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Ukraine

Making every school a health-promoting school: global standards and indicators

Credits

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Outcome

Supportive and empowering societies through addressing health risk factors

[COUNTRY STORY]

Multisectoral approach to NCDs from the management model of healthy cities, environments and ruralities

Colombia

Photo: PAHO/WHO Country Office Community of the healthy garden project from the CERSS model (Popayán, Colombia).

Multisectoral approach to NCDs from social determinants

Noncommunicable diseases (NCDs) are growing public health problem globally, accounting for 76% of premature mortality in Colombia and 80% in the Region of the Americas [1–4]. Cardiovascular diseases (CVD) are the main cause of mortality and morbidity, generating negative social and economic impacts [5]. Economic and social inequalities exacerbate risk factors for people in vulnerable conditions, leading to a higher prevalence of these diseases [6,7]. In addressing NCDs, it is essential to strengthen and promote the implementation of multisectoral actions that contribute to the promotion of environments and conditions that favour the health of the population. Through Pan American Health Organization/World Health Organization (PAHO/WHO) cooperation, the management capacities of health teams were strengthened, strategic planning actions were developed, and tools were implemented to reduce risk factors and improve the approach to NCDs at the multisectoral level in prioritized territories.

Key WHO Contributions

Conceptualization of the NCD approach with a focus on determinants and equity
Delivery of training programmes to local officials and leaders
Functional network of communicators working in NCDs and their risk factors
Development of innovative strategic and operational lines for NCDs and their risk factors, based on evidence and aligned with the SDGs.

How did Colombia, with the support of the PAHO/WHO Secretariat, achieve this?

PAHO/WHO Colombia played an instrumental role in the development and implementation of Colombia's Ten-Year Public Health Plan (PDSP, 2022-2031), which prioritized noncommunicable diseases (NCDs) and established operational lines to address social determinants of health and achieve Sustainable Development Goals [8]. The PDSP from 2022 to 2031, incorporated globally recognized strategies such as the comprehensive care model for chronic conditions and the social determinants of health with the CERSS model [9]. PAHO/WHO Colombia also provided technical expertise to develop the "strategic and operational plan for addressing chronic noncommunicable diseases 2020-2030" in Bogota and guidelines and tools for its implementation. This established strategic orientations and criteria for action, both for sectors beyond health such as education, environment, and economic development, as well as for the operational levels of the health sector. In addition, PAHO/WHO Colombia collaborated with the local government to implement NCD plans in local policy, such as in Bogotá, where goals to address NCDs were incorporated into the city's development plan.

^{PAHO/WHO Representative in Colombia, Dr Gina Tambini, during the course to journalists.}Photo credit:PAHO/WHO Country Office.

To further advance their efforts in addressing NCDs, PAHO/WHO Colombia implemented training activities for professionals in different sectors. For instance, a pilot workshop on NCDs and their risk factors was implemented for communicators and journalists to improve media coverage and quality of NCDs [9]. A leadership course for tobacco control was also developed, where 60 professionals and key actors at the national level were trained in competencies for the implementation of the framework convention on tobacco control. Furthermore, a functional network with more than 33 communicators trained in noncommunicable diseases and addressing the four main risk factors for NCDs was formed [10]. More than 10.000 professionals in the country were trained by PAHO/WHO’s Virtual Campus PAHO/WHO to the implementation of HEARTS for NCD care. Moreover, a complementary training was delivered for more than 117 health managers from 26 territories at the national level in the development of implementation plans for strategies to improve NCD care within the framework of primary care and the social determinants of health.

"As journalists, we are left with the responsibility to be meticulous with the information, to verify, to try to translate the scientific information. We had experts who can translate many issues from these public policies. Our responsibility is to bring them information."

-Maicol Buitrago, Journalist of Red Más Noticias.

To promote awareness and understanding of the impact of social determinants on NCDs, management tools were disseminated through implementation guides and workshops in two prioritized territories, Huila and Cauca. These actions also included identifying how the living conditions limit access to health services and interventions in the country, particularly among vulnerable populations. Additionally, the WHO NCD and Mental Health call for multisectoral action included the presentation of 19 cases related to significant experiences of how territories have addressed NCDs at the multisectoral level.

In addition, Colombia has concluded the three-year exercise of the Framework Agreement for Tobacco Control (FCTC) and continues with its implementation. Specific achievements include tax increases, smoke-free spaces, and development of campaigns. The implementation of smoking cessation campaign in care centres has had an impact on the reduction of tobacco consumption at the national level, going from a prevalence 8.3% to 7.3% [11].

“Informing the population about NCDs in a clear and timely manner helps to protect lives and prevent disease. We want to achieve an optimal level of health for the entire Colombian population, and we know that working with journalists and communicators will enable us to promote preventative actions.”

-Dr. Gina Tambini Gomez, PAHO/WHO Representative in Colombia

One of the key elements of Colombia's success in addressing NCDs is its approach to coordination across sectors. The government recognized the need for cross-sectoral collaboration to address all the determinants of NCDs, and this was reflected in the PDSP. PAHO/WHO Colombia provided technical expertise and resources to strengthen intersectoral action, including training for professionals in different sectors, and the development of strategic and operational plans that incorporated globally recognized strategies whilst catering for local needs. PAHO/WHO will continue to support the Colombian authorities in promoting healthy environments.