Health in All Policies (HiAP) framework for country action

This document serves as a 'starter's kit' for applying Health in All Policies (HiAP) in decision-making and implementation at national and subnational levels. It can be easily adapted for use in different country contexts and at the regional and global levels. WHAT IS 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, accountability, transparency and access to information, participation, sustainability and collaboration across sectors and levels of government.

Health and health equity are values in their own right and are also important prerequisites for achieving many other societal goals. Many of the determinants of health and health inequities in populations have social, environmental and economic origins that extend beyond the direct influence of the health sector and health policies. Thus, public policies in all sectors and at different levels of governance can have a significant impact on population health and health equity.

The Framework sets out six key components that should be addressed in order to put the HiAP approach into action: (1) establish the need and priorities for HiAP, (2) frame planned action, (3) identify supportive structures and processes, (4) facilitate assessment and engagement, (5) ensure monitoring, evaluation and reporting, (6) build capacity. These components are not fixed in order or priority. Rather, individual countries will adopt and adjust the components in ways that are most relevant for their specific governance, economic and social contexts.

Although governments as a whole bear the ultimate responsibility for the health of their citizens, health authorities at all levels are key actors in promoting HiAP. They should therefore actively seek opportunities to collaborate with and influence other sectors. Intergovernmental organizations and structures (multi-lateral, bilateral, regional, etc.) can provide significant support to multi-sectoral action on health and development outcomes. Finally, having taken a lead role in multi-sectoral initiatives on issues such as marketing of breast-milk substitutes, tobacco control and the international recruitment of health personnel, the World Health Organization (WHO) has a special contribution to make to HiAP at both international and country levels.