Tanzania is moving ahead in applying Health in All Policies (HiAP) as 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. Experts and decision makers from sixteen Ministries of the government of Tanzania came together in October for an orientation on the HiAP concepts, best practices and ultimately to develop a framework for interministerial actions that address causes of health inequalities in the country.
The training facilitated by WHO staff from the Regional and Country Office, focused on orienting participants on the Health in All Policies approach, concepts and key competencies for HiAP, and how HiAP can contribute to addressing the social determinants of health. Scenarios and case studies from Zambia, Namibia and Australia were presented to allow participants to appreciate best practices in the implementation of HiAP across the globe.
The Health Sector Strategic Plan 2015-2020 commits to address the social determinants of health, through collaboration with other sectors, while advocating for inclusion of health promoting and health protecting measures in other sectors’ policies and strategies.
"The journey towards implementation of HiAP in the country started during the 18th Joint Annual Health Sector Review Meeting held late in 2017. The meeting noted poor progress in the performance indicators for maternal health, adolescent health, environmental management and WASH, nutrition and NCD risk factors. This presented an opportunity for WHO to engage health experts and partners in dialogue on addressing the Social Determinants of Health through the Health in All Policies approach. A Policy Commitment was made to enhance intersectoral action as a means to address the underlying determinants of health contributing to the poor progress in the indicators/performance" narrated Dr. Catherine Joachim, Head, Health Sector Resource Secretariat, Ministry of Health in her presentation.
Specifically, meeting requested Ministry of Health in collaboration with the Prime Minister’s Office (PMO) and support from WHO to lead the:
- Review of key sector policies to identify opportunities for intersectoral action
- Develop a joint plan of action
- Develop a common accountability framework
In May 2018, the Ministry of Health under the leadership of the Prime Minster’s Office and with financial and technical support from WHO convened two working sessions for the Directors of Policy and Planning and Policy Analysts from 15 sector Ministries to review their sectoral policies and identify potential policy areas for collaboration. As an outcome of two working sessions, the directors developed a draft National HiAP Action Plan and proposed existing governance structures (with modification) that could be used to address the social determinants of health
A meeting of Permanent Secretaries from the respective sectors was convened in October 2018 to present the outcomes. Permanent Secretaries agreed to own the process and present to the Ministerial level and requested further capacity building for the Directors of Policy and Planning and Policy Analysts.
Actions that transcends one ministry are important in establishing a decision-making framework that applies evidence and involves the whole of government. This will contribute to the national goal of improved health for all by 2025.
“We are already witnessing the value of incorporating health in all policies. Since 2011, we have brought together different sector ministries to draw actions that address stunting among children in Tanzania. We learnt that we cannot fight stunting by working solely with the Ministry of Health. We needed the Ministry of Agriculture, the Ministry of Industry and Trade, the Ministry of Education, to mention a few. We were able to make progress because of leadership and coordination by the Prime Minister’s Office. I am confident that HiAP is the way to go and we must embrace it as a holistic approach to better health and wellbeing,” said Mr. Novatus Tesha, Nutrition Coordinator from the Prime Minister’s Office.
"Determinants of health cannot be addressed by the health sector alone, efforts to enhance intesectoral actions that contribute to good health outcomes are necessary” said Ms. Leticia Rweyemamu, WHO staff leading the HiAP initiative.