In this article, we examine the WHO's 'Health in All Policies' framework and the ways in which it might be deployed to achieve behaviour change at a local, national and international level of governance. 

Lessons from Wilkinson and Marmot 

In their report for WHO’s European office about the Social Determinants of Health, Richard Wilkinson and Michael Marmot argue that local, national and international government agencies and the food industry should ensure:

  • The integration of public health perspectives into the food system to provide nutritious, fresh food to all
  • Democratic, transparent decision making and accountability in all food regulation matters
  • Support for sustainable agriculture and food production methods
  • A stronger food culture for health, to foster people’s knowledge of food and nutrition
  • The availability of useful information about food, diet and health, especially aimed at children
  • The use of scientifically based nutrient reference values and food based dietary guidelines to facilitate the development and implementation of policies on food and nutrition.
Source: Paige Patterson on Flickr
Source: Paige Patterson on Flickr

A New Approach to Doing Health

In order to obtain cross disciplinary commitment to these objectives, WHO pursued a framework for country action called Health in All Policies (HiAP) . HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts in order to improve population health and health equity. As a concept it reflects the principles of:

  • Legitimacy grounded in the rights and obligations conferred by national and international law
  • Accountability of governments towards their people
  • Transparency of policy making and access to information
  • Participation of wider society in the development and implementation of government policies and programmes
  • Sustainability in order that policies aimed at meeting the needs of the present generation not compromise the needs of future generations
  • Collaboration across sectors and levels of government in support of policies that promote health, equity and sustainability

So Health in All Policies involves the health sector working with the transport, housing, employment, financial, agricultural sectors respectively to obtain health goals.

View the Infographic Here 

So what about Early Life Nutrition? 

When looking at Early Life Nutrition in the context of Health in All Policies, the necessity of different relevant sectors working together to change negative behaviours and enable positive ones becomes clear.

A case study from Finland 

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Six years ago, almost 1 in 5 five-year-olds in the Finnish city of Seinäjoki was overweight or obese. Not all schools and day care centres were providing nutritious food and sufficient physical activity. Since then, the municipality’s health department has worked with the childcare, education, nutrition, recreation and urban planning departments to ensure all day care centres and schools provide the same quality of services. As a result, the proportion of five-year-olds who are overweight or obese has been halved.

  • The urban planning department improved school playgrounds.
  • Recreation implemented more physical activity in schools.
  • Nutrition worked with day care centres to eliminate sugary snacks and with schools to serve healthier lunches.
  • The health department instituted comprehensive yearly health examinations in schools, which included parent education on healthy eating.

Oili Ylihärsila, Director of Health Promotion, Seinäjoki Health Centre sees this as the optimum way of achieving behaviour change:

“I am very proud of this programme, but it’s not just the programme that’s achieving good results. It’s the families who have worked hard to change their lifestyles. Parents are now wiser when it comes to good nutrition and exercise because of our efforts.”

Read More Here

References 

WHO (2013) Health in All Policies, A framework for Country Action http://www.who.int/healthpromotion/frameworkforcountryaction/en/

WHO (2015) Finland curbs childhood obesity by integrating health in all policies. http://www.who.int/features/2015/finland-health-in-all-policies/en/

Wilkinson, R & Marmot, M (2003) The Solid Facts http://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf