Cancer control implementation experience: The case of Health in All Policy Approach

Abstract

Abstract Health and health equity are important prerequisites to achieve most societal goals. However, governments still struggle facing lobbying and establishing a coherent policy approach to ensure health and health equity. Therefore, the WHO Health in All Policies (HiAP) Framework for Country Action has been developed to support the avoidance of harmful policies. In the framework of the JA iPAAC, semi-structured interviews with health administrators in 28 EU countries were conducted from September 2018 until January 2020. The objective was to gather experience and examples of cancer control policies implementation, including health promotion actions. We deductively coded the interview reports based on the WHO HiAP Framework core components to see how EU MS engaged efforts on these core components. Actions that relate to the 5 HiAP core components were found in all countries which discussed health promotion. Needs and priorities identification are reported through international commitments and risk monitoring. Frames for planned actions are mainly non-disease specific, but often risk-specific. Reported supporting structures and processes are bans, price regulation and inter-ministerial committees. To facilitate assessment and engagement of different actors, efforts were found in involving scientific communities, industry, health professionals and NGO's. Insuring policy monitoring, evaluation and reporting is experienced as challenging. Capacity building has been identified in the provision of guidance; training of policy makers, health care professionals and teachers; structural monitoring; and increase health literacy and empowerment. The frequency of efforts identified, importantly varies among the core components. While issue specific inter-sectoral platforms are frequently reported, impact assessments and sub-national capacity building were experienced as challenging. Other challenges concern industry interference and cultural and institutional resistance to change. Key messages Although most core components of HiAP are reflected in health promotion policies, more engagements are required into impact assessment and insurance of equity among sub-national levels. By sharing innovative examples applying a HiAP, EU countries can learn from each other on how to ensure population health and health equity.