Regional Vision on the Determinants of Health from the Perspective of theCivil Society in the Americas

Regional Consultancy OAS-PAHO

Regional Vision on the Determinants of Health from the Perspective of the

Civil Society in the Americas

Regional Consultancy OAS-PAHO

1. Executive summary

The Pan American Health Organization (PAHO) and the Organization of American States (OAS) worked together between July and October 2011, to receive the civil society perspective on social determinants of health in order to share it with relevant government authorities. The civil society perspective and experiences in the Americas on determining the impact of economic, social, cultural, and environmental determinants of health to the quality of life; the rights-based approach in social policy, especially on issues of health; the reduction in inequality in terms of access to health; and the advancement of the Millennium Development Goals were among the main topics discussed in this exercise.

The process consisted of two stages. First, a virtual consultation was held, reaching more than 4500 organizations and focal points in the Hemisphere, asking them to answer a survey and actively participate in a virtual forum. The survey included analytical questions, covering topics such as the perceived relationship between the Millennium Development Goals and Social Determinants of Health, as well as more specific issues, including the experience of the participating organizations in working with these determinants. Due to the strong electronic outreach campaign through databases and social networks, 271 civil society representatives responded in a period of three weeks. Responses came from close to 75% of the countries of the Americas, where all Latin America, with the exception of Paraguay, was represented.

These responses included, among others, the importance of policies and programs that defend human rights and promote the role and empowerment of communities, the recognition of a comprehensive and intersectoral health approach, the need for active participation of all stakeholders with special emphasis on civil society organizations, the implementation of agreements and partnerships between governmental and nongovernmental actors, and the need to leave behind scattered and isolated actions in order to join forces for a great development alliance.

At the same time, a virtual forum was created to promote and expand the discussion and debate on this issue. This space for dialogue is still online and has al least 111 active participants, 13 discussion threads and 97 comments posted, both in English and Spanish.

The second stage of this consultation with civil society was an on-site event in Costa Rica, parallel to the Meeting of Ministers of Health of PAHO, which was also being held in Costa Rica. Twenty three representatives from civil society were selected for this meeting according to specific minimum criteria and ensuring representation from all regions of the Hemisphere. Thus, the group represented 16 different countries and a broad scope of areas of work, including the defense of the rights of indigenous populations, access to health, persons with disabilities, HIV/AIDS, promotion of gender equity, consumer protection rights, development of social medicine, strengthening of education, care for the environment, integral development, human rights protection, and religious activities.

The preliminary results from the virtual consultation with civil society were presented at this meeting, including comments received through the virtual discussion forum. These provided an important contribution

to the dialogue in Costa Rica, and deepened the discussion which resulted in the drafting of a regional position statement from civil society on social determinants of health.

The final results of the whole consultation process, which are presented in the following document, constitute an invaluable input to regional and global discussions at the highest political level on social determinants of health as a comprehensive development strategy that delivers a better quality of life for everyone.

2. Social determinants of health in the context of a comprehensive approach to development

You can define social determinants of health as the circumstances in which people are born, grow, live, work and age, including access to health services and their quality. These "determinants" or circumstances are the result of the distribution of money, power and resources at the global, national and local levels, which, in turn, depend on the policies adopted by each country. The social determinants of health explain the unfair and avoidable differences within countries and between countries with regards to their health condition.

In 2005, the World Health Organization (WHO) convened the Commission on Social Determinants of Health to provide advice on how to reduce health inequities. The Commission, after a long study proposed three general recommendations in its final report:

1. Improve living conditions2. Fight against the unequal distribution of power, money and resources.3. Measure better and learn more about health inequities.

In observance of these recommendations, in 2009, the WHO World Health Assembly issued a resolution strongly demanding an approach that integrates the "Health in all Policies" approach and a renewed commitment to intersectoral action in order to reduce health inequities, as well as the implementation of a strategy based on social determinants for all public health programs and a greater capacity to measure health inequities and observe the impact of different policies based on social determinants. At the same time, the General Director of this organization committed to carry out the World Conference on Health Determinants by 2012 with the purpose of bringing together world leaders and discussing how to implement the recommendations of the Commission to advance in reducing health inequities in the world.

Within this context, the WHO regional bodies were instructed to consolidate regional positions on the issue with the involvement of all relevant actors ensuring a comprehensive and representative view. The Pan American Health Organization (PAHO), as a WHO regional office and the specialized health agency of the inter-American system, committed to this process through three parallel consultation processes: (i) with representatives from the ministries of health, (ii) with experts in the field, and (iii) with civil society organizations. This report focuses on the last of these and its results will serve as key inputs for the next WHO meeting, to be held between October 19 and 21, 2011, in Rio de Janeiro, Brazil.

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3. OAS-PAHO alliance

Social determinants of health cannot be analyzed only from the health sector perspective as it is required an intersectoral approach and a social development and equity commitment. Thus, PAHO established an alliance with the Organization of American States (OAS).

The OAS, through its Department of Social Development and Employment (DSDE), is working hard to support Member States in their efforts to alleviate poverty, reduce inequality gaps, and achieve higher levels of development for everyone. To this end, the DSDE promotes political dialogue at the highest level, acting as a catalyst to translate political agreements into concrete actions. It also promotes, coordinates and facilitates the implementation of programs, projects and technical cooperation on relevant issues in the region.

It is worth mentioning that, at the hemispheric level, the DSDE works together with and provides technical support to Member States in the development and implementation of regional instruments that advance the political dialogue and technical cooperation in social policy in order to improve the services delivered by the States to their population. For this reason, the DSDE provides technical assistance in negotiations within the OAS sphere for the declaration of the Social Charter, the Americas, and its Plan of Action. Additionally, it acts as the technical secretariat for the Working Group to develop indicators of progress to implement the Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights, "Protocol of San Salvador," which took effect on November 16, 1999, and is currently ratified by fifteen Member States of the Organization. According to its Article 19, the participating States commit to prepare periodic reports on progressive measures taken following standards established by the OAS General Assembly. In both processes, progress in health is fundamental and, therefore, the importance of the alliance with PAHO to deepen the discussion on social determinants of health as a fundamental approach to improving the welfare of all people from a universal and rights perspective. Thus, the OAS joined forces with PAHO with a common goal: to help reduce social inequality, including access and the right to health, in the Americas.

This alliance with the OAS strengthens and multiplies political spaces where the perspective of civil society could be taken1. Other advantages of the alliance with the OAS are the demonstrated experience in consultation processes and their links with civil society organizations. As a result of this work, the Department of International Affairs of the OAS has a database that has about 4500 organizations and contacts in the hemisphere, of which over 200 focus on the health area.

1 In 2007, the WHO, PAHO and OAS Summit of the Americas, held a consultation process with civil society on the social determinants of health. This consultation consisted of two stages: a survey responded by 70 civil society organizations, and the Regional Consultancy Meeting with Civil Society, from April 12 to 14, 2007 in Brasilia, Brazil. There, a discussion on participation, implementation and monitoring of the subject matter was carried out. This shows that the joint work of PAHO and the OAS is not new in this area. This time, the relationship with the OAS has expanded to include not only technological support and the greater outreach to civil society offered by the Summits of the Americas, but also the additional contribution of the Department of International Relations - which has a solid database of civil society organizations - and the technical collaboration of the DSDE, who has direct contact with relevant authorities and hemispheric incidence given by the legal instruments mentioned above.

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Virtual Forum

Additionally, a virtual forum was created to promote and expand the discussion on this issue. The launch of the forum was preceded by the design of a joint working plan between the OAS and PAHO for its administrative management, monitoring, update and promotion.

Currently, this dialogue space is available online and has 111 participants, 13 topics for discussion and 97 comments posted by participants. The virtual forum for this consultancy is available both in English and Spanish and can be accessed through the following links:

http://svc.summit-americas.org/es/forums/consulta- hemisferica-determinantes-sociales-de-la-salud (Spanish)

http://svc.summit-americas.org/forums/hemispheric- consultation-social-determinants-health (English)

The forum discussion topics are based on 5 themes presented in the WHO technical document on social determinants of health and their inputs have been used both, to expand the dialogue during the meeting in Costa Rica, as well as to enrich the vision of the rapporteurs of the regional positioning, which will be taken to the global meeting in Brazil (see Annex 1 for the Statistical Results of the Forum).

4. Virtual Consultancy with civil society

The first activity - within the framework of the partnership with the OAS - was the realization of a virtual survey with civil society. The OAS-PAHO Virtual Survey used two means to establish communication links with civil society in order to collect their ideas, experiences and contributions in the field of social determinants of health, and reduce the inequality gap that exists in the continent. One of the means used was sending a survey to the entire network of organizations identified by the OAS and PAHO. The second instrument was for the establishment of a permanent forum for dialogue.

The first instrument and the most commonly used in this consultation, was a survey designed through a joint effort between PAHO and the OAS. The survey’s objective was to initiate communication with civil society organizations interested in the subject, as well as, collect their thoughts and experiences working with social determinants of health.

The survey (see Annex 2 for a Sample of the Survey) consisted of two parts. The first part included questions about personal information of the representative and the organization they represented. The second part consisted of six analytical questions, ranging from the relationship between the Millennium Development Goals and the Social Determinants of Health, to more personal questions such as the organization's experience working with social determinants of health.

The survey was sent to the OAS Department of International Affairs and the Summit Secretariat directories, as well as the PAHO database. In addition, the electronic links to access the survey were shared on the institutional Facebook and Twitter accounts of both, the Summits Secretariat and the Department of Strategic Communication and Corporate Image.

Thanks to the effective dissemination media campaign through the means described above, 271 civil society representatives responded during the three-week period the survey was active ( see Annex 3 for the Directory of Participating Organizations of the Survey and their Objectives). The deadline for the surveys was set for August 3, 2011, which allowed enough time for a preliminary reading of the results at the on-site meeting to be held in Costa Rica.

a. Sample Analysis

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Table 1: Received surveys (as of August 3, 2011)

The results of the questions regarding the profile of the participants, which had the objective of determining what type of organizations responded the survey, are presented below.

As mentioned previously, this survey was available both in English and Spanish in order to ensure hemispheric representation. According to the results collected, Table 1 and Graph 1 show the distribution of responses by the language in which the surveys were received.

Graph 1: Distribution of the surveys received(as of August 3, 2011)

At first glance, we can observe that most of the responses received were in Spanish. It should be noted that both languages were promoted equally, so it is quite likely that this difference could be attributed to the distribution of the population that were contacted through the databases. For this reason, a more effective strategy which outreaches to representatives from the Caribbean should be considered in the future, so that we can obtain a sample with a better geographical distribution and produce results that are applicable to all States that participate.

Further, due to the different methods that were used to promote the survey, it includes various civil society representatives, some government and multilateral bodies representatives, as well as a small number of individuals without any affiliation. To obtain a better perspective of the sample to be analyzed, the organizations were classified using the definition of civil society used by the World Bank, which defines civil society as a “wide array of non-governmental and not-for-profit organizations that have a presence in public life, expressing the interests and values of their members or others, based on ethical, cultural, political, scientific, religious or philanthropic considerations. Civil Society Organizations (CSOs) therefore refer to a wide of array of organizations: community groups, non-governmental organizations (NGOs), labor unions, indigenous groups, charitable organizations, faith-based organizations, professional associations, and foundations”2. The sample was classified based on this definition and is summarized in the below table.

Table 2: Classification of the sample – type of organization2 Definition obtained from the official website of the World Bank, http://go.worldbank.org/G0SS6AXBW0

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Recieved surveys NumberSpanish 252English 19TOTAL 271

Type of Organization Number PercentageNon-governmental Organization (NGO) 199 73.43%Academic Organization 39 14.39%Governmental Organization 17 6.27%Private Organization 8 2.95%Individual 5 1.85%Multilateral Organization 3 1.11%Total 271 100%

Graph 2It can be observed, both in Table 2 and Graph 2, that most of the civil society sample is composed of non-governmental organizations.

It should also be noted that due to different definitions of civil society that exist, some of which include individuals and academic organizations or universities, the survey did not discriminate any response, except for duplicates. In these cases, only the most complete response was considered.

Within the survey, participants also responded to the following question,

“To which Social Determinants of Health is your NGO responding?”

This question allowed us to examine the determinants of health to which organizations are currently responding, according to their own view. It is important to note that this question was open-ended and the way it was studied was through an analytical review of the responses and its further classification into non-exclusive (since there are organizations that respond to more than one determinant) categories that were repeated the most. The responses are summarized in Table 3 and Graph 3.

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Graph 3

The previous figures show that over 60% of the organizations consider the advancement in access to health services to be part of their objectives. This demonstrates the high level of commitment of civil society with confronting the inequity in health problem in comparison with others. The high level of commitment with improving education and access to justice are also stressed by the respondents.

To conclude the sample analysis, the surveys were classified, this time by the country of origin of the organization responding. Table 4 shows the number of surveys received per country, which highlights the high level of participation of organizations from Colombia, Peru, Mexico and Argentina.

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Table 3: To which Social Determinants of Health is your NGO responding?”Social Determinants of Health Number PercentageAccess to health services 168 61.99%Education level 86 31.73%Access to justice 58 21.40%Gender 46 16.97%Income 45 16.61%Ethnicity 41 15.13%Participation in the decision making process 29 10.70%Environmental conditions 24 8.86%Other 18 6.64%Working conditions 15 5.54%Access to infrastructure and transportation 15 5.54%Disability 12 4.43%Political / Institutional strengthening 11 4.06%Violence 9 3.32%

Table 4: Surveys received by country

Based on the previous table, it is evident that the civil society sample is diverse and covers 26 countries of the continent, which represents about 75% of the 35 OAS Member States and a similar percentage of PAHO Member States. It should be noted that, as shown in the illustration above (Map 1), all Latin America was represented with the exception of Paraguay.

b. Results of the questionnaire

After analyzing the survey sample, we proceeded to study the results of the analytical questions. Thus, we then examined the importance of the social determinants described in the introductory question of the survey, which reads:

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Country NumberArgentina 21Barbados 1Belize 1Bolivia 8Brazil 5Canada 1Chile 6Colombia 74Costa Rica 9Ecuador 8El Salvador 14Spain 2Spain / Ecuador 1United States 7Global 1Guatemala 6Guyana 1Haiti 1Honduras 3Mexico 29Nicaragua 4Panama 4Peru 27Dominican Republic 11Saint Lucia 1Suriname 3Trinidad y Tobago 4Uruguay 4Venezuela 13(Blank) 1TOTAL 271

Map 1: Continental representativeness of the survey

“Please order by importance (1 being the most important and 11 the least) the following determinants of health inequities according to your organization’s experience”.

Table 5 shows the importance of the determinants according to the results analyzed, where the number 1 represents the most important according to the responses’ average, while 10 represents the least important. Each of the social determinants of health described is also accompanied respectively with its mode, median and average. Meanwhile, Table 6 shows the percentage of the sample that selected each of the rank positions when ordering the list of determinants. This table also shows the mode in bold for each determinant.

