From local to national: intersectoral network to create environments for healthy ageing

In Costa Rica, more than 16% of the population is over 60 years of age and the country is experiencing a rapid demographic transition 1. The country is therefore seeking opportunities to develop public policies regarding healthy ageing, including the creation of environments that support older adults’ capacities. Between 2015 and 2018, only two municipalities were part of the WHO Global Network for Age-Friendly Cities and Communities (GNAFCC). In 2019, several municipalities started to recognize the need to create coordinated actions and mechanisms to adapt their cities for ageing adults, in part thanks to the promotion of the Age-Friendly Cities and Communities (AFCC) Framework by the PAHO/WHO Country Office and counterparts from the Ministry of Health (MoH). Ten municipalities entered the programme in 2019 and by 2022, 23 municipalities were part of the network. They all benefited from guidance provided by available materials and strategies when holistically considering the wellbeing and participation of older people. Costa Rica’s goal is to have 100% of municipalities in the country in the GNAFCC by 2026.

How did Costa Rica, with the support of the PAHO/WHO Secretariat, achieve this?

With an ageing population and the demographic transition, Costa Rica identified the need to target the population over 60 years of age to maintain and improve overall well-being. The government requested PAHO/WHO Costa Rica’s support to develop programmes for its senior citizens in communities. Through this request, the country became aware of the GNAFCC which was established in 2010 to connect cities, communities and organizations worldwide, with the common vision of making their community a great place to grow old in. It focuses on action at the local level that fosters full participation of older people in community life and promotes healthy ageing. The AFCC Framework outlines eight interconnected areas that can help identify and address barriers to their well-being and participation. Through the technical and financial support of PAHO/WHO Costa Rica, 23 municipalities, covering 30% of the municipalities in the country, have enrolled in the GNAFCC.

To coordinate this work, an intersectoral group at the local level was established in 2019 through the national programme on AFCC. PAHO/WHO Costa Rica provided technical assistance for its formation in recognition of the intersectoral nature of the programme. The group recognized the need to promote actions that go beyond disease management while considering the social determinants of health and role of environments for healthy ageing. Intersectoral networks are crucial when addressing both the social and physical aspects of community life: these are essential when responding appropriately to the needs and preferences of older adults and promoting their health and wellbeing. A manual and toolkit for age-friendly practices were developed with PAHO/WHO technical support for the use of all communities which also received support through constant capacity-building promoted by the intersectoral group. PAHO/WHO Costa Rica, the MoH, the Institute of Development and Municipal Advisory (IFAM), ANAI (the national association of municipalities), and the Yamuni Tabush Foundation constituted the intersectoral group.

“ Definitely this ambitious initiative is of high public value. Older people take essential part of the initiative and can make their needs being heard, which makes them feel part of their communities. They can contribute with solutions for active and healthy ageing themselves.” - Ms Yuliana Cordero, Municipality of Orotina

When cities join the Network of Age- “ Friendly Cities and Communities, older people start to be seen as citizens with rights. Both the community and local institutions are encouraged to include them in community planning, with a focus on inclusiveness and well-being.” - Ms Cristina Cépedes, Municipality of Grecia

The municipalities that are part of the national programme in Costa Rica are also enrolled in the GNAFCC, and their work is monitored and presented on the GNAFCC platform. Indicators for completion of friendliness adaptation as well as continuous age-friendly practices are presented to showcase advances in the municipalities on improving actions for healthy ageing. For example, the municipality of Cartago developed a strategy on training for cognitive and physical abilities in day centres. This initiative focused on healthy ageing and social integration with family members who followed the development of the activities. A series of five virtual workshops was also conducted during COVID-19 to support functional activities and sensory stimulation at home 3. PAHO/WHO, with the goal of improving and protecting people’s health, promotes efforts to ensure that people live longer and healthier lives. PAHO/WHO manages the GNAFCC in the Region of the Americas and through concerted actions with countries. Currently, the Americas are the leader in the number of cities and communities that are part of the network. PAHO/WHO Costa Rica actively supports the initiative through technical cooperation and coordination of the intersectoral network at the national level.

The need for support from cities is increasing, which also means a challenge for institutions whose resources are limited. In addition, during the pandemic, implementation of the initiative was a challenge when trying to adapt processes which, by their nature, are aimed at older people and in-person rather than virtual. Nonetheless, PAHO/WHO Costa Rica, together with its partners, will continue programme implementation and expansion.

Knowledge

WHO country stories: delivering for all

“This impact story was published as part of the WHO country stories: delivering for all report, which presents a snapshot of how WHO has delivered on its mission in countries and contributed to health outcomes across a wide range of issues during 2022-2023.”