Multisectoral approach to NCDs based on the management model of healthy cities, environments and ruralities (Ciudades, Entornos, Ruralidades, Saludables y Sostenibles (CERSS)

Noncommunicable diseases (NCDs) are a growing public health problem globally, accounting for 76% of premature mortality in Colombia and 80% in the Region of the Americas1–4. Cardiovascular diseases (CVD) are the main cause of mortality and morbidity, generating negative social and economic impacts 5. Economic and social inequalities exacerbate risk factors for people in vulnerable conditions, leading to a higher prevalence of these diseases 6,7. In addressing NCDs, it is essential to strengthen and promote the implementation of multisectoral actions for environments and conditions that favour population health. Through Pan American/World Health Organization (PAHO/WHO) cooperation, the management capacities of health teams were strengthened, strategic planning actions developed and tools implemented to reduce risk factors and improve the approach to NCDs at the multisectoral level in prioritized territories.

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

PAHO/WHO Colombia played an instrumental role in the development and implementation of Colombia’s Ten-Year Public Health Plan (PDSP, 2022–2031), which prioritized noncommunicable diseases (NCDs) and established operational lines to address the social determinants of health and achieve the Sustainable Development Goals 8. The 2022–2031 PDSP incorporated globally recognized strategies such as the comprehensive care model for chronic conditions and social determinants of health based on the CERSS model 9. PAHO/WHO Colombia also provided technical expertise to develop the “strategic and operational plan for addressing chronic noncommunicable diseases 2020–2030” in Bogota along with guidelines and tools for its implementation. This established strategic orientations and criteria for action, both for sectors beyond health such as education, environment and economic development, as well as for all operational levels of the health sector. In addition, PAHO/WHO Colombia collaborated with local government to implement NCD plans in local policy, such as in Bogotá, where goals to address NCDs were incorporated into the city’s development plan.

To further advance their efforts in addressing NCDs, PAHO/WHO Colombia implemented training activities for professionals in different sectors. For instance, a pilot workshop on NCDs and their risk factors was set up to allow communicators and journalists to improve NCD media coverage and information quality 9. A leadership course for tobacco control was also developed, where 60 professionals and key actors at the national level received practical training on implementing aspects of the WHO Framework Convention on Tobacco Control. Furthermore, a functional network with more than 33 communicators trained in noncommunicable diseases and addressing the four main risk factors for NCDs was formed10. More than 10 000 professionals in the country were trained by PAHO/WHO’s Virtual Campus on implementing the HEARTS technical package for NCD care. Moreover, complementary training was delivered to more than 117 health managers from 26 territories at the national level in developing implementation plans for strategies to improve NCD care in the primary care setting based on the social determinants of health.

As journalists, we are left with the responsibility to be meticulous with the information, to verify, to try to translate the scientific information. We had experts who can translate many issues from these public policies. Our responsibility is to bring them information.” - Maicol Buitrago, Journalist of Red Más Noticias

To promote awareness and understanding of the impact of social determinants on NCDs, management tools were disseminated through implementation guides and workshops in two prioritized territories, Huila and Cauca. These actions also included identifying how living conditions limit access to health services and interventions in the country, particularly among vulnerable populations. Additionally, the WHO’s NCD and Mental Health call for multisectoral action included the presentation of 19 cases describing significant experiences of how territories have addressed NCDs at the multisectoral level.

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.”