Table 5: Order of the social determinants of health by importance as described in the introductory question of the survey

Social Determinants of Health Mode Median Average Importance*Income 1 2.00 3.18 1Access to health services 1 2.00 3.25 2Education level 1 3.00 3.62 3Working conditions 6 5.00 5.27 4

Participation in the decision making process 1 5.00 5.31 5Access to justice 7 6.00 5.85 6Ethnicity 6 6.00 5.86 7Access to infrastructure and transportation (bridges, roads, etc.) 5 6.00 5.91 8Gender 5 6.00 6.13 9Environmental conditions 10 7.00 6.18 10*Order of importance in accordance to the average of the answer

Table 6: Distribution of the sample according to the rank order selected for each social determinant of health described in the survey’s introductory question

Social Determinants of Health 1 2 3 4 5 6 7 8 9 10 11

Income 36.3% 16.5% 15.0% 7.1% 6.0% 5.2% 3.7% 3.7% 3.0% 1.1% 2.2%Education level 24.3% 18.7% 14.6% 12.4% 7.1% 6.0% 5.2% 4.5% 4.1% 1.5% 1.5%Access to health services 29.6% 21.7% 15.4% 10.5% 5.2% 3.0% 4.5% 2.6% 3.0% 3.7% 0.7%

Gender 9.1% 6.4% 6.0% 10.2% 11.7% 10.2% 6.8% 10.2% 7.2% 11.7%10.6%

Ethnicity 12.1% 6.8% 9.8% 3.4% 8.7% 12.5% 9.8% 11.0% 8.3% 9.8% 7.6%Working conditions 9.2% 3.1% 9.9% 13.4% 15.6% 18.3% 9.9% 8.0% 5.7% 4.2% 2.7%Access to justice 11.3% 7.1% 7.1% 6.4% 8.6% 10.2% 15.8% 9.4% 10.5% 9.8% 3.8%Participation in the decision-making process 17.9% 7.5% 9.0% 4.9% 12.7% 6.7% 11.2% 11.9% 7.5% 6.0% 4.9%Access to infrastructure and transportation 9.2% 5.0% 7.7% 10.4% 13.1% 8.5% 7.3% 12.7% 13.1% 10.8% 2.3%Environmental conditions 10.3% 6.1% 6.5% 8.0% 9.2% 5.7% 9.5% 9.5% 13.0% 18.3% 3.8%

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These results evidence that income, access to health services, and education level, are all perceived by civil society as the most important social determinants of health. Similarly, gender and environmental conditions are at the bottom of the list. This shows that while gender and environmental conditions are important determinants, they cannot be addressed without taking into consideration socioeconomic status, access to health and education, among others. In other words, we must respond through a comprehensive and coordinated approach to the challenges that pose health inequity to society as a whole.

The results of questions 1 and 2 of the survey were also consolidated in tables and graphs. Table 7 and Graph 4 summarize the responses to question 1, which reads:

“Through what policies and/or programs does your organization think social determinants of health are currently being addressed in your country or region? (Check all that apply)”

Table 7: Programs and policies through which organizations address the SDH“Through what policies and/or programs does your organization think social

determinants of health are currently being addressed in your country or region?– Programs and policies to … ”

Number of times

mentionedPercentage

Promote participation and community empowerment 176 64.94%Defend human rights 173 63.84%Extend access to free and universal health services 140 51.66%Address gender perspective 138 50.92%Promote sustainable development programs 127 46.86%Reduce poverty 122 45.02%Extend education 118 43.54%Address indigenous people and afro descendents needs 100 36.90%Reduce unemployment 89 32.84%Other(s) 85 31.37%

Graph 4

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These figures show that civil society recognizes the importance of the programs and policies that uphold human rights or promote participation and empowerment of communities. It can also be observed that, of all survey participants, at least about a third of them think that today, in his or her country or region, there are programs or policies that respond to each of the social determinants of health proposed.

Furthermore, the results to question 2a, which reads,

“Some of these determinants present major challenges to your country or region. From your organization’s perspective, who is addressing these challenges? Please specify. (Check all that apply),”

are summarized in Table 8 and Graph 5.

Table 8: Who is addressing the challenges proposed by the SDH?

From your organization’s perspective, who is addressing these challenges?

Number of times

mentionedPercentage

Civil society organizations 184 67.90%National government 131 48.34%Grassroots 115 42.44%State or local (municipal) governments 112 41.33%None of the above 21 7.75%

Graph 5

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These figures show that a large percentage of civil society organizations take responsibility in addressing health inequities, which is very encouraging for our continent. On the other hand, the need for joint work by all the actors involved, whether they are civil society organizations, grassroots organizations, national government, or provincial or municipal ones, is also supported.

Moreover, answers to the question 2b, which is a complement to the above question, was also consolidated. This question emphasizes how civil society is responding to the challenges described in the previous question.

Table 9: Channels through which the challenges of health inequity are being addressed

How? Please explainNumber of

times mentioned

Percentage

Through programs, projects or initiatives 161 59%Through focalized interventions in vulnerable groups 153 56%Through public policies 127 47%They are NOT being address 32 12%

Graph 6

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Both Graph 6 and Table 9 show that the most appropriate intervention methods for working with social determinants are those involving programs, projects and initiatives (59.41%) and focalized interventions in vulnerable population groups (56.46%). They also demonstrate that both have to co-exist with universal national coverage programs with actions focused on priority groups, seeking to act with relevance at all times even if the action is steady. However, the need to provide sustainable and political will to the efforts being carried out is also highlighted, making it necessary to work in the construction of public policies (46.86%).

The survey’s results showed that there is need for a balance between the state's commitment and civil society organizations’ actions in order to address health inequities. When asked about the entities that were responding to inequities in health, out of 271 responses, (67.9%) of all civil society organizations responded that the work was being done by themselves (civil society). Nevertheless, by analyzing the percentage of the liability assumed by government, whether national (48.34%), provincial or municipal (41.33%), it is clear that it is required a balanced effort between the different actors and sectors.

Some of the most important survey results are listed below:

- According to the survey, the most appropriate intervention method for working with social determinants are those having involving programs, projects and initiatives (59.41%) and focalized interventions in vulnerable population groups (56.46%). They also demonstrate that both have to co-exist with universal national coverage programs with actions focused on priority groups, seeking to act with relevance at all times even if the action is steady. However, the need to provide sustainable and political will to the efforts being carried out is also highlighted, making it necessary to work in the construction of public policies (46.86%).

- Unequal access to health services is without doubt one of the main, if not the most important, determinants of health. If the health status of different population groups is not compared, health inequalities remain invisible since progress based only on averages of health indicators usually hides the persistence or increase in differences between different social groups. The improvement in data

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at the national and sub-national level, as well as in the analysis of disparities, can help bring health inequities into public policy, and thus, better confront the problems responding with relevance to the needs of the population. Within these requirements, it necessary to identify the priorities and work accordingly. One channel that can be useful is through the study of the determinant of access to health services. During the survey, it was considered by 82.4% of the sample within 5 most important determinants. Once this information is analyzed, it can be published using a simple system such as color coding corresponding to the traffic light, in order to compare progress in different geographical areas in relation to this and other key social determinants. This process is an example of how to effectively disseminate information to the public while encouraging the authorities to work for the people interests through the dissemination of such results.

Graph 7

- Similarly, according to the WHO, the relationship between health and regional/national economic and social goals, is linked by poverty and inequality, which are key determinants of health. This is consistent with the survey, where 80.9% of civil society organizations chose income within the 5 most important determinants of health, as shown in Graph 8. While in Latin America there is a correlation between low income and ethnicity or race, it is a priority to respond to both determinants in a comprehensive manner. Both determinants are very important in facilitating the active participation of vulnerable groups of society, and thereby ensuring that the government's actions reflect the needs of society. Thus, by strengthening governance and partnerships between civil society organizations, government, financial institutions, donors and the private sector, steps are taken to address the root causes of poverty. This joint effort will pool resources to improve the conditions of inequality giving priority to the territories and/or groups in conditions of marginalization and poverty. Civil society organizations play a vital role in ensuring that all social groups participate and express their voice. All these efforts raise the possibility of building intersectoral public policies and increasing accountability spaces that result in sustainable change.

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Graph 8

- Similarly, the health-education partnership is vital to the local and community development. As the health sector is committed to reducing inequalities in access to its services, the education sector has been making efforts since the early twentieth century to ensure universal basic education for everyone in the region. There is a direct relationship between the population’s degree of schooling and their health. It has been shown that infant and maternal mortality is higher for illiterate people or people with very little schooling. There is sufficient evidence to ensure that education is an unquestioned determinant of health. The survey to the civil society also highlighted that education ranks third among the major determinants of health with 77.2 % of civil society organizations ordering it within 5 most important determinants.

Graph 9

- The most effective strategy that an individual has to supersede poverty is his or her working skills and capacity, which allow the individual to be more competitive in the work force as they improve. Because of this, employment and jobs constitute key factors to health and, as the survey indicates, one of the key determinants to health is decent and healthy employment. Of the respondents, 32.84% noted the reduction of unemployment as a mean to address the challenges proposed by the social determinant of health.

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c. General Considerations

All others survey questions were open-ended and of a very diverse qualitative nature, which is why its technical analysis was complicated. It is important to highlight that all answers are very valuable and, even thought they cannot be quantified, they allow us to analyze ideas of different organizations in the hemisphere that work very closely with the ultimate beneficiaries of all these efforts, the people.

After reading all the surveys and considering the WHO technical document, the following considerations are proposed:

1. It is recognized that health is not a medical heritage, therefore a comprehensive and an inter-sectoral perspective of health prevails.

2. All actors involved with Social Determinants of Health have an important role: national government, local government, civil society, and grassroots organizations.

3. There is a strong vision of rights when referring to Social Determinants of Health. 4. The importance of States’ work to reduce inequality and improve living conditions is recognized,

but at the same time a higher participation of organized civil society is as well.5. In this sense, the implementation of agreements and partnerships between governmental and

non-governmental actors is proposed. 6. Particularly, it is highlighted the importance of addressing social determinants: economic

conditions (employment and income), education, health services access and social participation as keys elements for achieving better health conditions for all citizens and their quality of life.

7. The importance of increasing government and civil society organizations resources is emphasized, where the latter cannot solely rely on voluntary aid.

8. It is urged to move beyond an existentialist approach and promote social participation as well as the empowerment of citizens and communities in order to contribute to the agenda of the Social determinants of Health.

9. It is recommended to leave behind scattered and isolated actions in order to join forces in a great alliance, where national governments, local governments and civil society work together to achieve attention and promote intersectoral actions which are required to obtain integral health for all.

The inputs collected through the survey can serve as contributions and be articulated within the framework of the five axes of the WHO technical paper to be presented at the World Conference on Social Determinants of Health in October 2011. At the meeting in Costa Rica, the selected civil society organizations interpreted the survey results in the framework of these 5 substantive axes, which will be developed in the next section of this document.3

5. Meeting with Civil Society, August 8-9, 2011, San Jose, Costa Rica

3 The 5 axes worked in the WHO technical document are:

Axis 1: Governance to tackle the root causes of health inequities: implementing action on social determinants of healthAxis 2: The role of the health sector, including public health programs, in reducing health inequitiesAxis 3: Promoting participation: community leadership for action on social DeterminantsAxis 4: Global action on social determinants: aligning priorities and stakeholders Axis 5: Monitoring progress: measurement and analysis to inform policies on social determinants

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Preliminary results of the virtual consultation with civil society, including the comments received until current date through the forum of dialogue, were presented at the mentioned meeting organized by PAHO in Costa Rica from 8 to August 9, 2011 to contribute to dialogue, reflection, and build the regional position of civil society on the subject.

a. Participants

Civil society representatives were selected to participate in this on-site meeting according to minimum standards established and ensuring representation of all regions of the continent.4

In this way, 23 civil society representatives from 16 different countries in the region attended this meeting, which had a wide range of working areas that included: the rights of indigenous peoples, facilitation of access to health, disability, HIV-AIDS, gender equality, consumer rights, social medicine, education, environment, integral development, human rights, and religious matters.

Below, there is a classification of main working areas of the organizations that attended, which also shows the extent of their work, according to their own estimates. It is worth mentioning that many of these organizations work in more than one area and also assisted in one way or another way to confront the challenges posed by health inequity and the social determinants.

Country InstitutionNumber of countries

served (approx.)Number of Organizations

with which it works (approx.)Indigenous People’s Organizations

Canada Metis National Council Canada and work at the International Level 5 Metis organizations

GuatemalaAssociation of Community Health Services - Movement of People's Health

1 57

Panama Napguana Association 6 countries of Mesoamerica 2

Organizations for the Rights of Women and Gender Euality

Bolivia Centre of Aymaras Women Candelaria

6 in Latin America & 2 in Europe 20+

HondurasLaw Center

1 15+/- in Hondurasof Women

Disability and Older People Organizations

4 The selection criteria were:

- Have Participated in the Virtual Consultation on the social determinants of health- Be a Civil Society organization- Have experience in the subject and a comprehensive work covering various aspects of health determinants- Have a clearly demonstrated commitment and action to reduce health inequities- Have a greater impact to the organization you represent (multiplier effect)- Have been selected by the Office of the OPS of the country concerned in consultation with the Ministry of Health- Have the availability to go to Costa Rica, 8 and 9 August

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Costa RicaFederation Red-Pro People with Disabilities in Costa Rica (FEREPRODIS)

3 23

Costa RicaInter-American Institute on Disability & Inclusive Development (IIDI)

18 in Latin America 67

Health Sector Organizations

Argentina World Doctors 8 in Latin America300+ in Argentina1,000+ in America

Brazil Movement for the People’s Health of Brazil (MSP - Brazil)

MSP-LA 1915+ in Brazil

MSP-Global 70+

Colombia Latin-American Association of Social Medicine

20 countries in the Caribbean & Latin America 30+

Costa Rica ASOVIHSIDA The Americas, Europe, and part of Africa (60+) 80+

El SalvadorCitizens Alliance Against Privatization of Health / Movement of People's Health

MSP 70 countries 35 +/-

NicaraguaCentre for Information and Advisory Services Health – MSPLA

MSRLA: 19 LA CRPSC 200+PHM: 70+ worldwide MSPLACRPSC: 9 PHM Impossible to define

Peru Health Forum 1 260+Dominican Republic COSALUP/MSP-LA/CRPSC MSP 19 10+ local

Organizations for Integral Development (Economic, Human, & Environment, etc.)

Chile Ciudad Viva Africa, Europe, Asia, U.S. 60 in Latin America

Costa Rica International Worldwide Vision 97 300+

Costa RicaCentral-American Association for the Economy, Health, and Environment (ACEPESA)

5 10

Costa Rica SEDEH, Security & Human Development 3 15

Uruguay National Users Movement 1 5

Organizations in the Field of Education (University Network)

19

Costa Rica

Inter-American Network for the formation of Social Determinants of Health – Inter-American Universities Organization

20+ 10+

Religious Based Organizations

United StatesInternational MinistriesAmerican Baptist Churches(ABC/USA)

15 LAC

22939 development countries

75 worldwide

b. Development of meeting

After the arrival of the participants, the on-site meeting which commenced on Monday, August 8 th and ended on Tuesday evening, August 9th, 2001.

The work began through a joint meeting with ministerial representatives of health sector. Here, Dr. Michael Marmot, professor at University College London (UCL) gave the keynote address where he talked about the latest studies in this field, its importance and the need of action by governments to face the problem proposed by social determinants of health in a comprehensive manner.

After sharing this session with ministerial representatives, civil society members began their work by presenting each of their institutions and main area of work. Dr. Evelyn Jacir de Lovo, Director of OAS Social Development Department presented the general results of the survey on social determinants of health from the civil society perspective.

Dr. Sofialeticia Morales, PAHO’s Senior Advisor on the Millennium Development Goals (MDGs), coordinated the meeting and commenced by providing a brief introduction to the topic of social determinants of health and the 5 main axes of the WHO’s technical document, which will be presented at the global meeting in Brazil.

Taking advantage of the presence of ministerial authorities in San Jose, and with the objective of taking the civil society perspective to their forum, Dr. Jacir de Lovo presented the mentioned survey results at this meeting as well.

Subsequently, civil society representatives were divided into five groups, considering the 5 main axes established at the WHO’s technical document. Each of these groups was instructed to discuss its theme and answer questions previously established by the organization committee for their dialogue and discussion. At the same time, each group was asked to appoint a secretary and a rapporteur to be in charge of moderating the discussion and collecting the main ideas of the group, respectively.

