Gaining health : analysis of policy development in European ...

Chapter 6
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be conflicting, and the likelihood that they will work effectively
together is not exactly high.
• Stakeholder analysis. A formal stakeholder analysis can
help ensure that important partners are not forgotten.
• Securing appropriate leadership. Leadership from a level
above that of the ministry of health, or from a sector
with outstanding knowledge and experience in a particular
area, can be effective.
• Agreeing on the terms of collaboration. Formal agreement
on the terms and process of intersectoral collaboration
can ensure a common understanding of the aims
and objectives, and the means of dealing with possible
conflicts of interest.
• Listening to potential partners. A national NCD policy
can be effectively implemented only through community
participation and partnerships at central, regional and
local levels. Much more could be done to strengthen
the links between levels of governance, not only to
support local levels in tackling NCD but also to listen to
and learn from them, creating a two-way rather than a
top-down policy process.
• Utilizing the settings approach. Settings where people
live, work, learn and play offer a huge but underutilized
potential for tackling NCD. In particular, schools and
the workplace offer broad opportunities for action in
tackling NCD.
• Working with the private sector. The emerging practices
of CSR indicate important new partners in the private
sector. There are exciting opportunities for further
action to tackle NCD in the workplace and for the
development of healthier products, but also for taking
advantage of knowledge and skills available in the private
sector for solving problems. Regular partnerships with
the public sector may strengthen and increase capacity,
provided agreements can be reached on principal social
values such as equity in health.
Reducing social inequalities related to NCD
It is clear that there is rapidly growing awareness of the
need to tackle socioeconomic inequalities in NCD, and opportunities
for doing this are already being explored.
• Reflecting socioeconomic inequalities. Particularly in EU
countries and through programmes such as CINDI,
standardized and comparable data for measuring socioeconomic
inequalities in NCD are being developed.
Guidance and examples of good practice are available
for all countries to ensure that regularly compiled data
reflect socioeconomic inequalities.
• Utilizing the work of the WHO Commission. The work
of the WHO Commission on Social Determinants of
Health has further clarified some of the policy pathways
for tackling inequalities. The results of this work could
be usefully disseminated among those responsible for
NCD policy at national and local levels.
• Taking gender differentials into account. NCD and their
risks can affect males and females differently, and their
needs for support may also differ. However, the gender
aspects of NCD policy and programmes are not always
given sufficient attention.
• Tailor-made solutions. Research has shown that the highly
educated pick up general health education messages
more quickly than their less educated counterparts.
Health communication tools for health promotion and
in the area of health care must be tailored to meet
the specific needs and cultural situations of vulnerable
groups, including, for example, those with a low level of
education, the poor and unemployed, migrants, older
people and ethnic minorities.
• Considering the impact on disadvantaged groups. The
potential impact of any NCD policy on disadvantaged or
high-risk groups needs to be assessed.
• Policies for social groups. The development of comprehensive
policies to tackle NCD in specific social groups
such as older people, women, adolescents, the Roma or
migrants could prove effective in some countries.
Pointers to the future