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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.
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.
The law of Social Prevention of Violence and Crime was issued by the State of Chihuahua, Mexico in 2010. It is an example of intersectoral cooperation implemented at a regional level. The most important aspect of this case is that the State System of Public Safety took leadership and handles criminal situations from a public health perspective, going beyond the criminal approach.
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 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.