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After many hours of dialogue and discussion, Dr. Rudiger Krench, Director of the Department of Ethics, Equality, Commerce and Human Rights and author of the WHO technical paper on which the participants had discussed, sat at the meeting. After a short presentation on the purpose and the topics discussed in his paper, the floor was opened for each group to share their ideas and make recommendations on the civil society role from their own perspective.

At the end of the first day, each group gave a short summary of its main ideas to the organizing committee in order for them to make a brief summary to be presented the next morning by Dr. Morales at the parallel meeting of ministerial representatives. The conclusions of the working groups during the first day are summarized in the presentation.

The second day was led by Mr. Andres Yi Chang of the Department of Social Development and Employment of the OAS, who directed the first dynamic of sharing some examples of the organizations’ experience on governance that had been successful in their regions and which could help draw positive aspects to be included in the regional civil society positioning. During the activity, there was a slight pause to observe, via E-lluminate, the presentation of Dr. Morales to the ministerial representatives, which summarized the main ideas of the first day of work.

Next, all participants returned to their groups to continue working in different tables. During this work, Dr. Santos-Burgoa, member of the PAHO’s Organizing Committee, was present in the room and briefly spoke with some of the participants. After a thorough discussion, each group secretary presented the abstract and the key ideas in plenary to expand the dialogue and include ideas from all civil society representatives. In parallel, rapporteurs were grouped so that they can work and write down what would later become the final civil society statement. Then, the same civil society members chose a representative who would be responsible for presenting the final conclusions of all groups at the ministerial meeting.

Finally, in order to wrap-up the meeting, the civil society group listened to the conclusions of their work which were presented to the ministerial representatives by their elected representative. Subsequently, experts and organizers addressed the attendees to give closure to the event, stating their gratitude for the participation of everyone.

c. Conclusions and commitments

The civil society organizations worked on a preliminary document during the first day, which was presented by Dr. Morales. Additionally, the two meeting days culminated with a draft, which was then worked on and refined by the same civil society representatives electronically, under the leadership of Dr. Morales. This work was carried out during the months of August and September 2011.

All this work of dialogue was made taking into consideration the five conceptual axes of the technical document prepared by PAHO and which will be a major input in Brazil’s Global Meeting in October 2011.

One of the commitments that the representatives of civil society assumed and that is also stated in its final statement, was to present their contribution to the Americas regional document, which will be

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presented at the World Conference of the social determinants of health, 10 case studies from different regions to enrich their positioning and regional vision.

Finally, many of the participants committed to disseminate the final document so it could be analyzed by other members of civil society that could not be present in Costa Rica, giving them an opportunity to share their opinions on the subject matter.

In the following section, the final statement prepared by the civil society representatives is presented. This document is based on the substantive issues that will be addressed during the global dialogues in Brazil.

6. Final Civil Society Statement

Final Civil Society statement on the Regional Consultancy on Social Determinants of HealthSan Jose, Costa Rica, August 2011

The civil society organizations gathered on August 8 and 9 in the city of San José, Costa Rica, as part of the Regional Consultancy on Social Determinants of Health convened by the Pan American Health Organization (PAHO) and the Organization of American States (OAS), assuming our full intention to influence the regional document for the Americas, consider that:

It is fundamental to this consultation to consider the historical trajectory of social medicine and collective health in Latin America, such as the indigenous and communitarian health contributions, which for over 30 years have been generating debate, scientific and academic production, and research and action in the field of social determinants of health, seeking as axes the transformation and social change in Latin America for the people’s right to health.

The first contribution of civil society is in reference to the epistemological debate on "social determinants of health," thinking in terms of "multidimensionality" and considering the economic, social, political, cultural and environmental dimensions that determine the processes of health-illness-attention-care, such as death. That is, those same organization forms of our societies are the ones that produce social inequalities and injustice, engraved with social class, ethnicity and gender inequities.

So we note with great concern the danger of the "social determinants of health" category being orchestrated in a reductionist way and emptied of its complexity and multidimensionality conception, being trapped in a piecemeal approach of "risk factors" and its impact on lifestyles.

Without any doubt, the global crisis of the current and most prevalent development model in the market and the financialization5 of the economy determine the decline of people’s quality of life and the environment, as they are the structural roots to think about "social determinants of health". Consequently, they are a generator of the unequal distribution of power, wealth, environmental resources depletion, lack of cultural diversity, racism, stigma and discrimination that affect the health of our societies at the individual and collective level. That is, for the Latin American civil society, the development model and the current economic system both constitute a major determinant of health.

From this perspective of social change, the native-indigenous-peasant people in Latin America are proposing a new

5 “financierización de la economía” (Spa). Interpreted from the context as the process by which the economy relies more and more on financial institutions and, therefore, credit and other financial instruments.

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development model, which is summarized in the paradigm of "living well", which involves a dispute with individualism, consumerism and competition, typical of the free-market society, to be replaced by solidarity and intercultural cooperation in a model of development that would satisfy the needs of everyone, not just some, and in full harmony with nature. It is clear that in order to progress in overcoming health inequities, it is required to constitute, in a fundamental way, sustainable models of social and economic development, that guarantee human, civil, political, economic, social, cultural, environmental, sexual and reproductive rights in a new institutionalism, territorialism, and state management model that prioritizes life protection through citizens’ integral and interdependent rights.

For this reason, in order to address the "social determinations6 of health", it is fundamental a political reform of the States that guarantees a new intercultural institutionalism with a management model based on a participative-deliberative democracy, the promotion of a new territorialism considering the right to the Mother Earth of our people and native-indigenous-peasant nations, such as urban populations, afro-descendants and migrants, thinking within the framework of a new humanist and popular democracy that recoups the public sphere7 for the care of the habitants and people of the world.

In this context, it is essential for Health to be considered a fundamental and universal human right, a duty and an obligation of the States, which implementation and effective enforcement requires a set of integral responses to a healthy and safe nutrition with food sovereignty; right to a dignifying job; access, use and ownership of land; interculturalism and respect for the other; adequate housing and healthy environment; democratic citizen participation; universal and integral access to health and quality education; non-sexist and equitable social relations; among others .

Ultimately, it is essential to incorporate the development of Universal Social Security Systems, in order to steer a new quality of life or “live well" idea responding to the collective needs of our people.

For this reason, regarding the Technical Document on Social Determinants of Health of the World Health Organization (WHO) and the Regional Document, we propose:

On Governance:

Governance cannot be restricted to be understood just for one State or country in isolation, as there are external dimensions that affect them, like free trade agreements, the implementation of unfair, exclusive and discriminatory global economic policies that increase the vulnerability of collective health, as well as the effects of the crisis generated by the accumulation processes of developed countries.

Global governance requires a political change in international relations, which should be designed not only in terms of intergovernmental relations, but to recover, as it is stated by the United Nations (UN) or even the Union of South American Nations (UNASUR), the relations between "Nations" where the essential main players of the "global governance" are both the States and Peoples, who must be consulted on health-oriented State policies in a clear, fair and binding way. In this area, it is important to promote the participation of civil society not only at the Nation-States level, but also at the level of supranational and multilateral bodies, as they are articulation spaces for global decisions that should gather the civil society’s opinion and not just government’s.

6 “determinaciones sociales de la salud” (Spa). Interpreted from the context as determinants of health but emphasizing the idea that they are determined by forces outside the control of the individual.7

“que recupere la esfera de lo público” (Spa). Interpreted from the context as the action of making it more accessible to regular people.

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One example is the New York Summit on Non-Communicable Diseases (NCD) that will define global policies regarding social determinants of health (SDH), which did not have serious and effective consultation with civil society. Policies in this Summit should affect the over-consumption of "junk-food", alcohol and tobacco, and the ecosystem destruction by primary extractive industries, as well as the access to medicine, all of which require global decisions, such as making relative the concept of intellectual property in the WTO (World Trade Organization) for taking care of people’s lives.

Governance in favor of determinants must be supported by a commitment to human rights, fulfilling the pacts, agreements, treaties and declarations on human rights signed by the States, emphasizing their interdependence, integrity and universality.

The level of the States’s autonomy to define internally the decisions of their policies represents a key indicator of development. A principle to be incorporated into the Governance is the sovereignty of the States and defense of public interests.

Encouraging a governance process from the determinants point of view should involve “transectoriality”8, where it is assumed the role of addressing the SDH by the union of the national government and the sub national / local ones, recognizing social needs and their complexity. Governance, at different government levels, must involve the real policy makers, so the reached consensus can be used as a tool to monitor the compliance of policies agreed with citizens.

An underlying approach within the WHO document about SDH is a vision of civil society as basically collaborative, cooperative, and submissive with Governments. It is set out that the Governments will always legitimately represent the interests and collective needs of their societies, which is not always the case. This perception does not consider the existence of social conflict as an underlying element in social relations and that its settlement does not necessarily requires civil society to put aside their principles, proposals and points of view. Within the framework of unequal, unfair and inequitable societies, the social relations conflict is a fact, and the construction of the Governance should seek to alleviate the conditions that create these situations without criminalizing social conflict or penalizing the actors involved.

It is important to highlight that there are no symmetrical power relations, so a strategy based on the SDH should consider the reduction of asymmetries, putting the parties involved on equal terms .

The line-of-thought on SDH regarding the decision-making capacity of citizens and civil society at the local level should always be done within a framework of power decentralization, without losing the guidance 9 of the Nation- States and their responsibility to ensure the right to health.

On the role of the health sector, including public health programs, on the reduction of health inequities:

The main contribution of the health sector must be linked to the inclusion in the agenda of States and societies the construction of a Universal Social Security Systems (health, social welfare, social protection, education, etc.) along with the development of Unique Health Systems assumed as a citizenship right and financed by general tax revenues. Considering that the approaches of social determinations have dimensions that transcend the Health Sector itself.

8 “transectorialidad” (Spa). Word referring to policies that affect and are orchestrated by many different areas or sectors.

9 “rectoría” (Spa). Economic term that refers to the power and capacity of the state to direct the activity of economic agents to achieve its development goals and objectives.

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From the assumption that the Health System is a determinant by itself, in order to make the Health System an enhancer of the SDH approach, it should be based on the principles of universality, integrity, interculturalism, equity, and preeminence of its public character.

This will not be possible if we do not single out that the Health Sector has been made hegemonic by the interests of a Medical-Industrial pharmacological involvedness and the financial sector, where without doubt the logic of business based on profitability and corporate revenues usually prevails over people's lives.

In this regard, we note with great concern that the progress of the logic of "assurances in health"10 through segmented and stratified social coverage, which consolidate the development of minimum, partial and focal coverage for “the poorest,” and that nowadays, under the adjective "universal coverage" is promoted by the World Bank in the Americas, results in a regressive reform of the right to health that actually generates a market of providers, insured clients and open-covered privatization of collective health in our countries.

The culture established in our countries, where the public health systems are conceptualized as services for impoverished sectors or for the "poor people", must be challenged stressing the need for building an expanded citizenship where all social classes, under a common core of rights, use and take ownership of a single social security and health system.

That for real progress in the development agenda of Universal Social Security Systems and Unique Health Systems, it is extremely determinant an integral tax reform to generate a fair, equitable and necessary funding.

As an organizing axis of Universal Systems, we consider Primary Health Care, transversally, as an integral strategy which promotes community and citizen participation, and the transectoriality.

The health sector is responsible for adapting the training of workers to the approach of the Social Determinants of Health, demanding educational-pedagogical institutions to be consistent with the needs arising from this process. Public universities should incorporate approaches of equity and social determinants of health in the training of health personnel, promoting action-research from a critical and socio-cultural epidemiology; and also contribute with civil society organizations through popular education with the promotion of human, technical, social and political skills that contribute to mobilize communities and the public in general.

The evaluation of health services should be guided by broader indicators, not only in terms of productivity, but also in terms of quality, cultural relevance and impact (that measure the equity of care, integrity, continuity/ cross-sectionality, community participation, among others) and not only by focalized indicators related to specific programs on social damage and/or disease.

We consider important to include how to address the stigma, non-discrimination, humanization of care, prioritizing communicable diseases such as HIV, STIs, among others.

On Social Participation:

Popular participation, understanding civil society as a multitiplicity of popular social actors, is essential to design and build a real democratization of our societies, considering that it has a central role from the local level to the global and vice versa to:

10 “aseguramientos en salud” (Spa). Interpreted from the context as the idea of being able to access the healthcare system most likely through a Universal Social Security System.

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At a national level, commit ourselves to the construction of an expanded public sphere that generates an impact on our countries’ political agenda on Government-States, political systems and civil society on its broadest definition.

Democratize decision-making at all levels (local, national, supranational), through an effective intercultural, diverse and inclusive citizen participation with real power. This requires the development of appropriate legal and institutional frameworks.

At the local level, foster the development of processes for local social participation, social gathering arenas, community and collective organization, generating a critical, problematic, popular and extremely humanistic local citizen subjectivity.

The role of civil society organizations to ensure representativeness and legitimacy, especially as an expression of vulneralized11 groups holds that it is necessary:

To monitor and advocate for governments’ public policies, funding and specific programs to meet the needs of vulneralized people and to not use the needs of these groups to take economical advantage of their situation.

In this context of participation, it is essential that the regional document is made available to the native-indigenous-peasant people, afro-descendants and migrants with their own experiences as people/nations and their own ways of doing health.

* Strategies to promote participation: Free self-determination of peoples, especially native-indigenous-peasant and afro-descendants, reaffirming

international instruments and agreements that have been already established.

Recognition of the organization for the original-indigenous Governments with valid dialogue of national States, as well as supranational bodies.

Improve communication and key information (epidemiological, health, social, legal, etc.) dissemination channels produced within the same organizations, States and the people.

Learn from the participatory experiences of other countries that share the same conditions, with the importance of access to technologies and ingenious ways of sharing their know-how and action.

* That the Governments / States establish clear mechanisms to enhance human, technical, social and political capacities of vulneralized groups to document and systematize their own knowledge, needs, experiences and practices.

Exchanges to boost knowledge and create new participatory, collective and respectful evidence, opposite to the formats of a "manipulated” consultation.

Carry out work and research-action processes with native-indigenous-peasant peoples, afro-descendants and migrants to build conceptual frameworks for the SDH.

Joint work of indigenous, afro-descendants and migrants peoples with the State's public institutions related to health in order to have an informed and competent participation respecting their own worldview, cultural diversity and adherence to the concept of intercultural in health.

11 “vulnerabilizados” (Spa). Interpreted from the context as the idea that the vulnerable groups are not vulnerable because they lack the capacity of overcoming their current situation but because society and other external factors do not allow them to do so.

26

Respectful exchange of knowledge and practice to help the intercultural strategy in health, as well as in public policy in general.

* Strengthening native-indigenous, afro-descendants and migrants people health models, taking them as strategic intercultural contributions to a Unique Health System:

Define criteria for identifying communities and/or territories, as well as indigenous, afro-descendants and migrants populations, in order for the States to fully respond to their particular health needs.

The recognition of the nature of Plurinational States12 by the Governments. Plural

Support to people's organization of indigenous-natives, afro-descendants and migrants, with economic and educational resources for the creation of a plural health system. Specific programs or inclusion of various models of healthcare.

The recognition and understanding by the governments of the native-indigenous, afro-descendant and migrant people’s reality on the continent and the development of a plural health system.

Inclusion of more indigenous-native, afro-descendant and migrant health workers in public health services.

On Measurement, Surveillance and Indicators of Social Determinants:

As people are part of the States, in order for them to have an articulated leading role and real participation in the surveillance of the SDH progress, it is fundamental to have the support of international organizations and, in the specific case of Latin America, of regional bodies.

