3.1. Advocacy and raising awareness among policy-makers for equity-focused PHC
Advocacy and awareness-raising efforts are crucial for building public and political support for PHC reforms focused on equity. By bringing communities and stakeholders together around the social determinants of health (SDH), we can ensure that health equity remains a priority in primary health care (PHC) policy and practice. This area of work drives systemic change through advocacy, raising awareness and leveraging community dialogue. It emphasizes the importance of political will and action in promoting equity-focused PHC models, underscores the relevance of the SDHE discourse in advancing health conversations, and mobilizes stakeholders to create equitable, community-supported PHC systems.
Examples from SIMASHE
Developing policy and legal frameworks in Lao People’s Democratic Republic: In 2022, a Memorandum of Understanding was signed between the Ministry of Health and the Ministry of Home Affairs to institutionalize PHC governance and intersectoral collaboration. In parallel, the National Assembly has endorsed a new Primary Healthcare Law, and there are plans to develop a national strategy for health equity.
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Developing SDH engagement strategies in different settings in Tolosa, Philippines: Engagement strategies were developed through the “Healthy Settings” initiative, to promote understanding of the social determinants of health. For example, to promote healthy workplaces, participants established the Sulibangko Practice (Meaning “By the Way”) to raise awareness about SDH among health office workers. This initiative involves organizing gatherings during work breaks and meetings that focus on discussing SDH and noncommunicable diseases. At a municipal level, the initiative’s Technical Working Group is developing policies to ensure support and inclusion of SDH during times of political change.
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Alignment of high-level national, sub-national and municipal support in three regions and seven SIMASHE municipalities, Chile: Commitment letters and municipal-level decrees were issued by mayors to establish Territorial Equity and Social Determinants of Health Commissions in the seven SIMASHE municipalities. Equity and Social Determinants of Health Commissions were also set up at the sub-national level in all three SIMASHE regions and in the national government, which has enabled vertical cooperation across all administrative levels to address social determinants and promote health equity, based on a comprehensive, intersectoral approach.
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Key intervention activities
SIMASHE is continuously seeking examples related to this area of work, including activities for:
- comprehensive advocacy for equity-focused reforms and PHC integration at local and national levels.
- promotion of knowledge-sharing and success stories for supporting equity-driven interventions.
- development of policy and legal frameworks for equity-based PHC.
- strategic communication and awareness campaigns for health equity.
- engagement of interculturally sensitive interlocutors – including Indigenous and community leaders – in health equity advocacy.
- universal enrollment for equitable access to PHC services.