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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.
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 Special Act to Regulate Tobacco in Honduras , has been active since 2011. This act regulates the production, distribution , marketing, import, consumption and advertising of tobacco. It was the result of an intense and intersectoral negotiation process to design it, promote it at the legislative level for its adoption as a policy, and subsequent coordination to familiarize citizens with it.
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.
The Zero Hunger Pact in Guatemala and its implementation in the municipality of Tajamulco, is a good example of how a national policy can be adopted and implemented locally through intersectoral cooperation. The Pact intervenes in the social determinants that generate malnutrition and inequality, improving access to food and nutrition of children in the municipalities and most vulnerable populations .
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.