We believe that the indicators proposed in the WHO document will not be able to demonstrate the improvement in structural determinants that define health inequities. This is why, in this regard, our organizations suggest building new indicators.

It is necessary for all the indicators to be developed taking into account the categories of social class, gender, age, ethnicity, education level, among others. This will allow to visualize the progress or setbacks in different population groups.

A determinant to be considered and incorporated in the surveillance and measurement process is VIOLENCE . We need indicators to measure different types of violence, including the institutional type, as well as the state violence through non-democratic and authoritarian regimes.

We propose to develop an indicator that takes into consideration the relationship between the military and police expenditure, and on the other hand, the investment on health and education.

On Global Action:

In this subject, the investment strategy must seek the creation of integral life systems that promote health, civic infrastructure and the general wellbeing. We encourage to set aside the idea that local is a "smaller" version of national or global matters. Is at the local level where the are issues on climate change, energy, pollution, health,

12 “Estados Plurinacionales” (Spa). Interpreted from the context as a State that is diverse in terms of population and ethnicity, respects and encourages the socio-cultural diversity of its population, and guarantees some specific rights to the Indigenous people and/or other vulneralized groups.

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active citizenship, and inclusion are articulated, and where we put forward three key components of very practical proposals:

1) REORGANIZATION of GOVERNANCE and INTERNATIONAL COOPERATION: promote initiatives for decent and healthy lives or "living well" with a regional council with parity of representatives from the civil society and international organizations, that finance cooperation and development projects addressing the social determinants and prioritizing issues such as global warming, health, environment, sustainable development, housing, education, among others.

2) FOCUS ON LOCAL AND METROPOLITAN PROJECTS THAT MOBILIZE ECOLOGIES OF ACTORS, CITIZEN-GOVERNMENT INITIATIVES WITH INCIDENCE on Corporate Social Responsibility (CSR). Such interventions should be co-managed by civil society entities in cooperation with local and metropolitan government entities, including the organized-neighborhood level.

3) Development of ACADEMIC RESEARCH AND ACTION CENTERS FOR A DIGNIFYING AND HEALTHY LIFE, with parity in the representation of civil society and academia. Supported by the global system, and created through an open government grant bid that convenes strategic partnerships between civil society actors and the academia in Latin America.

Consequently we take the citizen and militant commitment of:

Based on the importance of having access to the information about the debate on Social Determinants of Health of the WHO, we commit ourselves to develop alternative reports and to publish them in order to express, from our critical view, the progress in this process taking into consideration:

The strengthening of an effective participatory democracy. Strengthening civil society organizations, through the promotion of unity and informed participation, in decision-making spheres.

The promotion and incidence on SDH policies. Development of skills for political advocacy on the inclusion of the social determinants of health approach in policies at the global, national and local levels. Strengthen the propositional capacity of public policies based on evidence and with the ability to develop social mobilization.

The International Incidence. Strive to add in the agenda of national, regional and global non-health civil society, the determinants of health (e.g., World Social Forum, Vía Campesina, Global Union Movement, etc.).

Development of community experiences. These should have a strategic political perspective of the SDH to encourage all community efforts that strengthen power distribution and reduction of inequities.

Finally, we collectively agree to present as contributions to the Americas Regional Document, as well as to the World Conference on Social Determinants of Health the following study cases:

Historical experience of the Latin American Social Medicine Association (Asociación Latinoamericana de Medicina Social - ALAMES).

As a successful experience in the health sector, present the reform of the state on the development of the Unique Health System in Bolivia.

Document the experience of indigenous people participation for their inclusion in the National Health System in Guatemala.

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Document the experience of the National Users’ Movement for Public and Private Health (Movimiento Nacional de Usuarios de la Salud Pública y Privada) on citizen surveillance in Uruguay.

Document the case of the Citizen’s Roundtable (Mesa Ciudadana) for the bicycle paths inclusion in Chile.

Document the case of the political incidence for the transformation of the Peruvian healthcare system.

Document the experience of community action on social determinants of health and social participation in Porto Alegre, Brazil.

Document the case of the indigenous health model from a native nation in Canada and its participation in the Canadian system.

Document the reform process of the Health System in El Salvador regarding the participatory formulation of public policy, cross-sectoral approach experience and development of the National Health Forum as part of a community scaffolding of people’s leading role.

Document the experience in Haiti's Republic of the development of a promotional strategy of integral health assistance using the social determinants to combat the cholera outbreak.

Civil Society Organizations from: Argentina – Bolivia – Brazil – Canada – Chile – Colombia – Costa Rica – Ecuador – El Salvador – United States – Guatemala – Honduras – Nicaragua – Panama – Peru – Dominican

Republic – Uruguay

7. Next Steps

a. Consolidation of a civil society network of organizations committed to the social determinants of health

It is necessary to have a consolidated body of civil society organizations interested in building conceptual matters on the determinants, strategies for technical cooperation and the development of models to counteract the social determinants that affect health. This consultation process has consolidated a network of civil society organizations with whom it is now possible to dialogue strategies that can inform and communicate their perspective in order to address the relevant issues to government authorities in both the OAS and PAHO.

b. Establishment of a permanent virtual consultancy space on social determinants of health

This group of organizations requires a permanent virtual space to build consensus and share their experiences. Within the framework of the OAS-PAHO alliance, work is being done to have this tool as well as - among other things - a proven and efficient directory that includes civil society organizations that are genuinely interested in the issue of social determinants of health. In turn, this space would allow both PAHO and the OAS to create a working group to coordinate efforts in future instances. This group should become increasingly strong in order to encourage and increase civil society participation in shaping public policy decisions that affects them.

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As immediate steps, PAHO is developing a blog to continue the reflection on the social determinants of health, given that the OAS will continue to offer virtual forums for dialogue through the Summits Secretariat.

c. Activities within the framework of the WHO Global Conference, October 19 to 21, 2011, Rio de Janeiro, Brazil

To date we have been coordinating the space for civil society participation with the organizing committee, which is expected to involve a select group of representatives to present the results of this consultation.

d. Joint cooperation projects and initiatives for future Summits

The OAS and PAHO will work together to offer the results of this process as inputs to negotiations on matters that involve the subject and the Declaration to be signed by the Heads of State and Government in the framework of the Sixth Summit of the Americas. This Summit, to be held in April 2012 in Cartagena de Indias, Colombia, will have the mission statement of "Connecting the Americas, Partners for Prosperity" where one of the main topics of discussion will be poverty and inequality in the Hemisphere.

Additionally, the results of the consultancy will be presented to members of the Working Group which will develop indicators for measuring progress of the rights protected in the Protocol of San Salvador. The latter will serve as input on the rights perspective to confront the challenges proposed by health, as well as to share the methodology of the survey conducted by virtual means.

The Social Charter of the Americas is currently being prepared and will soon be designing its Plan of Action. In that space of dialogue, the Secretariat may also share the results of this activity with the political body of the OAS.

It should also be noted that the Department of Social Development and Employment holds a meeting of ministers and senior officials of social development every two years, in which PAHO has participated in the past. This forum will be conducive to further dialogue on comprehensive and multidimensional approaches to address the challenges of poverty and inequality.

8. Annexes

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Annex 1Summary Statistics of the Virtual Forum

Hemispheric Consultation: Social Determinants of Health (Total)USERS

Total, Registered Users 113*

Total, Female 56

Total, Male 57USERS BY AGE

Under 18 0

18-24 16

25-40 45

41-54 31

55 and over 21COUNTRIES

Total number of countries represented by users 29*DISCUSSION THREADS

Total number of discussion threads in the group/forum 13COMMENTS

Total number of comments in the group/forum discussion threads 97

*Calculated by a simple summation. The numbers might include duplicates due to the independent nature of the English and

Spanish versions of the Forum.

EnglishUSERS

Total, Registered Users 22

Total, Female 11

Total, Male 11USERS BY AGEUnder 18 0

18-24 5

25-40 10

41-54 2

55 and over 5COUNTRIESTotal number of countries represented by users 10DISCUSSION THREADSTotal number of discussion threads in the group/forum 4COMMENTS

Total number of comments in the group/forum discussion threads 12

SpanishUSERS

Total, Registered Users 91

Total, Female 45

Total, Male 46USERS BY AGEUnder 18 0

18-24 11

25-40 35

41-54 29

55 and over 16COUNTRIESTotal number of countries represented by users 19DISCUSSION THREADSTotal number of discussion threads in the group/forum 9COMMENTSTotal number of comments in the group/forum discussion threads 85

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Annex 2Sample of the Survey on Social Determinants of Health

Profile on the Determinants of Health in the Region of the Americas from the civil society perspectiveRegional Survey OAS - PAHO

Institution:

Country:

Contact information

Name: Position:

Phone: E-mail:

NGO Objectives

To which Social Determinants of Health your NGO is responding?

If selected, would you be available to travel to:

Costa Rica (August 8 - 9) YES____ NO____

Brazil (October 19 - 20) YES ____ NO____

The goal of this survey is to gain the perspective of civil society in the Americas regarding the impact of economic, social and environmental determinants of health on the quality of life, the reduction of the gap in health access inequality, and the advancement of the Millennium Development Goals.

The social determinants of health are the circumstances in which people are born, grow, live, work, and age, including access to healthcare and its quality. These “determinants” or circumstances are the result of income distribution, power and resources at the local, national and global levels, all of which, in turn, depend on the policies adopted by each country. The determinants of health explain the unfair and avoidable differences within and between countries with regard to their sanitary situation. For this reason, the results of this exercise will provide inputs on the reflection process in the observance of the right to health within the framework of the Additional Protocol of the American Convention on Human Rights on Economic, Social and Cultural Rights, “The Protocol of San Salvador”.

The results will be presented at the PAHO´s Regional Consultation Meeting on Determinants of Health, to be held in Costa Rica, on August 8-9, 2011, as a contribution to the dialogue and reflection on this matter.

The regional position will also be presented at the World Conference on Social Determinants of Health, which will take place on October 19-20, 2011 in Rio de Janeiro, Brazil.

Civil society representatives that respond to this survey will be selected to attend the Regional Meeting in Costa Rica, based on their response, active participation, and by ensuring the geographical representation of all the regions of the Hemisphere. In addition, in Costa Rica, some of these representatives will be selected to represent our regional civil society’s position at the World Conference on Social Determinants of Health in Brazil.

Please order by importance (1 being the most important and 11 the less) the following determinants of health inequities according to your organization’s experience:

( ) Income( ) Education level( ) Access to health services( ) Gender( ) Ethnicity( ) Working conditions( ) Access to justice( ) Participation in the decision making process( ) Access to infrastructure and transportation (bridges, roads, etc)( ) Environmental conditions( ) Other: __________________________

Questions

1. Through what policies and/or programs does your organization think social determinants of health are currently being addressed in your country or region? (Check all that apply)

Programs and policies to …Extend education Reduce povertyReduce unemployment Extend access to free and universal health servicesAddress gender perspective

Defend human rightsPromote participation and community empowerment Address indigenous people and afro descendents needs Promote sustainable development programsOther(s): ______________________________________________

2. a) Some of these determinants present major challenges to your country or region. From your organization’s perspective, who is addressing these challenges? Please specify. (Check all that apply)

National government: __________________________________________________________________________________________________________________________

State or local (municipal) governments: ____________________________________________________________________________________________________________

Civil society organizations: ______________________________________________________________________________________________________________________

Grassroots: ___________________________________________________________________________________________________________________________________

None of the above: ______________________________________________________b) How? Please explain.

Through public policies: ________________________________________________________________________________________________________________________

Through programs, projects or initiatives: __________________________________________________________________________________________________________

Through focalized interventions in vulnerable groups: ________________________________________________________________________________________________

They are NOT being address: (Why do you think this is the case?) _______________________________________________________________________________________

3. What is the relationship between social determinants of health and the Millennium Development Goals (MDGs)?_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

4. How would your organization help to successfully overcome the social determinants of health inequalities in your country/region over a ten-year period? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

5. In your organization’s experience, what has worked in addressing inequities in health? What has not worked?At the national level: _______________________________________________________________________________________________________________________________________________________________________________________________________________

At the local level: __________________________________________________________________________________________________________________________________________________________________________________________________________________

6. If you were selected to represent civil society in the Regional and World Conferences in Costa Rica and Brazil, what would be the main message you would include in a civil society declaration? (Max. 500 characters)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

THANK YOU FOR YOUR TIME!

Please submit the consultation by July 20, 2011.

Annex 3Directory of Participating Organizations on the Survey and their Objectives

Participating Organizations on the Survey and their Objectives on the Social Determinants of Health Subject

Country Institution NGO Objectives: To which Social Determinants of Health your NGO is responding?

Argentina Alianza Mesas Redondas Panamericanas La cultura y la educación

ArgentinaAsociación Azul - apoyos para la vida independiente de las personas con

discapacidadel derecho a la salud de las personas con discapacidad

Argentina Asociación Civil Trama - Lazos para el desarrollo Inequidad de género Inequidad por motivos étnicos

ArgentinaAsociación de Sordos Chubutenses +

Federación de Organizaciones Unidas de Discapacidad

A la Discapacidad

Argentina Centro de Estudios Ambientales (CEDEA)La ONG tiene como objetivo la promoción equitativa del desarrollo sostenible. Dentro de esta meta, la relación salud - ambiente es primordial, partiendo de la base que la inequidad es uno de los factores principales en los determinantes de la salud, y muy particularmente en los determinantes medioambientales.

Argentina Centro de Estudios Legales y Sociales (CELS) Nivel económico, acceso a servicios de salud, origen étnico, acceso a la justicia. condiciones del medio ambiente, acceso al agua

Argentina CREDES Nivel económico; Acceso a los servicios de salud; Nivel de Educación

Argentina Foro Ciudadano de Participación por la Justicia y los Derechos Humanos FOCO Pobreza, Empleo, migración

Argentina FUNDACION HUESPED

We work locally and regionally to respond to HIV/AIDS both as an infectious disease and as a social challenge. We improve access to information, education, treatment and prevention. We raise public awareness and support and build knowledge through research and training health professionals and empowering local community resources including legal protection against discrimination.

Argentina Fundación Huesped

Desarrollamos un modelo de intervención para la promoción de la salud sexual y reproductiva y la prevención, cuidado y tratamiento del VIH/sida e ITS basado en la defensa de los derechos humanos y la equidad de género y dirigido fundamentalmente a poblaciones vulnerables; en este marco se abordan de manera integral los determinantes culturales, políticos, económicos y sociales de la inequidad en la salud.

Argentina Fundación Rioja Niños con malformaciones congénitas quirúrgicas que por razones culturales y socioeconómicas no tienen acceso a la atención integral y continua. Nuestra fundación realiza cirugías de niños con labio leporino y otras malformaciones (www.fundacionrioja.org.ar) se fundamenta en atención médico-quirúrgica, investigación de malformaciones congénitas y factores de riesgo, y educación y acompañamiento a la información y formación para profesionales del

interior que en la soledad no tienen acceso a capacitación.

Argentina Hábitat para la Humanidad ArgentinaOfrecemos a familias que viven en condiciones inadecuadas la oportunidad de gestionar una solución a su problema habitacional abordando ésta de manera integral. Entendemos que existe una relación directa entre las condiciones habitacionales y la salud por lo que el acceso a una vivienda adecuada es también un acceso a la salud…

Argentina Instituto CS. de la Seguridad-Universidad CAECE

Nuestro instituto aborda la problemática de la "seguridad Humana", no solo como ideal, sino como objetivo y necesidad primordial. Este nuevo derecho incluye en su glosario al área de la salud como variable sustentable. Es fundamental para nuestra región que todos los determinantes planteados presentan un problema que no es de abordaje operativo sino de disfunciones estructurales.

