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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.
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.
The CONSATUR experience in the Dominican Republic was born in 1998 motivated by the need to bring together two engines of national development: Tourism and Health of its inhabitants and of those who visit. They have gradually been shifting from specific coordination actions to consolidate a space of alliance seeking a common goal: to create favorable conditions for health of people and to foster tourism as an important economic activity. It is a good example of practices previous to the HiAP initiative, since back then it was incorporating already many of its criteria.
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.
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 Pernambuco , Brazil, they have woven a strong network that involves leaders from the government, university and the community . Everyone collaborates by providing: courses, dissemination, volunteering, and specific plans to make municipalities a healthy experience. Everyone works as a network by meeting, coordinating and acting together. The goal is to develop health equity, social justice, cooperation and the preception of happiness.