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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.
In Mexico, the numbers of overweight and obese people are increasing every year, as well as the diseases associated to these conditions . To meet this challenge, a National Agreement for Healthy Nutrition was proposed. Different sectors promote food regulation, changing the family diet and creating awareness of eating habits, and increasing physical activity. Each sector has a specific agenda that is coordinated with the rest.
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.
Ecuador established the National Plan for Good Living as a way to plan and generate actions. The Plan permeated the entire state structure, integrating Health, Education, Labor and Social Inclusion sectors , among others. It created opportunities for citizen participation, from the national to the local level with a focus on rights. The plan has its own resources and it has Presidential and legislative support. It is a clear example of intersectoral action to build sustainable development.
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 Haitian Ministry of Health spearheaded the Strategy to Promote Health and Quality of Life in the Fight against Cholera in Haiti with support from the international community. This program grew out of the destruction and health challenges caused by the 2010 earthquake that devastated the island. An example of intersectoral action at the information sharing and cooperation levels, this strategy provides education and training to promote public awareness and community participation and empowerment to control the epidemic.