Argentina Lxs Niñxs Primero

Los objetivos fundamentales son: El pleno ejercicio de los derechos económicos, sociales y culturales. Desde esta perspectiva buscamos palear la pobreza, desnutrición, en las zonas rurales de alta vulnerabilidad social, buscando un acceso equitativo de los derechos de los niños/as, a la cultura, educación, salud, medio ambiente. Fomentando el desarrollo humano integral del niño y niña…

Argentina Médicos del Mundo Argentina/Cono Sur

Médicos del Mundo Argentina es una ONG humanitaria del campo de la salud colectiva, siendo la única delegación en el Cono Sur de la Red Internacional de Médicos del Mundo/Medecins du Monde (30 años de trayectoria), que desde hace 13 años trabaja por el derecho a la salud y calidad de vida de los pueblos en Argentina y América Latina (Perú, Bolivia, Haití, República Dominicana y Paraguay actualmente)…

Argentina Mujeres por la Solidaridad Nuestra organización trabaja por el derecho de las Mujeres y por lo tanto para nosotras las salud de las personas la tomamos desde el concepto de salud integral (biosíquica-social y económica)

Argentina Pequeña Casa de Nazaret

Nuestra ONG, una asociación civil sin fines de lucro, perteneciente a el sector de la OEA/OAS, se dedica desde el año 1986, al estudio, prevención y tratamiento de los jóvenes toxico-dependientes y pacientes de SIDA, además tenemos el grato honor de pertenecer a las Naciones Unidas, al Consejo Social y Económico de las Naciones Unidas, (ECOSOC) , desde el año 1990, con Status Consultivo Especial, tal cual, lo firmo, la Asamblea General de la Naciones Unidas, año 1991

Argentina Presidencia de la Nación - CONADIS A que son un grupo vulnerable las personas con discapacidad

Argentina Red de Personas Viviendo con VIH - Sida Mar del Plata Al empoderamiento de las Pvvs

Argentina UNCOEducación universitaria de grado en la Facultad de Medicina de la Universidad Nacional del Comahue con sede en Cipolletti provincia de Río Negro de la Patagonia, en la Cátedra de Bioética de la Carrera de Medicina. Desarrollamos temas relacionados con los fundamentos de la Bioética en el mundo y Latinoamericana…

Barbados Barbados Association of NGOs Poverty and the inability to access certain forms of healthcare and medication and immigration in respect to persons residing in Barbados for many years but who are not citizens

Belize United Belize Advocacy Movement We are an advocate organization that reduces stigma and discrimination using a rights-base approach with a focus on sex workers, MSM/LGBT and PLHIV populations.

Bolivia ADESPROC LIBERTAD GLBT Defensa de los DDHH de la población GLBT ADESPROC LIBERTAD responde a la salud mental (psicológica) y a la prevención primaria en población joven y población GBT y HSH

Bolivia CENTRO DE MUJERES AYMARAS CANDELARIA, BOLIVIA

En área de salud comunitaria trabajamos para que la comunidad tenga acceso a los servicios de salud, ligados a la educación y a la generación de ingresos económicos implementando proyectos productivos.

Bolivia MSP LA A la promoción del derecho a la salud, cuestionando la medicina mercantil, y sobre todo el modelo económico actual que impone condiciones de vida que enferman.

Bolivia ONAEMLas Trabajadoras Sexuales en Bolivia, no tenemos acceso a la salud integral, ya que las revisiones médicas que se nos practican sólo atienden al área ginecológica, olvidándose de nuestra persona en su integridad. Uno de nuestros objetivos es conseguir que se nos atienda de manera integral…

Bolivia Red Nacional de personas que viven con VIH Sida en Bolivia (REDBOL)

Somos una Red Nacional de Personas y Grupos de personas con VIH, sin fines de lucro, orientación religiosa o partidista, líderes en la incidencia política para el Acceso a la Atención Integral de las PVVS, somos una Red transparente…

Bolivia Red Vanguardia Internacional NABolivia SERCOIN LTDA Ejecución proyectos llave en mano, capacitación

Bolivia Wilde & Asociados SRLSomos una sociedad privada de odontólogos y dentro de nuestro capitulo de responsabilidad social empresarial esta el establecer nuevos protocolos de atención para la población de escasos recursos, prioritariamente en áreas rurales y periurbanas.

Brazil CCLP Worldwide Education, Sustainability and Livelihood

Brazil IIDAC - Instituto Internacional para el Desarrollo de la Ciudadanía SIDA

Brazil Instituto Brasileiro de Fluência - IBF

Trabalhamos com os portadores da gagueira (tartamudez), dando a eles assistência médica (fonoaudiológica) e assistência jurídica, tendo em vista que, por força do problema da fala, são discriminados no lar, na rua, na escola e no trabalho. Além disso, os itens discriminados em nossos Estatutos Sociais, de cujo conteúdo se encontra e registrado na Sociedade Civil da OEA.

Brazil Ipas

Ipas es una organización internacional no gubernamental dedicada a eliminar las muertes y discapacidades evitables atribuibles al aborto inseguro. Las mujeres con menor escolaridad, que viven en las áreas rurales y en las periferias urbanas, afro descendentes, indígenas y mestizas son las que tiene mayor riesgo de muertes evitables por aborto inseguro.

BrazilMovimiento para la Salud de los Pueblos -

Brasil (MSP - Brasil) / Movimiento para la Salud de los Pueblos Latino-América (MSP-LA)

Nuestro objetivo principal es contribuir para concretar el derecho a la salud (sistema universal - SUS en Brasil), fortaleciendo la participación comunitaria, junto con los consejos de salud, que son las instancias de participación concebidas en el sistema de salud de Brasil …

Canada Metis National Council

MNC acts as an advocate and liaison for the Metis Nation (One the three Aboriginal Groups recognized by the Canada's constitution) with the government of Canada and collaboratively works on the development of national policies for the furtherance of the Metis Nation's self- government aspiration. MNC supports the mandates of the ministries established within Metis Nation Cabinet this sector include: Social Development, Economic Development, Health, Environment, Culture and Heritage, Governance, youth and women’s issues.

ChileAgrupación de Personas Viviendo con

VIH/SIDA, Familiares y Amigos Positivamente Positivos Talcahuano

Nuestra Organización lucha por una salud integral hacia Personas Viviendo con VIH, en el Hospital Las Higueras de Talcahuano, y la cual solo existen la entrega irresponsable de los Tratamientos Antirretrovirales.

Chile Ciudad Viva

Al tema del diseño urbano, que inhibe el transporte activo y el uso de la calle y otros espacios públicos para actividades que fomenten la salud mental y físico de las comunidades urbanas, dañando particularmente la salud mental de los adultos mayores, y las posibilidades de desarrollo de los niños, especialmente donde no cuentan con áreas verdes adecuadas.

Chile Comisión Derecho Indígena Arica ParinacotaResponde a la inequidad de los factores de los residuos minerales por empresas mineras que afectan la salud y medio ambiente de la población Aymara de la zona y en la cual las políticas públicas no respetan los derechos esenciales del pueblo Aymara a ser consultado por los efectos que traerían estos en la salud y el medio ambiente del altiplano.

Chile Fundación de Beneficencia Hogar de Cristo El Hogar de Cristo acoge con amor y dignidad a los más pobres entre los pobres, para ampliar sus oportunidades a una vida mejor. Convoca con entusiasmo y vincula a la comunidad en su responsabilidad con los excluidos de la sociedad.

Chile Organización de Transexuales por la Dignidad de la Diversidad

OTD-Chile, se preocupa principalmente en lograr que las personas transexuales tengan acceso igualitario a la salud, primero respetando su identidad de género, es decir si legalmente son mujeres, pero se sienten hombres sean tratados como hombres, en sus ficha y de trato directo y segundo puedan acceder a los procedimientos quirúrgicos de readecuación genital y de terapia de sustitución hormonal…

Chile Universidad Bernardo O´HigginsBásicamente a la salud psíquica en tanto a la calidad de la salud, que puedan gozar los estudiantes, no sólo que tengan un acceso a aparatos clínicos sino, que tengan la libre elección de una salud expedita, de calidad y sin demoras de plazos postergados o a un nivel nominal de salud.

Colombia Aguas y Aguas de Pereira Agua potable y saneamiento

Colombia Alcaldía de MedellínLas condiciones de vida con estrategias de educación y asistencia social conducida, las circunstancias psicosociales con programas de atención individual en salud mental y actividades de recreación, actividad física y deporte , factores conductuales o biológicos…

Colombia Alcaldía de Toledo, Antioquia Como trabajo en una alcaldía municipal, nuestro objeto es el de responder y administrar todos los determinantes sociales, para lo cual se cuenta con distintos profesionales…

Colombia ALIANZAS PARA EL MEJORAMIENTO ORGANIZACIONAL

MEJORAMIENTO DE LA CALIDAD EN LA PRESTACIÓN DE LOS SERVICIOS DE SALUD CON ENFOQUE A LA SATISFACCIÓN DEL USUARIO Y SU FAMILIA

Colombia Asmedas Acceso a servicios de saludColombia Asociación Avanzar Acceso, atención, perspectiva de género, promoción y prevención.

Colombia Asociación Comunidad Motilón Bari de Colombia

Es una asociación de comunidades indígena en pro del desarrollo de la comunidad. (…) Nuestra organización es muy complicada porque no está en la líneas de trabajar la salud pero hemos hecho saber de mil manera que nuestro pueblo este acabando la tuberculosis…

Colombia Asociación de pacientes de VIH Nueva EPS Bogotá Acceso al sistema de salud “inequidad”

Colombia Asociación Latinoamericana de Medicina Social

ALAMES es una organización regional que busca incidir en los gobiernos, movimientos sociales y sociedad en general, en la generación de conocimiento y de incidencia para afectar los determinantes en su conjunto y aportar a la reflexión y participación social para la universalización de los servicios de salud, desde una concepción del derecho a la salud.

Colombia ASORUCALI A través de la vinculación de las diferentes organizaciones fortalecemos todos los aspectos relacionados con la ejecución de programas y el ejercicio de atención a las diferentes poblaciones sujetos de su intervención…

Colombia BIOPREVENTION SAS Mi organización diseña productos de bioingeniería y biotecnología para garantizar diagnósticos oportunos en casa; fortalecemos la atención primaria en salud con inventos seguros, costo-efectivos y de alta calidad.

Colombia Cabildo Indígena CHIBCARIWAKA que los indígenas que habitan en Medellín tengan acceso pleno a los servicios de salud de origen indígena como de origen occidental, sin importar la razón por la que llegaron a la ciudad sea desplazamiento forzado, por estudios o por otras razones.

Colombia Centro de Orientación Social Solidaridad Caribe

Promover, difundir y defender los DD.HH. y en Salud de la población en general, especialmente aquellas en contexto de vulnerabilidad. Promover el mejoramiento de la calidad de vida y la prevención de la enfermedad, especialmente las ITS, con énfasis en el VIH/Sida y las hepatitis virales. Velar por la calidad en la atención en salud en general. y el acceso a los servicios de salud.

Colombia Centro de Vida Sana Educación en prevención y promoción de la saludColombia Clínica Las Américas NA

Colombia Colectivo Sin Horario

El Colectivo recoge las inquietudes de trabajadoras y trabajadores que no forman parte de las plantas de personal de diversos sectores públicos de la ciudad de Bogotá, pero fundamentalmente de los hospitales del Distrito. Uno de sus objetivos es el análisis de las condiciones de trabajo y sus determinaciones en el estado de salud de los y las trabajadoras.

Colombia Colombia Rinde Cuentas Veeduría Participación en la toma de decisiones, Acceso a la Justicia

Colombia CORPLANIFICAR Red Regional de Consejeros de Planeación del Caribe

La organización articula y verifica con los consejos territoriales de Planeación la inclusión en los diferentes planes de desarrollo de la región Caribe Colombiana en temas que inciden en el mejoramiento de la calidad de vida de los ciudadanos que representan, especialmente salud, ambiente, vivienda digna, educación infraestructura y desarrollo económico entre otros. Se hace seguimiento y control a los planes de desarrollo de la Región.

Colombia CORPORACION OPCION POR EL DERECHO A SER Y EL DEBER DE HACER

INCLUSION DE LAS NECESIDADES DE SALUD DE LAS PERSONAS TRANS Y DE LAS PERSONAS EN EJERCICIO DE LA PROSTITUCION Y ACTIVIDADES CONEXAS ASI COMO LA DECONSTRUCCION DE TODO TIPO DE BARRERAS QUE IMPIDEN EL ACCESO A LOS SERVICIOS DE SALUD DEL ESTADO COLOMBIANO.

Colombia CORPORACION PROYECTO VISION “CORPOVISION”

Propendemos por el mejoramiento continuo de calidad de vida de la población vulnerable, a través de la prestación de un servicio social con sentido humanista en el marco de la constitución y la ley.

Colombia Empresa Social del Estado Hospital San Vicente de Paúl Acceso a los servicios de salud y la calidad de los mismos

Colombia ESE Hospital San Antonio NA

ColombiaESTRATEGIA PARA LA DISMINUCIÓN DE LA

POBREZA EXTREMA "UNIDOS" - PRESIDENCIA DE LA REPUBLICA

El trabajo de este programa, que de hecho es gubernamental, está orientado a cambiar algunas situaciones que son riesgo e imposibilitan un mejor goce o acceso a los derechos como ciudadano y ser humano…

Colombia Fac. Nacional de Salud Pública - Universidad de Antioquia De la salud con los determinantes asociados

Colombia facultad nacional de salud publica A la inequidad de accesos a los servicios de salud

Colombia Facultad Nacional de Salud Pública, Universidad de Antioquia

Participación en la toma de decisiones: la FNSP lidera y participa en las Mesas por la defensa del derecho a la salud que promueve reformas institucionales que garanticen la materialización del derecho a la salud…

Colombia FAO NA

Colombia Fundación Casa GAMIA los generados por el acceso a la salud, negación de los servicios por parte de las entidades de salud administradoras en el país (denominadas Entidades Promotoras de Salud), especialmente a personas con enfermedades que conllevan alto costo: Cáncer, Insuficiencia Renal, VIH y otras patologías…

Colombia FUNDACION CENTRO CULTURAL COLOMBO PERUANO

DENTRO DEL TRABAJO QUE REALIZAMOS INVOLUCRAMOS UN PROCESO DE APOYO SOMÁTICO CON EL CUAL SE DEBEN EQUILIBRAR MENTE Y CUERPO PARA EL DESARROLLO DE ARTESANÍAS, ARTES ESCÉNICAS Y EMPRENDIMIENTO CULTURAL, LO QUE APOYA SU CALIDAD DE VIDA Y POSIBILITA E INCENTIVA SU VINCULACIÓN AL SISTEMA GENERAL DE SALUD.

Colombia Fundación Cristiana Un Nuevo Amanecer A la Restauración y resocialización del adicto a sustancias psi activas y a la persona en situación de calle

Colombia Fundación Interdisciplinaria para el Desarrollo de las Comunidades

La Atención primaria en Salud y la atención en los Niveles 1,2,3 y 4 dependen del estrato y condición socioeconómica, mientras más recursos o dineros se tiene, mejor es la calidad de atención que se presta, esto es contrario a lo que establece la Constitución Nacional de Colombia…

Colombia Fundación Luz de Esperanza Personas que conviven con el virus del VIH-SIDA, Trabajamos porque estas personas luego de ser diagnosticados, accedan al sistema general de seguridad social en salud y puedan contar con una Atención Integral…

Colombia Fundación para La Investigación y Gestión Social FIGES:

Los determinantes sociales de la salud sobre los cuales da respuesta nuestra fundación son los relacionados con el respeto por la diferencia de etnias, los socioculturales y los relacionados con la educación intercultural, los relacionados con las enfermedades prevalentes y transmisibles en las comunidades desprotegidas y finalmente los determinantes ambientales.

