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.
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.
The Haitian Ministry of Health spearheaded the Strategy to Promote Health and Quality of Life in the Fight against Cholera in Haiti with support from the international community. This program grew out of the destruction and health challenges caused by the 2010 earthquake that devastated the island. An example of intersectoral action at the information sharing and cooperation levels, this strategy provides education and training to promote public awareness and community participation and empowerment to control the epidemic.
PLANAL is an experience in Paraguay where a government and its citizens work together to respond with holisticpolicies and actions to fight the main causes of food insecurity. It is a global governance strategy to improve the efficiency of State action. In this case a strong intersectoral coordination seeks to overcome the fragmented efforts and reverse the unequal distribution of resources.
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.
The experience of Boca de Mao in the Dominican Republic is a local example that shows how the Health In All Policies (HiAP) approach may be present at a smaller scale. It showcases the level of coordination between a strong community organization that presents and manages its demands, and a holistic and coordinated response from various government sectors. The experience focuses its efforts on raising awareness through education and moving towards concrete actions on issues that concern the environment, food safety, health monitoring and nutrition.