Colombia

In Colombia, the launch of the Health Equity Observatory marks a significant step toward the use of evidence on the equity impacts of social policies – particularly immigration policy –to inform change. In parallel, Colombia is advancing the Healthy and Sustainable Cities, Environments and Rural Areas Strategy – in Spanish, Ciudades, Entornos y Ruralidades Saludables y Sostenibles (CERSS) – a model for intersectoral local planning that considers health from the perspective of primary health care organization and services. As part of this work, the regional and country office has collaborated closely with the Ministry of Health and Social Protection, three local Colombian departments (Cauca, Casanare and Huila) and three pioneer municipalities to support CERSS implementation. Four meetings have been held in the country focused on developing a theory of change to ensure CERSS implementation includes an equity and SDH approach. These meetings have gathered professionals from national, regional and local levels of government, –and from the health sector and other sectors, along with civil society and community organizations.

Country achievement highlights

1. CERSS theory of change for integrating the social determinants of health approach and conducting relevant intersectoral actions in three municipalities through the Ministry of Health and Social Protection’s CERSS Strategy.
   
2. Letter of commitment to development of the initiative, signed by the mayors of each of the three pathfinder municipalities and the three sub-national governments involved in the Special Initiative.
3. Development of conceptual and cognitive mapping of perceptions about social determinants of health, among decision-makers, managers, service providers and the community.

Main activities 2025–2028

• Strengthening linkages between SIMASHE and the WHO Urban Governance for Health and Well-being Initiative, by identifying concrete opportunities for integration.
• Implementing in-person and online training on SDHE and the theory of change, tailored to Colombia’s context and involving national, regional and intersectoral teams from pioneer municipalities. In Colombia, key themes prioritized and with governmental commitment include improving water quality, road safety and mental health, and reducing substance abuse and violence.
• Advancing community and civil society engagement through a national capacity-building package for CSOs and communities, in collaboration with the International Development Law Organization.
• Promoting knowledge exchange and documentation of experiences, through case studies shared in academic publications, and hosting events such as a national launch of the world report.
• Undertaking an audit of theory of change implementation at the local level, to evaluate progress and and refine strategies for addressing the SDHE.
• Facilitating coordination between AMRO/PAHO, local governments and primary health care providers to co-develop a model for integrating the social determinants of health into primary health care practices.
• Establishing monitoring systems on SDHE and SDH-related policies, both locally and nationally, to improve understanding of the mechanisms involved in the production of health inequities, and inform the design, support and implement of targeted measures to reduce inequities.