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.
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.
Since 2003, by presidential decree, Brazil created the National Commission for Implementation of the Convention for Tobacco Control (CONICQ). The Commission comprises 18 areas of government acting together; for example: Finance develops tax policy, and combats the illegal tobacco market; Justice elaborates materials on illicit drugs; Agrarian Development, carries out a national program to promote crop area diversification, among other actions. Different sectors are working together for Health in All Policies (HiAP).
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 some schools in Havana, there are boys and girls who have classes that do not seem like classes, because there is no one dictating things but the narrative comes from the children experiencing and starring in them. In their classrooms children learn to use the" gender glasses" which help them to understand how they learn to be men or women, to play these roles, and how they can decide what to keep, discard or transform from that social inheritance. This program was initiated at the National School of Public Health in Cuba, which involves different disciplines and sectors, and includes faculty and families. This is the story of an action research project focusing on the Social Determinants of Health.
In Pernambuco , Brazil, they have woven a strong network that involves leaders from the government, university and the community . Everyone collaborates by providing: courses, dissemination, volunteering, and specific plans to make municipalities a healthy experience. Everyone works as a network by meeting, coordinating and acting together. The goal is to develop health equity, social justice, cooperation and the preception of happiness.
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.