Colombia Fundación Prevención Que la ciencia de la prevención, como cultura, en especial de la drogadicción y de la violencia, sea una actitud y comportamiento cotidiano de todas las personas, y ejemplo e imitación, a partir de la familia y la escuela.

Colombia FUNDACIÓN PROYECTO GENTE realizar procesos participativos e integradores con y para la gente aportando al proyecto de salud sexual y reproductiva

Colombia Fundación Renacer (…) Desde 2007, Fundarenacer desarrolla el Programa de Comedores Comunitarios que beneficia cada ano a mas de 5 mil niños y jóvenes de zonas urbanas y rurales en el Valle del Cauca y otras áreas del Pacifico colombiano.

Colombia FUNDACION UNIVERSITARIA SAN MARTIN Condiciones del medio ambiente y Socio culturales.Colombia Hospital San Vicente Empresa Social del Estado NAColombia IKALA-Empresa para el desarrollo social Participación en la toma de decisiones

Colombia Independiente

Como una de las profesionales del sector salud (entiendosé el global del entorno de interrelación con el medio de los seres humanos), es para mí de gran afectación un aspecto en singular es el sistema de seguridad social, desde la parte subsidiada, hasta la contribuyente... donde se enfoca más a gestiones administrativas y económicas de las entidades, y no en el "Ser Humano" como tal…

Colombia IPS UNIVERSITARIA Servicios de salud de atención primaria, baja, mediana y alta complejidad.

Colombia Liga Colombiana de Lucha Contra el Sida Objetivos: Proteger la vida y la salud de las personas que viven con VIH o con SIDA y de la comunidad en general mediante programas de asistencia integral ambulatoria y estrategias educativas de prevención…

Colombia MEDELLIN SOLIDARIADentro de sus objetivos esta no solo el de llevar la oferta y rutas de acceso al sistema de salud a la población más vulnerable, sino a través del conocimiento y la participación generar empoderamiento de sus procesos familiares y comunales que les permita autogestionar su propio desarrollo.

Colombia MEDISALUD DEL CAUCA IPS LTDALa organización a la que represento responde al determinante al accesos a los servicios de salud, nos hemos preocupados notablemente con la dificultad o la barrera que los usuarios deben soportar o esquivar al momento de solicitar los servicios de salud…

Colombia Mesa Intersectorial en Defensa de la Salud, Departamento de Santander

La Mesa Intersectorial en Defensa de la Salud, Departamento de Santander - Colombia es una organización que integra profesores de salud pública de distintas universidades, Asociaciones científicas de medicina, Asociaciones de Hospitales Públicos, Sindicatos de trabajadores de la salud y Usuarios del Sistema de Salud Colombiano de la región del Departamento de Santander con el propósito de promover y apoyar el cambio del actual sistema de salud en Colombia…

Colombia Metrosalud Acceso a los servicios de salud

Colombia Mi familia Nivel económico, acceso a los servicios de salud, nivel de educación, condiciones de trabajo, condiciones del medio ambiente.

Colombia ONG Centro de Investigación Multidisciplinaria para el Desarrollo

CIMDER desarrolla alternativas para mejorar la calidad de vida de la población que se encuentra en condiciones de mayor exclusión e inequidad (Género, Etnicidad, Pobreza)…

Colombia Particular. Hablo desde la larga experiencia Credibilidad y pertinencia de la información que se da a los usuarios y en general a la población en cuanto a promoción de la salud y prevención de la enfermedad…

Colombia Profesional Independiente En mi ejercicio profesional busco responder principalmente a acceso a los servicios, atención con enfoque diferencial, eliminación de barreras, mecanismos para la toma de decisiones y sistemas de información.

Colombia SANTAMARIA Fundación Los componentes de nuestra fundación son las violaciones de derechos que sufrimos las mujeres trans por nuestra identidad de género en los hospitales, EPS, IPS de nuestra ciudad Cali y otros municipios y en toda Colombia.

Colombia Santamaría Fundación Nuestra organización Trabaja el Tema de Salud Integral y maneja los siguientes componentes: VIH y sida, ITS, Tuberculosis, Transformaciones Corporales de las Mujeres Trans.

Colombia Secretaría de Educación de Jamundí La Secretaría de Educación del municipio de Jamundí, es la encargada de dirigir la educación de 22.000 niños y niñas. En las aulas estudiantiles es en donde se ve más la problemática de salud de los infantes…

Colombia SECRETARIA SECCIONAL DE SALUD DE ANQUIA Accesibilidad y oportunidad en la atención en salud con calidad

Colombia Universidad CES(…) como asesor municipal del sistema público de salud de Colombia (Régimen Subsidiado) del Sistema General de Seguridad Social en Salud, por tanto convivo, con los problemas que padecen las personas para poder acceder a la prestación de los servicios de salud, sobre este tópico se centra mi interés.

Colombia Universidad CESSomos una Universidad y formamos profesionales de la salud en pregrado (medicina) y postgrado. Nuestro interés es el de formar profesionales íntegros que dimensionen su quehacer y su práctica más allá del asistencialismo y de las respuestas mediáticas a las situaciones de salud…

Colombia Universidad de Antioquia A la falta de criterios de atención primaria en saludColombia Universidad de Antioquia NA

Colombia Universidad de Antioquia

En la Universidad se brinda un aseguramiento, con algunas limitaciones a los estudiantes que no poseen ningún tipo de aseguramiento en salud. La universidad cuenta con programas de promoción y prevención, salud sexual y reproductiva, citas sicológicas y deportes, todos estos de acceso gratuito para los estudiantes que deseen participar y resolver sus inquietudes o problemas…

Colombia Universidad de Antioquia Los ambientales como el cuidado y respeto o no de la naturaleza, del medio ambiente tanto próximo como lejano referente a la limpieza, polución, contaminación, los incendios, la tala de los bosques.

Colombia Universidad de AntioquiaAmpliación de la Cobertura en Educación (educación en áreas regionales, apartadas de la capital), Educación en mejorar las condiciones de vida (socio culturales, familiares y demás). Diseño e implementación de programas con los entes locales y regionales en educación en y para la salud.

Colombia Universidad de Antioquia Como docente trabajamos por el acceso a todos los servicios, es decir, todo aquello que resulta de la consulta también fuera otorgado sin barrera de ningún tipo

Colombia Universidad de Antioquia Nivel de educación. Condiciones del medio ambienteColombia Universidad de Antioquia Nivel de educaciónColombia Universidad de Antioquia NAColombia Universidad de Antioquia NAColombia Universidad de Antioquia EducaciónColombia Universidad de Antioquia Acceso a los servicios de salud

Colombia UNIVERSIDAD DE ANTIOQUIA A LA CALIDAD DEL ACCESO DE LOS SERVICIOS DE SALUD Y A LA FALTA DE EDUCACION, ADEMAS EL NIVEL ECONOMICO POR LA FALTA DE EMPLEO

Colombia Universidad de Antioquia, Escuela de Nutrición y Dietética

Como Institución educativa, estamos enmarcados en uno de los determinantes estructurales donde se ha encontrado mayor evidencia de las in-equidades en salud como la educación superior…

Colombia Universidad de Córdoba Acceso a los servicios de salud y calidad de los mismos, a través del ofrecimiento público de la educación

Colombia Universidad del Rosario Formar en Problemáticas Sociales Contemporáneas en Salud Pública, especialmente en el tema de biopolítica y salud mental.

Colombia Universidad Industrial de Santander -UIS Educación, prevenciónColombia universidad Remington NA

Costa Rica ASOVIHSIDASomos una Organización No Gubernamental, legalmente constituida por y para las PVVS, que busca apoyar a sus integrantes y participantes en un crecimiento integral. Ser una organización de Personas con VIH y sida integrada, capacitada, activa y consolidada…

Costa Rica FEREPRODIS Discapacidad

Costa Rica Fundación AMBIO UN DERECHO HUMANO FUNDAMENTAL DEBE GARANTIZARSE Y PROTEGERSE, ESPECIALMENTE EN RELACION A TEMAS CON CONSUMIDOR, INOCUIDAD ALIMENTOS, AMBIENTE

Costa Rica Instituto Interamericano sobre Discapacidad y Desarrollo Inclusivo (IIDI)

El IIDI trabaja en la promoción de los derechos humanos, particularmente en los derechos de las personas con discapacidad. En el tema de la salud, nos centramos en la necesidad de que las personas con discapacidad tengan derecho a todos los servicios de salud…

Costa Rica Organización Universitaria InteramericanaLa OUI es una asociación sin fines de lucro que persigue objetivos esencialmente educativos mediante la cooperación entre Universidades de las Américas, estimulando la comprensión y ayuda mutua, contribuyendo al desarrollo sostenible de los pueblos de las Américas y respetando la libre discusión de ideas.

Costa Rica Pensionada por Invalidez de la Comisión Europea

Colaboración con: -ACTMON: Asociación del Control de la Tuberculosis al Tercer Món. Programas Educativos y Sanitarios, en Haití, Uganda, Djibuti... -La Fundación Pepe Rubianes dirige sus esfuerzos y aportaciones a la colaboración internacional en zonas con una salud pública precaria. Kenia-Masais, Marruecos...

Costa Rica Red Determinantes Sociales de la Salud, REDETSomos una red de universidades de Latinoamérica que desde el año 2001 estamos trabajando en la capacitación de docentes e investigadores en el abordaje de la formación de recursos humanos en salud (de medicina, enfermería, nutrición, trabajo social, psicología y otros relacionados),..

Costa Rica SEDEH, Seguridad y Desarrollo Humano NA

Costa Rica Visión Mundial Internacional

Nuestra organización, con más de 50 años de experiencia en la defensa y promoción de los derechos de la niñez, ha lanzado el año pasado una campaña global de salud, con el enfoque en los Objetivos de Milenio 4 y 5, salud materna e infantil. En la región LAC, adonde la inequidad y las brechas sociales son uno de los principales obstáculos para cumplir con estos objetivos, vemos la importancia de la introducción del tema de los Determinantes Sociales de Salud en nuestra campaña de incidencia política…

Ecuador COLECTIVO NACIONAL DE MUJERES GUADALUPE LARRIVA

Al bajo índice de acceso a proyectos de salud comunitaria en el área de prevención en las áreas rurales y urbano marginales. Necesidad de capacitación a las Mujeres para ser Promotoras de Salud

Ecuador Coordinadora de las Organizaciones Indígenas de la Cuenca Amazónica - COICA

Objetivos estatutarios de la COICA; Promover, desarrollar e impulsar los mecanismos necesarios para la interacción de los Pueblos y organizaciones indígenas miembros de la COICA…

Ecuador FOS AndesTrabajo digno - derecho a un trabajo digno, fortalecimiento en la organización de sindicatos, reconocimiento de las tareas remuneradas de las trabajadoras del hogar. Apoyo a las organizaciones en denuncia de condiciones de trabajo que afectan la salud de los trabajadores: ej. Floricultura, agrotóxicos y enfermedad…

Ecuador Fundación ECOLOGICA MISION VERDE Social Económico Ambiental

Ecuador Núcleo de la Sociedad de Lucha Contra el Cáncer de Machala

Los objetivos fundamentales de la Sociedad de Lucha Contra el Cáncer en la Provincia de El Oro, son: Prevenir el cáncer en la Provincia de El Oro. Luchar contra el cáncer en la Provincia de El Oro…

Ecuador Universidad Andina Simón Bolívar, Sede Ecuador

Condiciones del medio ambiente; participación en la toma de decisiones; origen étnico; sexo; acceso a servicios de salud y médicos.

Ecuador UNIVERSIDAD ESTATAL PENÍNSULA DE SANTA ELENA

Principalmente a las condiciones de vida y trabajo, somos una universidad ubicada en la Península de Santa Elena, nuestro departamento a través de las diferentes carreras de la universidad…

Ecuador Universidad Técnica de Ambato y Hospital Julio Enrique Paredes SOLCA Tungurahua

En el caso del Hospital son Realizar el control del cáncer en las provincias centrales del Ecuador En el caso de la Universidad es formar profesionales en ciencias de la Salud con competencias científicas, humanísticas y técnicas capaces de resolver y apoyar en el trabajo sanitario sobre los problemas más frecuentes de la salud de las comunidades.

El Salvador ALDESAIEsta enfatizado a la atención a la niñez, en el enfoque de mejorar escuela saludable y llevar una mejor control en la nutrición de la comunidad escolar en las edades de 4 a 18 años, con tal de disminuir la desnutrición en los infantes, y control de la anorexia y bulimia en los adolescentes.

El Salvador Alianza Ciudadana contra la privatización de la salud

Todos los determinantes estructurales, del mayor o menor grado de salud son objeto de nuestras acciones de incidencia social y política.

El Salvador Alianza Ciudadana Contra la Privatización de la Salud Acceso a la salud

El Salvador Alianza Ciudadana contra la Privatización de la Salud/Movimiento salud de los Pueblos

La ASPS es integrante de la Alianza Ciudadana, Trabajando en base de promover, garantizar y defender el derecho humano a la salud, a través de procesos de organización, participación y movilización social…

El Salvador Alianza Ciudadana contra la Privatización de la Salud/Movimiento de Salud de los Pueblos

Fundación Maquilishuatl, como fundación contamos con 25 años trabajando la promoción de salud. Trabajando con base los determinantes de la Salud, en el 2003 adoptamos la estrategia de municipios y comunidades saludables, logrando que 8 municipios de San Salvador y 8 de Sonsonate trabajen por los determinantes de la salud en cada uno de sus municipios…

El Salvador Alianza Ciudadana Contra la Privatización de la Salud y Movimiento por la salud de los Pueblos

Se analiza o concibe a la salud como el bienestar y la enfermedad, sino aquellas determinantes y sus relaciones que existen entre la comprensión de cómo dar salud a la población que se verá determinada en los mecanismos que influencia en lo social (vivienda digna, empleo, creación de espacios saludables y recreativos, acceso a los servicios básicos de salud, acceso a la información de programas) sobre lo biológico (aplicación de vacunas, tratamientos de enfermedades degenerativas)…

El Salvador CIDEP CIDEP trabaja en pro del desarrollo de las poblaciones desprotegidas del país a partir de la educación incluyendo la educación en la salud, trabajamos en el progreso de las comunidades rurales luchando por sus derechos humanos.

El Salvador FEDERACION SINDICAL DE TRABAJADORES/AS DE LOS SERVICIOS PUBLICOS

NUESTRA ORGANIZACION RESPONDE A GARANTIZAR MEJORAR LAS CONDICIONES DE VIDA DE LAS Y LOS TRABAJADORES, SOBRE LA BASE DE UNA DISTRIBUCION JUSTA Y EQUITATIVA EN LA SOCIEDAD

El Salvador Foro Nacional de Salud

Fortalecer y desarrollar una amplia organización comunitaria que irá tomando control de los determinantes sociales de la salud y apoyará a los servicios de salud para el aumento de la calidad de la atención, la resolución de los problemas de salud, la transformación del enfoque en salud hacia la promoción de la salud, poner más alto a salud como prioridad en la agenda política del gobierno y lograr más recursos para salud.

