Strategic Lines of Action
In 2008 Rio de Janeiro received two important and contrasting news: it was selected as the host of the Olympic Games in 2016 and it appeared as the Brazilian city with the worst health indicators. The Municipal Government decided to link the two facts and intends to organize the Olympics where the main legacy that is left for its citizenship is a reform of Primary Health Care (APS) that benefits the development of competition as well as improving and dignifying life for the citizens of Rio. They have gone from coverage in APS of 150 thousand people in 2008, to 2.5 million people in 2012 , nearly 40 % of its target population. An example of an international sports event that was used as a motivation to produce results in Health with an equity approach.
The experience of Boca de Mao in the Dominican Republic is a local example that shows how the Health In All Policies (HiAP) approach may be present at a smaller scale. It showcases the level of coordination between a strong community organization that presents and manages its demands, and a holistic and coordinated response from various government sectors. The experience focuses its efforts on raising awareness through education and moving towards concrete actions on issues that concern the environment, food safety, health monitoring and nutrition.
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.
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.
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.
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.