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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.
In 2013 the Chilean Ministry of Health studied the experiences developed since 1998 with the Communal Plans for Health Promotion. The careful review of the evidence gave rise to the Healthy Municipalities, Cities, and Communities strategy. New focus was put on the municipalities that are leading on the territorial participatory assessments, with strategic plans for the next three years and that are strengthening the ability of its people to understand and act on their context. This allows finding solutions to territorial problems using local resources and capabilities, strengthening intersectorial action and at the national level. The local - community - national dialogue is one of the strengths of the strategy, because the policies, actions, and decisions are not going in different directions, but are in constant dialogue with each other.
In Bolivia , a Life Point is a mobile tent located in a public place . Anyone can come and learn to prevent the risks of contracting non communicable diseases . The program began in La Paz and has spread to all nine departments of Bolivia . The initiative was started by a civic organization that has achieved to mobilize certain government sectors. The long queues in front of the tents speak of the warm reception that citizens have given to the project.
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.
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.
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.