Power walk Copyright(creative commons license): RLCD at http://www.rlcd.org/

Was empowerment an obstacle for your character? …a process that helps people gain and/or strengthen control of their lives …about putting power in the hands of women and men of all groups Copyright: Amir Esmann at https://www.flickr.com/photos/viennacameraman/3212346560/in/photolist-5TS7Hw-7AXLXt-2m7jUU-5WiDUx-XhXS-oft3my-9kcAj4-nY8Hez-6Lf9as-ofqyEW-ofAx1G-ofsGzE-ohq7Gv-ofAvVA-oaoMYH-bctoU6-ohpkDK-7G7n6e-o8vWyW-nY8BhJ-odAPAw-nR84uX-o8AM6k-nR8hZT-nYay8f-nR8H3H-nR7nYK-o8isUa-At4om-odSbWW-At4xD-agpd8P-AATAS-nY9Cev-nYb7ho-AAT63-nY8a2j-nY7YUp-nWxCFj-ofr1Ns-nYbcwS-ofuk2q-nWxwA4-ofEDhz-nYaYou-ofo7B4-AAUkR-AAQRH-AKEAu-7cfeC7

World Health Organization 27 April, 2017 Did gender matter? Copyright (creative commons license): Samnang Danou at https://www.flickr.com/photos/danou_info/4880930201/in/photolist-8rj3uZ-7aFEHS-cSXkY3-7ACaHB-7p55TH-5mkz86-dC2Q8j-6fyogb-7bemry-4tHQ7H-cuXSG5-7aFER3-DkyfD-9aiX5R-dwQo92-kAzNkt-68MZE3-95SFMj-68N2gS-7rkbNX-7w9Cta-4nTEEq-jADc83-kAs5oK-7ACaAv-5ahdu4-58mZCz-q5kFEd-8qVq8E-jAB5y6-bcu5DD-a1uZDA-8qt2KY-6Z8rRJ-68Cpse-6YHmyd-7oEYnw-7cgFKJ-p8rXEL-q4iWxW-4oW4PN-aptST7-7CfEzt-5Tk56P-qQFCUw-4FXeDd-jEwKWQ-aebbTY-4nPxA6-odFsnX [image modified]

Gender matters because… Biological differences are not enough to explain different disease patterns. Due to gender norms, roles and relations, there are differences between different groups of men and women in: exposure to risk factors household-level investment in nutrition, care and education access to and use of services their experiences in care settings social impact of ill-health Many differences in health can be mitigated or prevented altogether.

How did your access to or control over resources affect your ability to move forward? UHC and health equity cannot be achieved without action on social determinants of health and coherent recognition of health across other sectors. Copyright (creative commons license): : Amir Esmann at https://www.flickr.com/photos/viennacameraman/3212346560/in/photolist-5TS7Hw-7AXLXt-2m7jUU-5WiDUx-XhXS-oft3my-9kcAj4-nY8Hez-6Lf9as-ofqyEW-ofAx1G-ofsGzE-ohq7Gv-ofAvVA-oaoMYH-bctoU6-ohpkDK-7G7n6e-o8vWyW-nY8BhJ-odAPAw-nR84uX-o8AM6k-nR8hZT-nYay8f-nR8H3H-nR7nYK-o8isUa-At4om-odSbWW-At4xD-agpd8P-AATAS-nY9Cev-nYb7ho-AAT63-nY8a2j-nY7YUp-nWxCFj-ofr1Ns-nYbcwS-ofuk2q-nWxwA4-ofEDhz-nYaYou-ofo7B4-AAUkR-AAQRH-AKEAu-7cfeC7

Social determinants of health Bringing together different sectors is not easy. However, there are examples and guidance from WHO. The first concept is known as “Health in All Policies” which was the basis for discussion at the 8th Global Health Promotion Conference in Helsinki in June 2013. Countries such as Finland have emphasized and used this approach that has translated into using many legal, economic, and health strategies to reduce cardiovascular disease, for example. Action on the social and environmental determinants of NCD represents a field for urgent application of the principles of health in all policies and an opportunity for revitalising health promotion. It also represents a core part of the UHC agenda. Social determinants of health

Poverty as a social determinant The vicious circle : Ill health leads to poverty Poverty leads to ill health The virtuous circle : Good health is linked to higher income and welfare Higher income is linked to good health

Health in All Policies An approach to public policies across sectors that: systematically takes into account the health implications of decisions seeks synergies across sectors avoids harmful health impacts to improve population health and health equity Copyright: http://c8.alamy.com/comp/E08TGA/flower-hmong-people-at-the-ethnic-market-in-can-cau-lao-cai-province-E08TGA.jpg Bringing together different sectors is not easy. However, there are examples and guidance from WHO. The first concept is known as “Health in All Policies” which was the basis for discussion at the 8th Global Health Promotion Conference in Helsinki in June 2013. Countries such as Finland have emphasized and used this approach that has translated into using many legal, economic, and health strategies to reduce cardiovascular disease, for example. Action on the social and environmental determinants of NCD represents a field for urgent application of the principles of health in all policies and an opportunity for revitalising health promotion. It also represents a core part of the UHC agenda.

ROLE PLAY Copyright(creative commons license)

Role Playing – Inter-sectoral work Break into pairs Each pair takes a role play scenario (one play person 1 and other will play person 2) 5 minutes to prepare (read scenario, information related to your role only) Consider how you will approach the meeting you are about to have with your partner Each pair has 10 minutes to ‘role play’ their meeting

Role Playing – guiding questions What do you want to get out of the meeting? What do you think they will want from you? What can you offer or ask for? How will you introduce yourself? Who else could be invited to future meetings?

SDH sectoral briefings

Patterns of interaction between health and other sectors Brazil N Zealand England Sri Lanka Wales Malaysia N Ireland Quebec Scotland Sth Australia Sweden Cuba Finland Thailand Iran Norway Informative Cooperation Coordination Coherence Integration

Broad or issue-specific intersectoral action? broad strategies; integrating a systematic consideration of health into other sectors’ policy processes. issue-centred strategies; integrating a specific health concern into other sectors’ policies, e.g. Both can be used

HiAP into action: Establish the need and priorities for HiAP Assess and engage other sectors Foster common understanding between sectors Identify supportive structures and processes Enhance community participation Ensure monitoring, evaluation, reporting and accountability 1. Create a policy framework and an approach to health that are conducive to intersectoral action. 2. Emphasize shared values, interests, and objectives among partners and potential partners. 3. Ensure political support; build on positive factors in the policy environment. 4. Engage key partners at the very beginning; be inclusive. 5. Ensure appropriate horizontal linking across sectors as well as vertical linking of levels within sectors. 6. Invest in the alliance-building process by working towards consensus at the planning stage. 7. Focus on concrete objectives and visible results. 8. Ensure that leadership, accountability, and rewards are shared among partners. 9. Build stable teams of people who work well together, with appropriate support systems. 10. Develop practical models, tools, and mechanisms to support the implementation of intersectoral action. 11. Ensure public participation; educate the public and raise awareness about health determinants and intersectoral action.

Urban HEART: Urban Health Equity Matrix POLICY DOMAIN INDICATORS NEIGHBOURHOODS #1 #2 #3 #4 #5 #6 PHYSICAL ENVIRONMENT & INFRASTRUCTURE Access to safe water Access to improved sanitation SOCIAL & HUMAN DEVELOPMENT Prevalence of tobacco smoking Completion of primary education Skilled birth attendance ECONOMICS Poverty Unemployment GOVERNANCE Government spending on health Voter participation