Hassell Trevor A, Hutton Maisha T, Barnett D Beverley
Healthy Caribbean Coalition Bridgetown Barbados Healthy Caribbean Coalition, Bridgetown, Barbados.
Rev Panam Salud Publica. 2021 Oct 18;45:e104. doi: 10.26633/RPSP.2021.104. eCollection 2021.
Achieving health equity and addressing the social determinants of health are critical to attaining the health and health-related targets of the 2030 Agenda for Sustainable Development and its Sustainable Development Goals. Frameworks for health, including the Sustainable Health Agenda for the Americas 2018 - 2030, emphasize reduction of health inequities and "leaving no one behind" in national sustainable development. Health equity includes advancing universal health and the primary health care approach, with equitable access for all people to timely, quality, comprehensive, people- and community-centered services that do not cause impoverishment. Equally important, and a hallmark of good governance, is accountability for such advances. Governments have primary responsibility for reducing health inequities and must be held accountable for their policies and performance. Civil society has been recognized as a key partner in advancing sustainable and equitable national development. Effective accountability mechanisms should include civic engagement. The Healthy Caribbean Coalition (HCC), the only Caribbean regional alliance of civil society organizations working to prevent and control noncommunicable diseases-a major health priority fueled by inequities-has played a significant role in holding governments accountable for advancing health equity. This case study examines factors contributing to the success of the HCC, highlighting work under its five strategic pillars- accountability, advocacy, capacity development, communication, and sustainability-as well as challenges, lessons learned, and considerations for greater effectiveness.
实现健康公平和应对健康的社会决定因素对于实现《2030年可持续发展议程》及其可持续发展目标中的健康及与健康相关的目标至关重要。健康框架,包括《2018 - 2030年美洲可持续健康议程》,强调在国家可持续发展中减少健康不平等现象并“不让任何一个人掉队”。健康公平包括推进全民健康和初级卫生保健方法,确保所有人都能公平获得及时、优质、全面、以个人和社区为中心且不会导致贫困的服务。同样重要的是,这种进展的问责制是善治的一个标志。政府对减少健康不平等负有主要责任,必须对其政策和表现负责。民间社会被视为推进可持续和公平的国家发展的关键伙伴。有效的问责机制应包括公民参与。健康加勒比联盟(HCC)是加勒比地区唯一一个致力于预防和控制非传染性疾病的民间社会组织区域联盟,非传染性疾病是由不平等加剧的一项主要健康优先事项,该联盟在促使政府为推进健康公平负责方面发挥了重要作用。本案例研究考察了促成健康加勒比联盟成功的因素,突出了其在五个战略支柱——问责制、宣传、能力发展、沟通和可持续性——下开展的工作,以及面临的挑战、经验教训和提高成效的考虑因素。