Taking action across sectors—such as health, education, and social protection—is critical to assuring conditions for health and well-being for all. Consistent with the action plan, this may involve implementing or advocating for programs and policies in different sectors relevant to addressing priority issues.
Key Questions to Consider
- What will success for intersectoral action look like (e.g., sectors involved, conditions that will change, improved outcomes)?
- What strategies and evidence/practice-based interventions (e.g., changes in programs, policies, and practices) will be implemented—through which sectors and settings?
- Have we identified and prepared the workforce to implement priority strategies?
- How do we need to adapt the intervention (and plan) so that they fit the context and realities of the situation?
- What available resources and assets will support implementation, including the knowledge and experience of those most affected?
- How will we deliver the intervention so that it achieves results and reaches those who most need to benefit?
- Do we have the conditions necessary for success of the action/intervention (e.g., time, money, people, leadership, technical assistance, monitoring)?
Some Recommended Actions
- Identify what “success” for the intersectoral action or intervention would look like. Include:
- Description of what success would look like. How will conditions for the municipality or community be different—including for those most affected—if the intervention is successful?
- Specific objectives the intervention will achieve. What (conditions, behaviors, outcomes) will change, by how much, and by when? What inequities between groups (and places) will be reduced?
- Create and use the political will to take the actions needed to meet the mission and objectives.
- Assess promising strategies and interventions for their potential in addressing priority issues and attention equity, inclusion, and human rights.
- Specify the core components and elements of the intervention based on the analysis, and participating partners from different sectors. Be specific about elements to be included for each of these potential components.
- Providing information and enhancing skills (e.g., public announcements, skill training—through health and education sectors)
- Modifying access, barriers, and opportunities (e.g., improved access to health and basic services—through health and transport sectors, non-governmental organizations)
- Enhancing services and supports (e.g., strengthening preparedness and response for emergencies, disasters, and epidemics)
- Changing the consequences (e.g., increasing incentives for desired behavior—through health and social protection sectors)
- Modifying policies and broader systems (e.g., public policies, practices in the finance or housing sectors)
- Identify resources and assets in particular sectors (e.g., health, education, finance) to be used in the activities or intervention (e.g., people, financial resources, knowledge and skills, technologies, networks).
- Indicate how you will deliver the intervention so that it achieves results and reaches those who most need to benefit (e.g., involve key sectors, trusted networks, and non-governmental organizations in delivery).
- Provide technical support to implement and adapt the strategies (intervention) to fit the needs, context, and realities of the community (e.g., differences in resources, values, interests, experiences, competence, language, power).
- Build leadership and strengthen the workforce for collaborative action, including among those experiencing vulnerable situations.
Examples of Taking Action
The Zero Hunger Pact
The Zero Hunger Pact was created in 2012 by Guatemalan President Otto Perez Molina as part of his “National Agenda for Change”. The program was designed to reduce malnutrition, provide education, and create better opportunities for families, especially those living in poverty.
The Pact’s programs and policies placed equity at the core and benefited from political commitment from the highest level of government. It galvanized action from a broad, multi-sectoral group including the Guatemalan government, the Scaling Up Nutrition (SUN) Movement, World Food Programme, World Vision International, the Inter-American Development Bank, and other UN and civil society organizations. In just 12 months after its creation, the Zero Hunger Plan achieved positive results in 166 municipalities, particularly for children under five.
In one locality, the municipal government of Tajumulco formally adopted the healthy municipalities strategy. It designed and implemented a local health plan to address social determinants of health in alignment with the Zero Hunger Pact. Tajumulco set up a Municipal Commission on Health, Food Security and Nutrition (COMUSSAN) to coordinate implementation of the Zero Hunger Pact. The City Council, represented by the council member for health, chaired the Commission and provided legal backing for its activities.
The implementation of the Zero Hunger Pact in the municipality of Tajamulco is a good example of how a national policy can be adopted and implemented locally through cooperation among different sectors.
- Pan American Health Organization. Health in All Policies: Summary of experiences from the Americas. The 8th Global Conference on Health Promotion; 2013 Jun 10-14; Helsinki (Finland). Washington, DC: PAHO; 2013
- Pan American Health Organization (PAHO). Health in All Policies in the Americas: The Zero Hunger Pact and its Implementation in Tajumulco [Internet]; 2016. Available from:http://saludentodaslaspoliticas.org/en/experiencia-amp.php?id=3
Red Intersectorial Guarulhos Ciudad que Protege (Taking Action to Protect Children)
The “Red Intersectorial Guarulhos Ciudad que Protégé” (RIGCP) was created in 2010 to strengthen action to defend and promote the rights of children and adolescents and to prevent violence in Guarulhos. The project used a comprehensive and systematic approach to increase problem-solving capacities in the implementation of public policies of the Municipality of Guarulhos. The initiative was launched in schools. Partners included the Municipal Secretariats of education, health and social assistance; the Municipal Council for the Rights of Children and Adolescents; the Violence Prevention Committee; the Coordinator of the Woman; and the Secretariat of Public Security.
