Route of the Americas
When PAHO’s Directing Council approved the first Regional Plan of Action in the world for Health in All Policies in September 2014, it took the lead in implementing an innovative and ambitious approach to the formulation of public policies. HiAP was first defined in the Adelaide Declaration of 2010 and then in the global framework for action by the countries in the Helsinki declaration. The prompt action of the Organization reveals the promise of this new approach to health promotion and the broad support of its goals and objectives.
At the same time, the HIAP incorporates many elements of health promotion and the formulation of health policies that have been developed and debated for decades. It is based on the widespread view of health and well-being defined by Alma Ata (1978) and addressing the public health policies established in the Ottawa Charter (1986). It also recognizes the important contributions of the movement in addressing the social determinants of health and health equities identified by the WHO Commission on the Social Determinants of Health (2008).
In the context of the 8th Global Conference on Health Promotion, Health in All Policies is defined as "an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts, in order to improve population health and health equity”. In the framework for country action, PAHO’s Action Plan on HiAP was based on six strategic areas identified in the Declaration of Helsinki as well as on elements from the Rio Political Declaration on Social Determinants of Health and the Rio + 20 Conference on Sustainable Development, which required dynamic approaches to policymakingacross sectors to address growing inequities, particularly in the area of health.
Due to its importance, a strategy to move the Plan of Action on HIAP into effective results was put into action. Given its innovative nature, expert guidance was sought and experiences have been studied both in the Region of the Americas and elsewhere. With these objectives in mind, the Special Program on Sustainable Development and Health Equity organized an Expert Consultation on HiAP in Washington, DC, from March 31 to April 1, 2015. This meeting provided an opportunity to gather world leaders in the field as well as experts from academia and politics of the Americas and other countries with relevant experience in HiAP, such as Finland and Australia. The purpose of this meeting was to translate the Plan of Action on HIAP into a roadmap, identifying concrete actions that would be crucial for the Region to implement HiAP.
2009
Faces, Voices and Places in the Bolivian Chaco
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.
2012
The Zero Hunger Pact and its Implementation in Tajumulco
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 .
2013
Healthy Municipalities, Cities, and Communities strategy
In 2013 the Chilean Ministry of Health studied the experiences developed since 1998 with the Communal Plans for Health Promotion. The careful review of the evidence gave rise to the Healthy Municipalities, Cities, and Communities strategy. New focus was put on the municipalities that are leading on the territorial participatory assessments, with strategic plans for the next three years and that are strengthening the ability of its people to understand and act on their context. This allows finding solutions to territorial problems using local resources and capabilities, strengthening intersectorial action and at the national level. The local - community - national dialogue is one of the strengths of the strategy, because the policies, actions, and decisions are not going in different directions, but are in constant dialogue with each other.
2005
Green and Healthy Environments Program in Sao Paulo (PAVS)
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.
2011
Special Act to Regulate Tobacco
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.
2010
Cencinai: Education Centers, Nutrition and Holistic Care
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.