Introduccin de tecnologias sanitarias en el SSPA

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HEALTH IN ALL POLICIES FROM THE DECLARATION TO
ACTIONS 2nd Session Matching Regional
Practices and European Policies REGIONAL
PRACTICES Health Policies in water supply for
human use in Andalusia
Health in All Policies Workshop Brussels,
November 25th 2008
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Josefa Ruiz General Secretary for Public Health
Participation Regional Ministry of
Health Government of Andalusia josefa.ruiz_at_juntad
eandalucia.es
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Jose L. Rocha General Secretary for Quality
Modernisation Regional Ministry of
Health Government of Andalusia josel.rocha_at_juntad
eandalucia.es
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• Andalusia Short view
• 87,268 sq Km.
• 8,039,399 inhabitants

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Autonomous Region since 1981
Regional Parliament
Regional Government
Regional Court of Justice
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Health in All Policies Approach (HIAP)
Development of a Governmental cross-sectoral
approach for more effective health policy But
also involvement of other partners outside the
health sector in achieving health improvements
industry, non-governmental organizations,
university, researchers, professional
associations, citizens organizations
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Multidimensional model to reduce health
inequalities (G.Kaplan)
Social and Economic Policies
Institutions
LIFE CYCLE
Community neighbourhood
Living Conditions
Social Relationships
Intervention of other policies
Individual Risk factors
genetic/constitution factors
Intervention of Healthcare Services
Physiopathology
Individual health/population
ENVIRONMENT
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Scientific basis of HIAP Approach

• The Facts
• Evidences about the
• health impact from
• The Social Gradient
• Stress
• Early life
• Social exclusion
• Work
• Unemployment
• Social support
• Addiction
• Food
• Transport

• Policy Implications
• Guidance to improve health in
• many policies
• Social
• Labour market
• Education
• Family welfare support
• Integration
• Employment
• Social participation
• Food production marketing
• Tackling addictions
• Mobility and transport
• etc

Richard Wilkinson Michael Marmot
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How to apply the HIAP Approach The experience of
Andalusia
Political position
Critical Success factors
New specific tools
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The Political Position

• Placing Public Health planning at the highest
  political level
• Situating the citizen at the center of the
  Government activities.
• Facilitating the convergence of interests,
  considering the Public Policies as a upper value.
• Developing a cross-sectoral planning sharing
  objectives, methods and resources
• Fostering Social cohesion reducing inequalities
• Establishing alliances outside the health sector
• Reinforcing the capacity of Public Health
  Authorities

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New Specific Tools

• Governance
• Instruments for Health actions
• Contract Program
• Adapting the Health Plan to the Provinces Towns
• Joint Planning, Implementation Evaluation.
• Collaborative Protocols.
• Inter-sectoral Bodies. Councils, Committees
• Participation
• Health Impact Assessment Health Outcomes
  Assessment

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Plans and directives
Local adaptation
Inter-regional Council
EU Administration
National Administration
Advocacy Combined individual and social actions
to reach political commitments, so as support for
ours health policies too
Regional Administration
Adapted Plan for Provinces
Local Administration
Territory and actors
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New Specific Tools

• Governance
• Instruments for Health actions
• Contract Program
• Adapting the Health Plan to the Provinces Towns
• Joint Planning, Implementation Evaluation.
• Collaborative Protocols.
• Inter-sectoral Bodies. Councils, Committees
• Participation
• Health Impact Assessment Health Outcomes
  Assessment

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Inter-sectoral Bodies

• Committees
• Technical Committee for the Childcare Plan
• Interdepartmental gender-based violence
  coordination Committee
• Alzheimer Plan Monitoring Committee
• Disability Plan Committee
• Early Care Coordination Committee
• Occupational Safety and Health Interdepartmental
  Committee

• Councils
• Andalusian Biodiversity Council
• Childrens Health Council
• Youth Council
• Andalusian Council for elderly people
• Andalusian Health Council
• Andalusian Water Council
• .....

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Inter-sectoral Bodies

• Executive Committee for preventing a possible
  Pandemic Influenza
• Presidency
• Vice-president, Andalusian Government
• Members Representatives from
• Regional Ministry of Home Affairs
• Regional Ministry of Environment
• Regional Ministry of Agriculture
• Regional Ministry of Health
• Secretariat
• General Secretary of Public Health

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New Specific Tools

• Governance
• Instruments for Health initiatives
• Contract Program adapting the Health Plan to the
  Provinces Towns
• Joint Planning, Implementation Evaluation.
• Collaborative Protocols.
• Inter-sectoral Bodies. Councils, Committees
• Participation
• Health Impact Assessment Health Outcomes
  Assessment

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Joint Planning, Implementation Evaluation
Assessment of pesticide contamination in damps
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Working Approach in Environmental Health
Risks associated to the state of the milieu
Water
Air
Soil
BIOME
Goods production Agriculture, Industry, Mining
Competence
Assessment Management
Prevention
European
Services Production Communica-tions, energy,
transport
National
Risk Situations
Involved Sectors
Foresight
Regional
Urbanization spaces, installations, buildings
Local
Alerts
Communication
Population
Chemical
Physical
Biological
Risk Factors
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Objectives Actions
Causes
Agriculture Industry Urban areas
Preventive Measures Quality surveillance Correctin
g measures
Diffuse pollution (nitrates, pesticides) Urban
industrial waste
Health Impact (Chemical and microbiological risks)
Pressures
Water Supply Quality Bathing Water Quality
Impact
An example Water
Environmental state
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Specific Objectives Water
1.- Achieve the suitable for consumption
qualification in 100 public supply of drinking
water. 2.- Adapt supply and sewage
infrastructures to European Directives. 3.-
Reach the adequacy to quality standards for 100
of bathing water.
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Actions Water
Preventive Measures Reduce the use of
fertilizers pesticides (Agric Min) Spread Good
Farming Practices (Agric Min) Purify urban sewage
water (Envir Min, Local Auth) Better technologies
in the industry (Industry Min) Quality
Surveillance Quality Network of surface water and
groundwater (Hid Auth) Monitoring system for
drinking water quality ( Wat Supp
Comp,PubHealth) Inspection and supply control
(PubHealth Dpt) Surveillance of bathing water
quality (PubHealth Dpt) Correcting
Measures Invest in supply and sewage improvements
(Envir, Local Auth) Improve the quality of the
management (Wat Supp Comp) Bans and use
limitations (PubHealth Dpt)
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Measures intended to the reduction of pesticides
levels in supplies
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Success Factors
GENEROSITY
Specific REGULATION
Upgrade the political level of the Public Health
RESPECT
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Spanish Constitution of 1812 (enacted in Cádiz).
Art. 13. The purpose of the Government is the
happiness of the nation, because the main
objective of all political societies is the
welfare of the individuals who compose them
Thank you!