Systematizing community-based health services for autistic individuals: a municipal model from Chile

There is a significant gap in health and social service provision for autistic children and youth in Chile, particularly regarding access to community-based care models that promote inclusion and quality of life. In response, this study presents the design and preliminary evaluation of a municipal health service model focused on autistic children and youth. This model integrates principles from the neurodiversity paradigm, the biopsychosocial model of disability, and quality of life approaches within a situated Theory of Change framework. A qualitative, participatory approach was adopted, involving document analysis, participatory observation, and interviews with professionals and families. The study focused on the implementation process, the articulation of services provided, and the preliminary outcomes observed during the first two years of operation. Data were analysed thematically to assess the model’s contributions to service access, family well-being, and community engagement. Since its inception, the Municipal Centre has delivered more than nine thousand health and support services to nearly five hundred families. The model has strengthened local support networks, promoted community awareness, and contributed to changing social imaginaries about autism. Initial findings indicate improvements in access to care, family quality of life, and coordination between health and social services. However, challenges remain regarding long-term sustainability, intersectoral collaboration, and the absence of formal public policies ensuring continuity. This study contributes to the field of community-based health services by offering a replicable, rights-based approach to addressing the needs of autistic populations. It highlights the importance of integrated, participatory, and territorial strategies in health service delivery, particularly in contexts with significant gaps in provision. Further research is needed to evaluate long-term outcomes and scalability.