El Salvador Fundación Cordes Región II Cabañas- Cuscatlán A la prevención de la violencia y a la seguridad alimentaria

El Salvador Juventudes por la Vida El Salvador Luchamos por la educación y hacer conciencia en la juventud por el cuidado al medio ambiente

El Salvador Movimiento de Profesionales de la Salud "Dr. Salvador Allende"

Nuestro movimiento ciudadano responde a los determinantes de las inequidades expresados en las Políticas públicas, específicamente a las políticas de salud, haciendo acciones de incidencia política en favor de la recién iniciada Reforma de Salud salvadoreña…

El Salvador Plan InternacionalReducir las brechas en el cumplimiento de los derechos de la niñez (salud, educación, protección entre otros). Contribuir con el estado a mejorar la cobertura (sanitaria, educativa y de protección) de calidad en la primera infancia (0 a 7 años) …

El Salvador Red Centroamericana de Personas con VIH REDCA+

Trabajar coordinada y solidariamente en el desarrollo de acciones que contribuyan a mejorar el acceso a la atención integral con calidad de las personas con VIH o Sida. Participar en espacios de incidencia política relacionadas al VIH o Sida y los derechos humanos…

Spain Asociación de AFROHISPANOS y Afrocaribeños en España(ACODI)

Nuestra Asociación realiza una labor muy ardua destinada a que se elimine la condición irregularidad e ilegalidad de los Inmigrantes en general y de los AFRODESCENDIENTES en particular. El origen Étnico y racial de los AFRODESCENDIENTES juegan un papel muy importante en la inequidad en la salud de POBLACION Afro ya que es precisamente esa realidad la que les impide acceder a los centros sanitarios (salvo) en situaciones de extrema urgencia.

Spain Fundación Pepe RubianesLa Fundación Pepe Rubianes es una organización apolítica, aconfesional y sin fines lucrativos, tenemos por objetivo mejorar las condiciones sanitarias de la Comunidad Masai de Amboseli en Kenia, fundamentalmente en sus aspectos preventivos sobre nutrición, enfermedades infecciosas y tropicales…

Spain / Ecuador Fundación Cibervoluntarios

La visión de la organización es utilizar las nuevas tecnologías para eliminar brechas sociales, entre ellas la inequidad en la salud. Hoy por hoy la tecnología es un gran aliado para poder visibilizar, sensibilizar, informar y formar a los ciudadanos sobre temas de salud. Nuestro objetivo es que el aprendizaje de estas herramientas sea con un fin social los principales son: de salud, educativo, de participación y laboral…

United States At-sik-hata:Nation-of:Yamassee-Moors We are not NGO. We are an IPO (Indigenous People Organization)

United States Banco MundialEl Banco Mundial tiene el compromiso ayudar a los países a lograr mejores resultados en salud, de modo a impulsar el crecimiento económico y el buen gobierno y contribuir para la equidad en la cobertura, acceso y calidad a los servicios de salud…

United States Chait & Associates PROMOTE GENDER EQUALITY AND EMPOWER WOMEN Interests including research are in risk and protective factors for disabled women and children; developing interventions for high-risk and understudied disabled women and

disabled adolescents with a history of sexual victimization, substance abuse, and/or improper treatment by paid or family caretaker

United States International Ministries, American Baptist Churches, USA

Childhood and Adult Education; Rural Community Health; Economic Development and Social Entrepreneurship; Micro-Finance

United States OVIDA, Inc. Como organización internacional provee protección a los ciudadanos.United States PAHO Los que afectan el acceso y la retención de las personas al diagnostico y TARV.

United States Phelps Stokes Uno de los determinantes es el acceso a servicios básicos sanitarios, médicos y establecimientos de atención en salud.

Global Transparency International Transparency International (TI) es la organización global de la sociedad civil que lidera la lucha contra la corrupción a través de más de 90 capítulos en todo el mundo y una secretaría internacional en Berlín…

Guatemala Alianza Joven ONG

Niños y jóvenes vulnerables con falta de oportunidades educativas, falta de acceso a actividades recreativas, lúdicas y deportivas en espacios seguros, desintegración familiar, maltrato físico y psicológico; condiciones sociales en la comunidad con mucha violencia delictiva y reducción de la percepción de violencia en la recuperación de espacios públicos.

Guatemala Asociación ADERSO Focalizar los problemas de la desnutrición infantil, la capacitación de comadronas y promotores de Salud,

Guatemala Asociación de Servicios Comunitarios de Salud - Movimiento de Salud de los Pueblos

Fundada en 1978, por el Comité Regional de Promoción de Salud Comunitaria, la Asociación de Servicios Comunitarios de Salud –ASECSA-, es una organización civil no gubernamental de interés social y no lucrativo que a través de la Atención Primaria en Salud contribuye al trabajo de salud comunitaria y salud pública en Guatemala…

Guatemala Asociación Frente de Salud Infantil y Reproductiva de Guatemala, FESIRGUA

Contribuir en la reducción de la Mortalidad materna en Guatemala, especialmente en las mujeres indígenas de áreas rurales, reducir la brechas que existen en los servicios de salud con mujeres indígenas y no indígenas en Guatemala

Guatemala Corporación de Servicios y Apoyo para el Desarrollo Comunitario "CORSADEC"

Educación en Salud (trabajar para educar en las comunidades más postergadas e indígenas del país, como restablecer su estado de salud. Promover el desarrollo sostenible en las comunidades con respeto de su identidad. Fortalecer la organización comunitaria para ser auto sostenibles

Guatemala Grupo de Apoyo Mutuo Impulsar el acceso con calidad universal a la salud pública, vigilando la transparencia en los gastos, en las compras y en las contrataciones.

Guyana University of Guyana Education

Haiti Fondation Mains ouvertes(Fonmo) Reduire la mortalite infantile. Ameliorer la sante maternelle. Combattre le VIH/SIDA, le paludisme et dáutres maladies.

HondurasAsociación Para Una Vida Mejor de Personas

Infectadas/Afectadas Por El VIH-Sida en Honduras (APUVIMEH)

A las Personas Infectadas/Afectadas por el VIH y Sida en Honduras (Mujeres, Hombres, Niños(as) y Adolescentes) y miembros de la Comunidad LGBTI (Lesbianas, Gays, Bisexuales, Trans, Travestis, Transgénero e Intersex )

Honduras Centro de Derechos de Mujeres Género

Honduras ENLACE DE MUJERES NEGRAS DE HONDURAS SALUD SEXUAL Y REPRODUCTIVA DEL PUEBLO GARIFUNA. MEDIO AMBIENTE Y CONDICIONES HIGIENICO-SANITARIAS DEL PUEBLO GARIFUNA

Mexico Asociación Civil de Desarrollo Integral Vecinal de las Colonias del Ajusco Medio

Como organización nos fundamos con la finalidad de gestionar nuestros derechos fundamentales como son la salud, educación, vivienda, servicios básicos -drenaje, alumbrado, pavimentación, etc.-, ante las autoridades que tienen la capacidad económica, política e institucional para proporcionar las condiciones de una mejor forma de vida…

Mexico Balance Promoción para el Desarrollo y Juventud A.C. A los relacionados con la inequidad de género

Mexico CAPACIDADES DIFERENTES MARCE A.C.A la falta y seguimiento de servicios especializados y de rehabilitación para personas con discapacidad la falta de acceso a la justicia nulo nivel de educación por inequidad en los servicios de educación básica y profesional accesibilidad a un nivel económico por falta de oportunidades de inclusión laboral

Mexico Closet de Sor Juana Al acceso a los servicios de salud.Mexico CMUCH Educación, Género y Equidad

Mexico Coalition Against Trafficking in Women

La Coalition Against Trafficking in women trabaja el tema de la salud de las mujeres en tanto derecho humano vulnerado en el momento en el que las mujeres son explotadas a través de diversos fines. Las diversas formas de explotación afectan significativamente la salud de las mujeres, entendiendo la salud no solo como ausencia de enfermedad…

Mexico CONCEPTO VIH-SIDA E ITS A.C.

A promover la Asistencia y Atención Médica en Instituciones Especializadas de las Personas con VIH en un Marco de Respeto a los Derechos Humanos, así como Promover, Difundir y Aplicar los Programas que las Instituciones Públicas y Privadas, Nacionales e Internacionales que hagan a Favor de la Restitución, Atención y Tratamiento de las Personas con VIH, Fortaleciendo la Capacidad Médica Integral.

MexicoConfederación Mexicana de Organizaciones en

favor de la Persona con Discapacidad Intelectual A. C.

Defensa de derechos de las personas con Discapacidad Intelectual y mejora de su calidad de vida y la de sus familias CONFE es una organización que lucha por la promoción y el respeto a los derechos humanos de las personas con discapacidad intelectual y de sus familias en nuestro país…

Mexico Consejo Coordinador De ONGs en Quintana Roo

El Consejo Coordinador lo integramos asociaciones del Estado de Quintana Roo, México de distintos objetos sociales, por ello nos constituimos en diversas Redes. En la Red de Discapacidad se atiende la inequidad en el ámbito de la salud fundamentalmente en el desarrollo de las terapias que requieren se lleven a cabo en espacios que antes eran públicos como los deportivos, albercas, etc. y que ahora se están privatizando, cobrando cuotas lejos de su alcance económico.

Mexico Desarrollo Integral de la Familia (DIF) Municipal de Mazatlán Villa de Flores, Oaxaca, México.

La inequidad de la salud que se encuentran nuestras comunidades Indígena es precaria el Instituto Municipal del Desarrollo de la familia busca el bienestar de sus pobladores.

Mexico FLASEP Fundación Latino Americana de Apoyo al Saber y Economía Popular

Promoción de la economía solidaria como estrategia del combate a la pobreza. Desarrollo de la educación popular. Fomento de la interculturalidad (respeto a saberes y cosmovisión indígenas). Promoción de la equidad de género. Determinantes: Nivel económico, origen étnico, nivel de educación

Mexico Fundación Arcoíris por el respeto a la diversidad sexual Acceso a los servicios de salud y acceso a la justicia

Mexico Fundación Aztahuacan para el Desarrollo Comunitario A.C.

MISIÓN: Somos una organización de la sociedad civil que impulsa procesos de desarrollo comunitario a través de la cultura, educación, salud, deporte, mejoramiento urbano, ambiental y comunicación popular que contribuyan a la acción y participación ciudadana autogestiva, desde el ámbito comunitarios hasta el universal…

Mexico FUNDACION DOCTOR HERNANDEZ ZURITA IBP A la atención de las personas en estado de marginación, de pobreza extrema y de preferencia indígenas, más que nada resolviendo sus incapacidades visuales como consecuencia de padecer cataratas de diferente etiología

Mexico Fundación Doctor Hernández Zurita, I.B.P. Acceso a los Servicios de Salud, Nivel económico, Origen étnico, Acceso a infraestructura y transportes

Mexico Iniciativa Global Komen en MéxicoEl cáncer de mama en México se convirtió hace cinco años en el tumor maligno que más vidas de mujeres sesga. Conforme se ha dado la transición a enfermedades crónicas y no transmisibles, resulta en la vida de las mexicanas una experiencia mortal por su detección tardía…

Mexico Instituto Nacional de Salud Pública NA

MexicoINSTITUTO POLITECNICO NACIONAL ESCUELA

SUPERIOR DE MEDICINA SECCION DE POSGRADO

Pertenezco a una organización académica (IPN) soy docente, pero principalmente soy activista, También formo parte de tres consultoras, Consultoría de los pueblos indígenas del norte de México, Personas que viven con VIH/SIDA , TUDYSEX.

Mexico Intlapa´tianime (las sanadoras) Capacitar a la población en general sobre promoción de salud en temas de alimentación, conservación del medio ambiente, economía solidaria, siembra, cultivo y cosecha de huertos familiares (autoconsumo, medicinales)…

Mexico Juventudes Políticas de América Latina y el Caribe

Promover los ODM entre juventudes políticas de América Latina y el Caribe y específicamente en plataformas electorales de partidos políticos para su consecución e implementación en los planes de desarrollo nacionales y locales en la región.

Mexico N/A NA

Mexico Programa de Apoyo Nutricional (Proan) A.C. Desnutrición infantil en comunidades indígenas, pobreza y marginación de las mujeres madres de familia.

Mexico Proyecta Proyecta busca investigar y promover el acceso universal a la salud independientemente del sexo y condición socioeconómica de la población.

Mexico RADIO UNIVERSIDAD NACIONAL AUTONOMA DE MEXICO.

COLABORO COMO VOLUNTARIO EN MEDIOS EN LA OSC, MOVIMIENTO MEXICANO DE CIUDADANIA POSITIVA, A.C. SU MISION ES CONTRIBUIR A LA DISMINUCION DE LA TRANSMISION, DISCRIMINACION Y EL ESTIGMA DEL VIH/SIDA...

Mexico Secretaria de la Mujer Regional (Montaña) Difundir la disminución de la violencia a la mujer salud Materna.

Mexico SERVICIOS DE SALUD DE ZACATECAS ATENCION MEDICA EDUCACION EN SALUD

Mexico Sociedad Cooperativa Chac Lol y Consejo Regional Indígena y Popular de Xpujil S.C. A la nutrición a través de la producción de hortalizas y apicultura orgánica

Mexico Universidad Autónoma de Tamauolipas, Facultad de Ingeniería y Ciencias Ambiental

Mexico World Youth Alliance

We are a global coalition of young people reflecting diverse ethnic, cultural, economic, political and social backgrounds from all regions of the world. We have observed with concern the lack of progress made on MDG 5, Improving Maternal Health, which is currently the least achieved MDG. Maternal morbidity and mortality are largely preventable and must be addressed by person-centered health policies that focus on the needs of women in the context of maternal health.

NA NA Incidir en la transformación de la realidad

Nicaragua Asociación de Mujeres Profesionales por el Desarrollo Integral Acceso a los servicios y medicamentos por las mujeres

Nicaragua Centro de Información y Servicios de Asesoría en Salud-MSPLA

Promover .con enfoque de gestión integral de riesgo, los procesos de participación, organización, investigación, articulación social e incidencia de la población, desde el ámbito de la comunidad pero tomando en cuenta los niveles local, nacional e internacional…

Nicaragua GAYGAS Comunidad de hombres gays y HSH, las condiciones de discriminación, es desigual e impera la inequidad en las condiciones y la calidad de atención y acceso a la salud para hombres gays y la diversidad sexual.

Nicaragua Proyecto Construyendo Alianzas de VIH en las zonas rurales de Centroamérica A los Culturales, Sociales (estilos de vida y origen étnico) y Personales (sexo y edad)

Panama Asociación Napguana

Como organización indígenas, velamos por el desarrollo en la salud en nuestras comunidades indígenas, muchas veces estos estados no responden las en necesidades urgentes de los pueblos indígenas, somos nosotros a veces hemos hechos proyectos de agua potable, infraestructuras de centro de salud, estas tareas eran de los gobiernos, que muchas veces no cumplen.

Panama FUNDACIÓN "TOTUS TUUS" TODO TUYO, MARÍA

Al derecho a la atención integral que tiene la Persona con Discapacidad a la habilitación y a la rehabilitación, para poder acceder a ella y mejorar su calidad de vida para que esta le permita lograr la plena inclusión social e inserción laboral…

Panama Fundación Privada en Pro del Desarrollo Eco y Social. Promover el desarrollo económico y social de comunidades en condiciones de vulnerabilidad y marginación.

Panama UNIÓN LATINOAMERICANA DE CIEGOSNUESTRA ORGANIZACIÓN NO ES DE SALUD, SINO QUE PROPORCIONA PREVENCIÓN Y REHABILITACIÓN A LAS PERSONAS CON DISCAPACIDAD VISUAL EN AMÉRICA LATINA. ASÍ COMO TAMBIÉN ANTE LOS GOBIERNOS LA GESTIÓN DE POLÍTICAS PÚBLICAS

Peru AMA ASOCIACION INDIGENA DEL PERU, es una organización indígena.

AMA tiene como propósito la promoción y facilitación de la defensa, el fortalecimiento, consolidación y desarrollo anhelado de los pueblos amazónicos, andinas y familias autónomas y víctimas de la violencia política.

Peru Apoyo a Programas de Población - APROPO. Acceso a servicios de salud. Nivel educativo

Peru Asociación De Mujeres Indígenas Tawantinsuyo Prevención de Salud en el Seno familiar con una sana alimentación.

