levels of care and territories, promoting continuity of care, and strengthening healthcare governance. It reviews their evolution in Spain since Law 16/2003 on cohesion and quality in the NHS, highlighting their dual dimension: an instrument for rational planning and an expression of political and ethical commitment. Based on an evidence-based and participatory approach, the structural components of an effective strategy are identified: definition of the object, vision and mission, scope, guiding principles, participation, evaluation, territorialization, and connection with international commitments. Relevant experiences, such as the Strategy for Addressing Chronicity, are examined, and international contributions from the World Health Organization and leading authors are incorporated. It concludes that the success of strategies depends on their ability to integrate different levels and actors, institutionalize participatory processes, and ensure the continuity and sustainability of actions. Their value lies in converting the principles of equity, justice, and rights into operational decisions that strengthen public health and the cohesion of the NHS.