Peru

In Peru, SIMASHE focuses on strengthening local government capacities for intersectoral action, grounded on development of a theory of change to enhance collaborative models for addressing the social determinants of health. In September 2023, SIMASHE began work with an initiation meeting with the Ministry of Health and three prioritized municipalities (El Porvenir, José L. Bustamante y Rivero), including an awareness-raising workshop and an introduction to using theory-of-change methodology. Peru’s engagement has also included participation in regional meetings held in Colombia and Cuba, as well as in the regional webinar series on migration as a social determinant of health. Earlier involvement in 2022 included contributing to the development of life stories of domestic workers participating in the regional domestic workers’ union (CONLACTRAHO).

Country achievement highlights

1. Political leadership of two municipalities (Jose Luis Bustamante y Rivero and La Libertad) committed to their being pioneering local areas of the Special Initiative. 
2. The main focus has been to form local teams, building capacities for managers and decision-makers at the local and national levels, and defining the theory of change for addressing the social determinants of health equity in their areas.
   

Main activities 2025–2028

• Developing and delivering in-person training courses and workshops on the SDHE, tailored to Peru’s specific historical, governmental and social context, building on foundations established during Phase I.
• Undertaking an audit of theory of change implementation at the local level, to evaluate progress and reinforce intersectoral approaches 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.
• Analysing and disseminating a concept mapping of perceptions of SDHE, based on insights from policy-makers and service providers.
• 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.
• 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 enable the design, support and implementation of targeted measures to reduce inequities.