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.
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 .
1998
National Commission of Health and Tourism CONSATUR
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.
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.
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.
2012
Medellin: A Healthy City for living
In 2012, Medellin set out to transform itself into a healthy city. It assessed its past, reevaluating the achievements and developments of previous administrations. It studied its present, joining efforts with the University of Antioquia, assessing the challenges and possibilities of a healthy model for the city. And the city began to build its vision by joining citizens, their organizations and the private sector. These efforts have allowed that in the recent four years the city has invested its resources and efforts to improve its surroundings where people can either gain or lose health by acting on key determinants such as the environment, employment, education, housing and poverty. Since then the Ministry of Health not only runs the programs it is responsible for, it also coordinates and supports all of the health generating structure of the city.
2012
Glasses to perceive gender roles: Play and teach Health in School
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.