Peru Asociación Regional de Mujeres Ingenieras La misión de la organización está referida a los determinantes económicos, sociales y ambientales de la salud en la calidad de vida, propiciando el desarrollo sostenible, acceso a la salud y avance de los ODM.

Peru CENTRO AMAZONICO DE ANTROPOLOGÍA Y APLICACIÓN PRÁCTICA NO TRABAJAMOS EL AREA DE SALUD DIRECTAMENTE

Peru Centro Latinoamericano de Estudios y Cooperación para el Desarrollo CENLAT Mortalidad infantil, mortalidad en la niñez, desnutrición crónica inequidad sanitaria

Peru CONAPEDIS Coordinadora Nacional de Asociaciones de Personas con Discapacidad

Los Objetivos tomados de Nuestra Constitución Legal inscrita en los Registros Públicos son: * Promoción y Defensa de los Derechos de la Persona con Discapacidad de acuerdo con la Ley General de Personas con Discapacidad Ley 27050 y la Convención ONU sobre los Derechos de las Personas con Discapacidad…

Peru Confederación nacional de Pueblos Indígenas del Perú La poca atención en materia de salud a los pueblos indígenas de la amazonia y la zona andina

Peru Defensoría del Pueblo - Chimbote

De conformidad con lo dispuesto en el artículo 162º de la Constitución Política del Perú, concordante con el artículo 1º de la Ley Nº 26520, Ley Orgánica de la Defensoría del Pueblo, esta institución se encuentra configurada como un órgano constitucional autónomo, encargado de la protección de los derechos fundamentales y constitucionales de la persona y la comunidad, así como de la supervisión del cumplimiento de deberes de la Administración Pública…

Peru DIRECCION DE SALUD V LIMA CIUDAD

Hace poco participe en un curso en Quito, allí discutimos acerca de los determinantes sociales de la salud: eran de dos tipos, en este caso la pregunta va hacia los determinantes sociales de las inequidades en salud que incluyen a los determinantes sociales de las inequidades en salud. Mi organización es un órgano desconcentrado del Ministerio de Salud, al cual le han facultado funciones de gestión, conducción e implementación normativa en una jurisdicción de la ciudad de Lima (22 distritos)…

Peru DIRECCIÓN REGIONAL DE EDUCACIÓN -PIURA Salud rural

Peru ECOAMAZON

Fines y objetivos de ECOAMAZON, recogida del estatuto institucional. Título II. Art. 5º Para lograr su finalidad la asociación deberá: A) Coordinar y canalizar los esfuerzos institucionales y personales, estimulando los trabajos de investigación científica y propuestas técnicas de solución a los problemas económicos y sociales para contribuir el desarrollo regional y nacional. B) Captar recursos nacionales y externos, especialmente de la cooperación técnica internacional…

Peru Federación de Comunidades Nativas YaneshaEs una organización representativa y líder del pueblo indígena Yanesha, al servicio de las comunidades socias y sus futuras generaciones, defendemos nuestros derechos e identidad cultural en un clima de convivencia armónica e intercultural con el fin de mejorar la calidad de vida de la población Yanesha.

Peru Federación de Nacionalidades Andinas de Puno Revaloración de la medicina natural andina. Investigar, revalorar, desarrollar y difundir las manifestaciones culturales de los pueblos andinos: Quechuas y Aimaras del Perú

Peru Foro de la Sociedad Civil en Salud - ForoSalud

Foro Salud trabaja el conjunto de determinantes de la salud, desde este posicionamiento venimos promoviendo iniciativas ciudadanas a favor de la Reforma del Estado en Salud con garantía del acceso universal integral y digno. Nuestra orientación básica es lograr un compromiso del conjunto del Estado ´para reducir las brechas de inequidad, eliminar las condiciones de pobreza,, exclusión y discriminación.

Peru Futures Group International A los generados por la inequidad existente a los servicios de salud y su reforzamiento por su condición de género y origen.

Peru GERENCIA REGIONAL DE SALUD AREQUIPA Acceso a los servicios de salud, sexo,Peru I.E Humberto Luna Cusco No es ONG, es una Institución Educativa Estatal del Gob. Peruano

Peru IFMSA-PERU

Los dos determinantes de inequidad en salud en los cuales trabajamos más son la educación y en el acceso a la justicia. Somos una organización de estudiantes de medicina de Perú asociados a una red mundial de estudiantes de medicina, la Federación Internacional de Asociaciones de Estudiantes de Medicina (IFMSA). Trabajamos en pro de la Salud Global por medio de campañas de salud, intervenciones en poblaciones y proyectos.

Peru Instituto Internacional de Aprendizaje para la Cohesión Social (IIACOS)

En materia de equidad de género, emancipación política al dar poder a la comunidad a construir su propio proceso de salud comunitaria, y la educación en salud comunitaria en ámbitos rurales.

Peru Investigaciones Médicas en SaludA mejorar la calidad de vida mediante e acceso a la salud, autosuficiencia económica, lucha contra la violencia y discriminación, manejo del consumo de alcohol y drogas y utilización del tiempo libre, y además al estudio clínico de PRep.

Peru Movimiento de Mujeres que viven con VIH-SIDA Región Callao

Promover los derechos sexuales y reproductivos de adolecentes y jóvenes para generar estilos de vida saludable atreves del desarrollo de capacidades, el fortalecimiento del autoestima y la implementación de políticas y estrategias preventivas para la construcción de una sociedad más justa y equitativa.

Peru ONG ONOTZI Inclusión de la salud a los pobladores indígenas (Andinos, Amazónicos) y afro descendientes.

Peru Organización de Jóvenes Indígenas de la Región Ucayali Trabajar la salud sexual y reproductiva de los y las jóvenes indígenas de la Amazonia Peruana

Peru SERVICIO ACTIVO EN BENEFICIO DE LA EDUCACION Y SU REFORMA

Capacitamos a la comunidad en el tema de Alfabetización Digital para que el usuario de la comunidad use las herramientas tecnológicas para prevenir enfermedades y como aprender políticas alimentarias para prevenir enfermedades…

PeruSindicato Único de Trabajadores de la

Municipalidad Nuestra Señora de las Mercedes Mi Perú

Somos parte del comité de vigilancia ciudadana

Peru VIDA DIGNA (ONG´D)Promoción de la calidad de la salud en las poblaciones nativas, campesinas, afroperuanas del interior del territorio peruano, mediante la capacitación, provisión de equipos y materiales médicos, así como, el uso de la medicina alternativa en beneficio, principalmente, en la niñez, juventud y adultos mayores.

Dominican Republic Asociación Pro-Desarrollo de la Mujer y Medio Ambiente (APRODEMA) Inaccesibilidad territorial y económica a servicios de salud Inaccesibilidad a servicios de salud sexual y reproductiva

Dominican Republic Centro de Orientación e Investigación Integral - COIN

Contribuir a incrementar el acceso a servicios de salud integral, con altos niveles de calidad y eficiencia, para las comunidades vulnerables y pobladores de barrios urbanos en condición de pobreza.

Dominican Republic Colectiva Mujer y SaludPromover la salud integral de las mujeres en todas las etapas de la vida, a través de la defensa de los derechos humanos de las mujeres, en particular los derechos sexuales y reproductivos, así como también el acceso a servicios básicos de salud para personas LGBTTI.

Dominican Republic COSALUP/MSP-LA/CRPSC

1. Mejorar las condiciones de salud de la población a través de facilitar el acceso a servicios de salud. 2. Impulsar la organización comunitaria para la realización de acciones de incidencia en las políticas económicas y sociales. 3. Desarrollar y fortalecer las habilidades de las personas para incrementar el ingreso familiar. 4. Promover la protección del ambiente a través del impulso de prácticas agroecológicas.

Dominican Republic Federación NACIONAL DE MUJERES TRABAJADORAS (FENAMUTRA)

El principal es el tema del Acceso a los servicios ya que aglutinamos esencialmente las personas de la Economía Informal, que hasta la fecha en nuestro país no se la ha dado respuestas, y que al mismo tiempo se transversaliza con el tema de los Sexos ya que más del 50% de esta población son Mujeres, por lo que también abarcamos la Educación y la distribución justa de la Economía

Dominican Republic Fundación Étnica Integral A la determinante del trabajador/a informal, el trabajo domestico, el inmigrante haitiano irregular y apátridas.

Dominican Republic Instituto Dominicano de Apoyo a la Juventud (INDAJOVEN)

Contribuir al Acceso a servicios de salud de calidad de los y las pobladores de comunidades vulnerables urbanas y rurales.

Dominican Republic Instituto para el Desarrollo y Promoción de la Producción Organizada Inc. (INDEPRO),

Objetivos de INDEPRO • Contribuir con el desarrollo productivo, la articulación de nuevas formas de organización de la producción y del trabajo. • Promover la asociatividad y la cooperación cooperante entre las pequeñas empresas dominicanas como forma de contribuir con el desarrollo de los sectores productivos del país…

Dominican Republic Movimiento Socio Cultural Para Los Trabajadores Haitianos (MOSCTHA)

Acceso a los servicios de salud, Nivel de educación, Respeto a los Derechos Humanos, especialmente aquellos ligados a la salud y acceso a la justicia (Derechos de los inmigrantes al acceso a los servicios de salud).

Dominican Republic Universidad Autónoma de Santo Domingo Educación y cultura Hábitos de Vida Condiciones de trabajo e ingresos Justicia e inclusión social Acceso a servicios de salud Socio demográficos

Saint Lucia THE ALDET CENTRE-SAINT LUCIA Access to and quality of health care

Suriname Ministry of Education and Community Development NA

Suriname Stg. Wadeken Wasjibonmaria Good health services and qualified medical personnel in the hinterland (interior).Suriname SWWM NA

Trinidad and Tobago G.O. International - Consultants in Education Social - With respect to psychological health.

Trinidad and Tobago GAYAP Violence Prevention Peace and Love Movement Policy making

Trinidad and Tobago International Education and Resource Network, Trinidad and Tobago (iEARNTnT) NA

Trinidad and Tobago Port of Spain Corporation - Public Health Department

Self empowerment - Allowing individuals to be responsible for their health welfare in a holistic manner by providing the necessary information as tools for the basis of independence from the state.

Uruguay Ciedur - Inmujers Determinantes sociales

Uruguay Federación Internacional de DiabetesA la conciencia pública; a la educación, al desarrollo de asociaciones de diabetes, a la falta de Gobiernos comprometidos con la salud pública que no han desarrollado políticas de estado adecuadas y eficaces para controlar las enfermedades no trasmisibles, especialmente la diabetes..

Uruguay Instituto de Formación Docente "Mtro Dardo M. Ramos" Es la Institución de nivel terciario en Formación Docente

Uruguay Movimiento Nacional de la Salud Pública y Privada

Luchamos por una salud con accesibilidad y equidad. Fomentar la organización de los usuarios, informando sobre sus derechos y deberes. Que todos los usuarios reciban lo que necesiten para lograr una vida digna.

Venezuela Asamblea Nacional Que mi pueblo indígena warao reconozca sus Derechos Sociales, Económicos y Culturales (Los Des) y en mi caso específico la salud y una mejor calidad de vida.

Venezuela Asociación por La Vida Nuestro objetivo es La Educación y Prevención de La Infección por VIH, así como Defensa de Derechos Humanos de

las personas con VIH. 1.- Al acceso reducido de las personas con VIH a los centros de salud públicos, motivado a su ser o estatus. 2.- A la discriminación y estigmatización por parte de los funcionarios públicos (equipo de salud) dirigido hacia las personas con VIH (niños, niñas, adolescentes y adultos)…

Venezuela CATEDRA DE LA PAZ Y DERECHOS HUMANOS "MONS. ROMERO" A.C.

Asociación Civil Cátedra de La Paz y Derechos Humanos “Mons. Oscar A. Romero, Organización Comunitaria de Desarrollo Social, adscrita a La Dirección General de Cultura de La Universidad de Los Andes dedicada a generar propuestas para la promoción, la formación y la protección de la Cultura de Paz y Derechos Humanos de la Infancia y Adolescencia…

Venezuela Fundación ABORIGEN

ATENCION A COMUNIDADES Y PUEBLOS INDIGENAS, AFRODESCENDIENTES Y GRUPOS EN SITUACION DE VULNERABILIDAD (NIÑOS, NIÑAS Y ADOLESCENTES, PORTADORES DE VIH) A TRAVES DE LA FORMULACION DE PLANES, PROGRAMAS Y PROYECTOS ORIENTADOS EN FORTALECER ACCIONES DE REDUCCIÓN DE CONDICIONES DE VULNERABILIDAD, RIESGOS Y ASIMETRIAS SOCIALES…

Venezuela Fundación Fundakual un Nuevo AmanecerA la atención integral del embarazo precoz en adolescentes y la atención a las madres adolescentes en su inserción en la sociedad con énfasis en el cuidado del embarazo para evitar que nazcan niños con problemas físicos y emocionales.

Venezuela FUNDASIDARTA (Fundación Sida Región Táchira) *Acceso de las PVVs a la Atención Médica *Acceso a Exámenes de Control y Pronóstico. *Acceso a Tratamiento.

Venezuela Iglesia de la Comunidad Metropolitana

La Iglesia de la Comunidad Metropolitana (ICM) no es un espacio limitado por muros, ritos y normas, sino un esfuerzo por crear una comunidad en las que podamos experimentar y compartir la presencia y acción de un Dios que no discrimina por condición social, género, raza, orientación sexual, estatus serológico, nacionalidad, etc. Es un esfuerzo por construir una comunidad comprometida con el enriquecimiento de la dignidad individual evitando el juzgar, fraccionar y segregar para vivir una espiritualidad plena basada en el contacto cotidiano con la realidad en que vivimos…

Venezuela Instituto de Altos Estudios "Dr. Arnoldo Gabaldon" Acceso a los servicios de salud, educación e igualdad de genero

Venezuela Instituto de Biomedicina. MPP Salud-Universidad Central Venezuela

El Instituto de Biomedicina tiene como misión la atención integral de Educación, Participación Social, la prevención y control de diferentes endemias como: dengue, leishmaniosis en sus diferentes formas clínicas, oncocercosis, chagas, lepra, tuberculosis, entre otras, básicamente en comunidades pobres rurales/indígenas/urbano marginales…

Venezuela MUJERES EN POSITIVO POR VENEZUELA

Proveer asistencia integral a mujeres, niñas, niños y adolescentes infectados y afectados por el VIH Educar e informar a mujeres, jóvenes, adolescentes, niños y a toda la sociedad sobre la prevención del VIH/SIDA. Defensa de los derechos humanos de las mujeres niñas y adolescentes afectadas e infectadas por el VIH. Inclusión de la perspectiva de género en nuestras acciones. Provisión y canalización de ayudas económicas y alimenticias para la población afectada.

Venezuela ONG Conciencia por la Vida Captar, reclutar e integrar a través de mecanismos y estrategias planificadas en la Asociación a los pacientes diagnosticados que aún no han sido asimilados el significado físico y el costo material y social que implica el VIH/SIDA. Reducir y controlar el impacto que el VIH produce en los individuos y en la colectividad. Desarrollar a través de

talleres, conferencias y cualquier tipo de actividades tanto individuales como de grupo labores informativas y formativas sobre el VIH…

Venezuela Universidad de Carabobo. Departamento de Salud Pública

Como Institución Universitaria responde a la importancia de concientizar a los futuros profesionales de la salud en la influencia del modo, condiciones y estilos de vida en el perfil de salud de las poblaciones, involucrando en la perspectiva de análisis a todos los determinantes de inequidades involucrados, especialmente los relacionados con la satisfacción de los derechos sociales de los venezolanos.

Venezuela Universidad de Carabobo. UNIESAP Educación y salud