Social determinants of health

Supporting policy implementation

Translating knowledge to support policy-makers

"This is not just another health program – it is a fundamental re-think of the values and goals of health and other sectors and the way they work together to achieve society’s aspirations. It adds a strategic dimension to existing programs and policies – a strategy that focuses on equity as an outcome, and looks at a broad range of societal actors, both inside and outside of the health sector, in achieving it."

---- Don Matheson, Chair of WHO Expert Resource Group on Implementation, June 2008

The framework shown below was proposed at the Department of Ethics, Equity, Trade and Human Rights (ETH) June consultation held to discuss implementation challenges being faced by countries trying to improve health equity through tackling health determinants (see link below). It is based on learning from the Commission's country work stream (see link below). The framework identifies two starting points at the country level for institutional change and two areas of technical competency:

  • institutional change can start within the health sector by making adjustments to the design of the health sector or to public health programmes;
  • change can also be initiated through engaging players from other ministries, with the role of the ministry of health varying from advocacy to leadership.

The ETH policy implementation stream has used the framework to organize its technical work around two starting points for institutional change (within the sector versus across sectors) and two technical areas of competency (intersectoral action, and social participation).

Framework for supporting social determinants of health and health equity policy implementation

SDHE framework diagram

Based on the rationale that supports the framework described, WHO will support policy implementation through:

1. Creating a resource group of experts

2. Building on the WHO-PHAC Collaboration to enhance the work on Intersectoral Action

2. Building on the WHO-PHAC Collaboration to enhance the work on Intersectoral Action

3. Supporting "pathfinder countries" across the regions

Encouraging the development of implementation models, the application of tools, and the sharing of country experiences related to:

  • SDHE in health systems and programs (e.g. "Integrating social determinants of health and health equity into national health programmes"), building on the work of the PPHC knowledge network (see below);
  • SDHE across sectors, building on strategies such as Health in All Policies strategies - HiAP), related mechanisms (e.g. e.g. accountability frameworks, building capacity) and tools (e.g. equity lenses, audits, health impact assessment).