Intersectoral action: local governments promoting health.

Abstract

Many local governments around the world promote health through intersectoral action, but to date there has been little systematic evidence of these experiences. To bridge this gap, the World Health Organization Centre for Health Development conducted a study in 2011-2013 on intersectoral action for health (ISA) at local government level. A total of 25 cases were included in the final review. Various approaches were used to carry out ISA by local governments in low-, middle- and high-income countries. Several common facilitating factors and challenges were identified: national and international influences, the local political context, public participation and use of support mechanisms such as coordination structures, funding mechanisms and mandates, engaging sectors through vertical and horizontal collaboration, information sharing, monitoring and evaluation, and equity considerations. The literature on certain aspects of ISA, such as monitoring and evaluation and health equity, was found to be relatively thin. Also, the articles used for the study varied as regards their depth of information and often focused on the point of view of one sector. More in-depth studies of these issues covering multiple angles and different ISA mechanisms could be useful. Local governments can offer a unique arena for implementing intersectoral activities, especially because of their proximity to the people, but more practical guidance to better facilitate local government ISA processes is still needed.