A multisectorial approach to health

1
A multi-sectorial approach to health

• J. Jaime Miranda
• EDHUCASALUD, Peru
• IFHHRO Annual Meeting Harare, Zimbabwe
• 25 October 2007

2
Health Policy

• Walt G (1994) Health Policy. An introduction to
  process and power. London Zed Books.

3
Health Policy

• Power and process are two themes integral to
  understanding the making of health policy.
• The content of health policy and, therefore,
  ultimately, peoples health, are largely
  determined by who makes and implements policy
  decisions (those with power) and how decisions
  are made (process).

• Walt, Gill (1994) Health Policy. An introduction
  to process and power. London Zed Books.

4
What we understand by?

• Multi-sectorial
• Health
• Who are the ones involved
• Where does it happen
• Whose interest

5
What we understand by?

• Multi-sectorial
• Health
• Who are the ones involved
• Where does it happen
• Whose interest

• Health
• Education
• Sanitation
• Housing
• Finance
• Employment
• Academy
• Civil Society

6
What we understand by?

• Multi-sectorial
• Health
• Who are the ones involved
• Where does it happen
• Whose interest

• Prevention
• Curative
• Social determinants
• Right to health

7
What we understand by?

• Multi-sectorial
• Health
• Who are the ones involved
• Where does it happen
• Whose interest

• ACTORS
• Public sector
• Private sector
• PPP
• NGO
• International orgs
• Donors
• Governments
• Alliances

8
What we understand by?

• Multi-sectorial
• Health
• Who are the ones involved
• Where does it happen
• Whose interest

• CONTEXT
• Rural / urban
• Local
• Regional
• National
• International
• Global

9
What we understand by?

• Multi-sectorial
• Health
• Who are the ones involved
• Where does it happen
• Whose interest

• How decisions are made?
• PROCESS
• Health for all
• PHC Selective PHC
• Vertical Programmes
• PPP
• Global health

10
Salud para todos vs Paquetes selectivos

• Cueto M. The origins of primary health care and
  selective primary health care. Am J Public Health
  200494(11)1864-74.

11
WHO transition

• The term global health emerges as part of major
  political and historical processes where WHO
  found threatened his predominant role and start
  to reposition itself within a varied structure of
  alliances of power

• Brown TM, Cueto M, Fee E. The World Health
  Organization and the transition from
  "international" to "global" public health. Am J
  Public Health 200696(1)62-72.

12
Main actors in health funding

• Bill and Melinda Gates Foundation
• Global Fund
• Do they also influence the health agenda?

13
Multi-sectorial approach to health

• Moving away from single entity actors /
  institutions
• Needs to understand processes and actors
• Takes advantage of variety of actors
• Important to make synergistic progress