Territorialization of health policies in France : using network analysis to investigate the social and health care delivery organization dedicated to vulnerable populations in Cayenne area (French Guiana)

This article studies the organization of the health and social system for vulnerable populations in the Communaute d'Agglomeration Centre Littoral (CACL) in French Guiana (Cayenne agglomeration). It is based on a survey by semi-structured interviews, conducted between 2017 and 2019 among the local actors of this territory, studied using network analysis (graph theory) by crossing different measures of centrality. The results show that the system of actors is essentially made up of public institutions but also includes national humanitarian organizations and local organizations acting for the health of vulnerable populations. Some of these institutions and organizations constitute important "crossing points" in the health and social care of vulnerable populations. Although the relationships between actors of associative and institutional status are mainly between peers, a dynamic of relational openness has been observed between actors working in different fields of activity, particularly within the perimeters of the "Politique de la Ville" (QPV). Complementarities between actors are observed, whereas outside of these areas, the actions initiated by the "outreach practices" actors' are few in number and only in a voluntary basis.