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Health in All Policies As Part of the Primary Health Care Agenda on Multisectoral Action

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SOCIAL DETERMINANTS OF HEALTH ACCESS TO POWER, MONEY AND RESOURCES AND THE CONDITIONS OF DAILY LIFE — THE CIRCUMSTANCES IN WHICH PEOPLE ARE BORN, GROW, LIVE, WORK, AND AGE Social Determinants of Health Discussion Paper no. 11 [energy] [investment] [community/gov.] [water] [justice] [food] [providers of services, education, etc.] [accessible & safe] [supply & safety] Health in All Policies as part of the primary health care agenda on multisectoral action ISBN 978 92 4 151502 3 WORLD HEALTH ORGANIZATION AVENUE APPIA 1211 GENEVA 27 SWITZERLAND DEBATES, POLICY & PRACTICE, CASE STUDIES WWW.WHO.INT/SOCIAL_DETERMINANTS/EN/ B HEALTH IN ALL POLICIES AS PART OF THE PRIMARY HEALTH CARE AGENDA ON MULTISECTORAL ACTION Michele Herriot and Nicole B Valentine Health in All Policies as part of the primary health care agenda on multisectoral action/ Michele Herriot, Nicole B Valentine (Discussion Paper Series on Social Determinants of Health, 11) ISBN 978-92-4-151502-3 © World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. Herriot M, Valentine NB. Health in All Policies as part of the primary health care agenda on multisectoral action. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing. Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user. General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions expected, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. The named authors alone are responsible for the views expressed in this publication. Layout by L’IV Com Sàrl, Villars-sous-Yens, Switzerland. Printed in Switzerland. Health in All Policies as part of the primary health care agenda on multisectoral action Contents ACKNOWLEDGEMENTS IV 1 INTRODUCTION 1 2 NEED TO TACKLE HEALTH DETERMINANTS AND USE HEALTH IN ALL POLICIES APPROACHES 3 3 CHANGES OVER TIME 5 Alma-Ata Declaration: conceptualizing the determinants of health and multisectoral action 5 Challenge of the Alma-Ata Declaration: primary health care 5 4 FROM INTERSECTORAL ACTION TO HEALTH IN ALL POLICIES 7 Key actors 7 Scope of the determinants of health and health priorities 7 Need for and scope of policy change 8 Health in All Policies (and One Health): an emerging practice 8 5 HEALTH IN ALL POLICIES AND THE SUSTAINABLE DEVELOPMENT GOALS 10 Need for Health in All Policies to address the Sustainable Development Goals: role of the health sector 10 Health in All Policies: a transformative approach to the Sustainable Development Goals 11 Role of primary health care and universal health coverage 12 6 IMPLEMENTING A HEALTH IN ALL POLICIES APPROACH IN COUNTRIES 14 Putting Health in All Policies into action 14 Initiating Health in All Policies 16 Implementing Health in All Policies 16 Sustaining Health in All Policies 17 7 CONCLUSION 18 REFERENCES 19 iii Acknowledgements This background document was produced under the overall direction of Nicole Valentine and Maria Neira in the department of Public Health, Environmental and Social Determinants of Health and Shannon Barkley and Ed Kelley in the department of Service Delivery and Safety, WHO headquarters, Geneva, Switzerland; and David Hipgrave, UNICEF Health Section, UNICEF, New York, USA. Luke Allen (WHO Consultant, Geneva) was the coordinating editor. The principal conceptualization and writing team consisted of Michele Herriot (WHO consultant) and Nicole B. Valentine (WHO headquarters). We also acknowledge a number of members of the UHC2030 Multisectoral Action Technical Working Group who contributed to the document; Justin Koonin (ACON), Emmanuel Odame (Ministry of Health, Ghana), Toomas Palu (The World Bank), Tricia Petruney (Pathfinder International), Carmel Williams (Government of South Australia) and Shehla Zaidi (Aga Khan University, Pakistan). The views expressed in this document do not necessarily represent the opinions of the individuals mentioned here or their affiliated institutions. This publication is also published as a background paper for the Global Conference on Primary Health Care (2018), Astana. iv Health in All Policies as part of the primary health care agenda on multisectoral action 1 Introduction orty years after the Alma-Ata Declaration participation, and as self-carers and on Primary Health Care, the Astana caregivers to others; Declaration on Primary Health Care will be released at the Global Conference on 3 Ensuring people’s main health problems FPrimary Health Care. The conference is being are addressed through comprehensive cohosted by the Government of Kazakhstan, promotive, protective, preventive, the World Health Organization (WHO) and the curative, rehabilitative and palliative care United National Children’s Fund (UNICEF), throughout the life course. Key services on the occasion of the 40th anniversary of the that are responsive to those who are most Declaration of Alma-Ata. vulnerable and marginalized aimed at the population (e.g. public health functions) The conference recommits to strengthening and personal services are the central primary health care through the Astana Declaration elements of integrated service delivery on Primary Health Care, and puts forward a across all levels of care. vision for primary health care as an approach or strategy for health in the 21st century that orients The components of the Astana Declaration are society and health systems to maximize health designed to move societies towards universal and well-being with equity. The primary health health coverage and the Sustainable Development care approach is centred on the importance of the Goals (SDGs) (2). The SDGs provide the first needs and circumstances of people, as individuals comprehensive, consensus blueprint for human and communities. People’s (primary) health care development, within which population health is (1) a term coined by the historian, Professor Anne- a precondition, an outcome and an indicator of Emanuelle Birn, comprises three interrelated and sustainable development (3). Health and the health synergistic components (see Fig. 1): sector contribute to, and are influenced by, actions taken to achieve all other goals and targets. 1 Systematically addressing social, economic, environmental and commercial This background paper discusses the importance determinants of health through evidence- of the Health in All Policies approach as part informed public policies and actions across of the Astana Declaration in pursuing universal all sectors; health coverage and the broader SDGs through addressing determinants of health. Health in All 2 Empowering people, families and Policies (HiAP), defined internationally in 2013 communities to take control of their health, (see Box 1), is a proven approach to address the as advocates for policies that promote determinants of health across many sectors by and protect health, as codevelopers developing the needed
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