Davison Munodawafa Programme Area Coordinator Determinants & Risk Factor (DRF)

1. POLICY AND STRATEGY ISSUES FOR ADDRESSING THE KEY DETERMINANTS OF HEALTH IN THE SMALL ISLAND DEVELOPING AFRICAN REGION Davison Munodawafa Programme Area Coordinator Determinants & Risk Factor (DRF) Health Promotion Cluster (HPR) WHO Regional Office for Africa, Brazzaville, CONGO. Email: munodawafad@afro.who.int

2. SITUATION ANALYSIS • The SIDS face high disease burden from multiple preventable causes; • Inequities within and between countries contribute to high morbidity and mortality among women and children; • The disparities are due to structural determinants e. g., education, urbanization, trade and governance;

3. What WHO CSDH Concluded, 2008. The societal conditions in which people are born, grow, live, work and age and the systems put in place to deal with illness produce health outcomes; Social and economic policies have a determining impact on whether a child can grow and develop to full potential and live a flourishing life or whether its life will be blighted;

4. WHY SHOULD WE SEND PEOPLE BACK TO THE VERY SAME CONDITIONS THAT MADE THEM SICK IN THE FIRST PLACE?

5. WHO CSDH overarching recommendations. • IMPROVE DAILY LIVING CONDITIONS • TACKLE THE INEQUITABLE DISTRIBUTION OF POWER, MONEY AND RESOURCES • MEASURE AND UNDERSTAND THE PROBLEM AND ASSESS THE IMPACT OF ACTION

6. The Risk Factors - SDH Continuum

7. Regional Strategy for addressing key determinants of health in the African Region

8. WHO AFRO Guiding Principles • Health equity policies – aiming to elevate those at the bottom of the socioeconomic ladder; • Equity for all – the health system should be built on the principles of fairness; • Participatory– all voices must be heard, including those of marginal and minority groups; • Partnership– engage various players to achieve policy coherence, inter-sectoral action and community, empowerment in order to reduce health equity gap; • Ownership– countries own the process and the outcomes;

9. PRIORITY INTERVENTIONSHealth and non-health sectors • Strengthening the stewardship/leadership role of the ministry of health; • Building capacity for policy development, leadership and advocacy to address the social determinants of health; • Advocating for legislation and regulations to ensure a high level of protection for the general population; • Creating health systems that are based on universal coverage and quality health care; • Enhancing fairness in health financing and resource allocation and monitor the equity gap;

10. Roles and Responsibilities Member States to reduce health inequities through action on the social determinants of health by: • Strengthening the stewardship role of the MoH to coordinate and advocate for intersectoral action for health; • Building national capacity for advocacy, evidence gathering and dissemination of informationabout SDH; • Embracing a “whole-of-government” approach in order to integrate “health equity in all policies“ across all sectors; • Establishing sustainable financing mechanisms to implement the SDH strategy; • Advocating for good governance and corporate social responsibility.

11. Rio Political Declaration • To adopt better governance for health and development • To promote participation in policy-making and implementation • To further orient the health sector towards reducing health inequities; • To strengthen global governance and collaboration • To monitor progress and increase accountability

12. Challenges and Opportunities Health Systems as a key determinant Addressing key determinants and the risk in an integrated manner (NCDs as an entry point); Intersectoral actions (HIAP, Social Participations, Good Governance, Partnership, Financing, Leadership/stewardship roles)

13. The New role for the Health Sector • Work with other arms of government to achieve their goals • Create regular intersectoral platforms for dialogue • Understand other sectors' political and administrative imperatives • Build the evidence base of policy options • Analyze health and well-being consequences of policy options during the policy development process • Evaluate the effectiveness of intersectoral work and integrated policy-making • Build capacity for ISA and HiAP and dedicated staff

14. Thank You