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.
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.
2009
Intersectoral Health Commision (CISALUD)
The Intersectoral Health Commission of El Salvador is a space for horizontal dialogue where different sectors define health priorities. The sectors make recommendations and each focuses its decisions and resources to develop actions that affect the Social Determinants of Health and promote health equity.
2010
Social prevention of violence and crime
The law of Social Prevention of Violence and Crime was issued by the State of Chihuahua, Mexico in 2010. It is an example of intersectoral cooperation implemented at a regional level. The most important aspect of this case is that the State System of Public Safety took leadership and handles criminal situations from a public health perspective, going beyond the criminal approach.
2008
Health Program in School
This experience of Florianopolis, Brazil, shows two core development sectors acting in a coordinated manner and with oa focus on Social Determinants of Health. On the one hand, the educational sector, modifying the school curricula to longitudinally address health issues such as drug abuse, violence, culture of peace, and healthy eating, among others. And on the other hand, the health sector, training educators and school communities as health promoters.
2005
Anti-Dengue Campaign: Kill it with Thirst
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.
2006
National Plan for Good Living (PNBV)
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.