HEALTH IN ALL POLICIES
It is a public health approach that takes into account in a systematic way, the implications of the decisions on health, seeking synergies, and avoiding negative impacts on health, with the goal of improving population health and health equality.
A family living in poverty and vulnerability faces the risk of nurturing its children inadequately. A wide inter-sectoral response led by Health and Education was successful in providing this children in Costa Rica with holistic care as well as nutrition and education services. Working mothers are also given the support they need to succeed. This is an example of inter-sectoral coordination in the presence of a social determinant of health.
After hosting the sub-region first Health in All Policies (HiAP) training, the government of Suriname requested support from PAHO and immediately moved towards implementation of the HiAP approach for addressing the social determinants of health. A dedicated team has worked under the leadership of the Ministry of Health on the sub-region first Quick Assessment of Social Determinants of Health to understand the underlying causes of major health problems and associated health inequities. This participatory and intersectoral process lasting six months has left Suriname organized and motivated, with 8 areas of specific action. These will make sure that the responsibility of the health of the population is not only a matter for the Ministry of health, but shared with other sectors, including eight Ministries working closely with non -governmental and community organizations, the private sector, academia and the entire civil society. The experience started in 2015.
The Intersectoral Health Commission of El Salvador is a space for horizontal dialogue where different sectors define health priorities. The sectors make recommendations and each focuses its decisions and resources to develop actions that affect the Social Determinants of Health and promote health equity.
A law that seeks a tobacco-free country, was the result of a hard negotiation process that mobilized the health sector in Suriname. From the beginning this sector knew it could not act alone . It is based on a collaborative effort with contributions from different sectors. It included lobbying with political leaders and the private sector, as well as a creating awareness and mobilizing citizens. The law was passed in 2013 with an absolute majority.
Cuba exemplifies a process of incorporating the focus of health promotion in the national system that was initiated at the time of the Revolution, and adapted to the perspective of the social determinants of health over time. It is a case of inter-sectoral work that has been institutionalized and is reflected in the Constitution, where all relevant actor, including community representatives, are summoned to collaborate on the design, implementation and monitoring of policies and programs.
In 2008 Rio de Janeiro received two important and contrasting news: it was selected as the host of the Olympic Games in 2016 and it appeared as the Brazilian city with the worst health indicators. The Municipal Government decided to link the two facts and intends to organize the Olympics where the main legacy that is left for its citizenship is a reform of Primary Health Care (APS) that benefits the development of competition as well as improving and dignifying life for the citizens of Rio. They have gone from coverage in APS of 150 thousand people in 2008, to 2.5 million people in 2012 , nearly 40 % of its target population. An example of an international sports event that was used as a motivation to produce results in Health with an equity approach.