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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.
Bolsa Familia is a Brazilian government program that originated from the legislative and executive powers. It serves families in extreme poverty by increasing their human capital and improving their development opportunities through cash transfers and by increasing access to public services and food, among other actions. It assumes an intense inter-sectoral coordination and shows good results in child nutrition, lower fertility rates, improved maternal education and a higher purchasing power.
The case study from Uruguay describes the actions taken to control and reduce the prevalence of dengue in the country. This is a case of intersectoral action at the level of information sharing. While it does not meet many of the criteria to be considered a Health in All Policies approach, it is an example of a successful partnership between government institutions and the National Movement of Public and Private Health Users (NMPPHU), a nongovernmental organization that addresses public health issues.
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).
A joint-effort between those responsible for preventing sexual and domestic violence and those caring for their victims was key for the work done in Campinas, in the state of Sao Paulo, Brazil . The coordination was made possible when domestic violence was considered a public health issue, not only a concern for the police force. Today the care for victims is quick and protective; education on this topic increases awareness by teaching people how to identify cases of violence, and to aid in the prevention and reporting of cases when they occur.
In 2012, Medellin set out to transform itself into a healthy city. It assessed its past, reevaluating the achievements and developments of previous administrations. It studied its present, joining efforts with the University of Antioquia, assessing the challenges and possibilities of a healthy model for the city. And the city began to build its vision by joining citizens, their organizations and the private sector. These efforts have allowed that in the recent four years the city has invested its resources and efforts to improve its surroundings where people can either gain or lose health by acting on key determinants such as the environment, employment, education, housing and poverty. Since then the Ministry of Health not only runs the programs it is responsible for, it also coordinates and supports all of the health generating structure of the city.