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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.
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.
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.
Since 2003, by presidential decree, Brazil created the National Commission for Implementation of the Convention for Tobacco Control (CONICQ). The Commission comprises 18 areas of government acting together; for example: Finance develops tax policy, and combats the illegal tobacco market; Justice elaborates materials on illicit drugs; Agrarian Development, carries out a national program to promote crop area diversification, among other actions. Different sectors are working together for Health in All Policies (HiAP).
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 .
In Sao Paulo , Brazil, this initiative is born to face the dismantling of policies and build an environmental management with active community participation . It empowers environmental managers who work in coordination with health promotion . They train people , help them identify needs and develop projects in areas such as tree planting, water, solid waste, healthy food, and the revitalization of public spaces, among other projects. It is an example of intersectoral strength and community participation.