The RIGCP’s objectives were to improve the flow of services for cases of violence against children and adolescents, strengthen the Network for the Protection of Children and Adolescents’ Human Rights, and implement Municipal decrees protecting children and adolescents in public policies and educational curricula. Related actions included:
- Capacity-building and joint dialogue on how to increase the flow and improve the effectiveness of problem-solving actions in cases of violence
- Producing materials and documents to guide actions from different areas of public policy
- Implementing violence-themed awareness campaigns and seminars, and developing specific violence prevention projects in the territories
An intersectoral managing committee within the Municipality was put in place in 2015 to help sustain the effort, even when policies change.
- Secretaria Municipal da Educação de Guarulhos. 2016. A Trajetoria de Articulação da Rede Intersetorial ´Guarulhos Cidade que Protege´ no Enfrentamento às Violencias contra Crianças e Adolescentes.
- Grupo Gestor Intersetorial. 2012. Carta de Principios da Rede Intersetorial ´Guarulhos Cidade que Protege.
Movilidad Sustentable (Taking Action for Sustainable Transportation)
CIUDAD DE MEXICO, MEXICO
The Estrategia de Movilidad en Bicicleta / Bicycle Transportation Strategy (EMB) was established in Mexico D.F’s Secretariat of Environment in 2009. It promoted bicycling as a sustainable means of transportation. Key activities included creating networks of bicycle lanes, integrating biking in the networks of public transportation, rendering bicycles accessible to people, and promoting a culture of bicycle use.
Implementation featured four main projects: (1) Muevete en Bici (Move on a Bike), an initiative where the local government closed some of the main avenues to encourage locals to use the roads on bicycle; (2) BiciEscuela (BikeSchool), a capacity-building program on road safety to teach about the rights and responsibilities of those using bicycle lanes, with tailored iterations for working-age adults (18-45 years old), students, and public servants; (3) ECOBICI, a bike-sharing program for locals to borrow a bike from a station and drop it off at another station; and (4) Equipment and infrastructure, to increase and improve the uni-directional bike lanes, exclusive lanes for buses and bicycles, and areas of slow traffic as well as make available enough bicycle parking spaces as possible.
This strategy reflects a city model of common good that promotes harmonious living in the city, recuperating public spaces, and improving people’s health.
- Ciudad de México, Secretaría del Medio Ambiente.Movilidad Sustentable [Internet]; 2017. Available from: http://www.sedema.cdmx.gob.mx/programas/programa/movilidad-sustentable
- Gobierno del Distrito Federal Secretaría del Medio Ambiente. Estrategia de Movilidad en Bicicleta: Estrategia de Movilidad en Bicicleta en la Ciudad de México. Available from:http://data.sedema.cdmx.gob.mx/sedema/images/archivos/movilidad-sustentable/movilidad-en-bicicleta/emb/estrategia-movilidad.pdf
- Gobierno del Distrito Federal Secretaría del Medio Ambiente. Visión integral: Estrategia de Movilidad en Bicicleta en la Ciudad de México. Available from:http://www.sedema.cdmx.gob.mx/storage/app/media/programas/movilidad-sustentable/movilidad-bicicleta/vision-integral.pdf
Some Resources to Help You Take Action
Tools from the Community Tool Box
- Toolkit: Developing an Intervention
- Toolkit: Advocating for Change
- Toolkit: Building Leadership
- Toolkit: Enhancing Cultural Competence
- Toolkit: Influencing Policy Development
- Chapter 30: Principles of Advocacy
- Chapter 19: Choosing and Adapting Community Interventions
- Chapter 27: Cultural Competence in a Multicultural World
- Chapter 33: Conducting a Direct Action Campaign
- Chapter 35: Responding to Counterattack
- Chapter 17, Section 5: Addressing Social Determinants of Health and Development
- Troubleshooting Guide: There is not enough action to promote change
- Troubleshooting Guide: We are facing opposition or conflict
- Troubleshooting Guide: We need to assure better conditions for implementation
Resources from the World Health Organization/Pan American Health Organization
- A conceptual framework for action on the social determinants of health
- Implementation Tools: Package of Essential Non-communicable (PEN) disease interventions for primary health care in low-resource settings
- WHO Humanitarian response plans 2015