Strategic Lines of Action
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 case study from Uruguay describes the actions taken to control and reduce the prevalence of dengue in the country. This is a case of intersectoral action at the level of information sharing. While it does not meet many of the criteria to be considered a Health in All Policies approach, it is an example of a successful partnership between government institutions and the National Movement of Public and Private Health Users (NMPPHU), a nongovernmental organization that addresses public health issues.
Bolsa Familia is a Brazilian government program that originated from the legislative and executive powers. It serves families in extreme poverty by increasing their human capital and improving their development opportunities through cash transfers and by increasing access to public services and food, among other actions. It assumes an intense inter-sectoral coordination and shows good results in child nutrition, lower fertility rates, improved maternal education and a higher purchasing power.
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.
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.
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.