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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.
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.
PLANAL is an experience in Paraguay where a government and its citizens work together to respond with holisticpolicies and actions to fight the main causes of food insecurity. It is a global governance strategy to improve the efficiency of State action. In this case a strong intersectoral coordination seeks to overcome the fragmented efforts and reverse the unequal distribution of resources.
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 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.
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.