Chronic diseases and health promotion

Part Four - Taking action: essential steps for success

Chapter One: Providing a unifying framework - the role of government

Planning step 3

STEP 3: Identify policy implementation steps

The third planning step is to identify the best means by which policy can be implemented. The comprehensive approach requires a range of interventions to be implemented in a stepwise manner, depending on their feasibility and likely impact in the local conditions and taking into account potential constraints and barriers to action. Some of the selected interventions are primarily under the control of the health ministry, for example realigning health systems for chronic disease prevention and control. Others are primarily the responsibility of other government sectors or the legislative branch. In these cases, the ministry of health, as the primary steward of population health, should ensure coordination in cooperation with government partners.

A key decision - whether at global, regional, national or local level - is on how, where and when to proceed with different steps of implementation. This requires a blend of evidence, experience, judgement and advocacy. The most feasible activities should be selected first. Selecting a smaller number of activities and doing them well is likely to have more impact than tackling a large number and doing them haphazardly. Countries should also try to ensure that any new activities are complementary with those already under way locally, at state or province level, and nationally.

Health policy levers:

  • Health financing
  • Legislation and regulation
  • Improving the built environment
  • Advocacy initiatives
  • Community mobilization
  • Health services organization and delivery.