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This experience is an example of local development and health in the communities of the Guarani in the Bolivian Chacoregion. The program approaches reality with a focus on the social determinants of health . It focuses on the coordination of national, subnational and local levels, as a strategy to improve the health of vulnerable people. The results are positive as the program manages to aid this specific population with its particular challenges and opportunities.
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.
When classes end, the children in Costa Rica go to school stores to buy food. The Ministries of Health and Education saw the daily need for food and drinks as an opportunity to promote healthy eating habits and proposed regulating which products are sold in school stores. In the midst of a national debate led by the food industry, the decree was finally passed. The importance of health was proven to be more important than the economic interests of corporations.
In Sao Paulo , Brazil, this initiative is born to face the dismantling of policies and build an environmental management with active community participation . It empowers environmental managers who work in coordination with health promotion . They train people , help them identify needs and develop projects in areas such as tree planting, water, solid waste, healthy food, and the revitalization of public spaces, among other projects. It is an example of intersectoral strength and community participation.
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.
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.