Q: What is a multisectoral approach?
Multisectoral refers to engagement with one or more government sectors outside of health (1). A multisectoral approach is one in which multi-stakeholder engagement takes place and action is across different sectors (2).
Q: What is a multisectoral action plan?
A national multisectoral action plan with national targets is a necessary framework for addressing noncommunicable diseases and their risk factors through a public health approach. Instead of one plan per disease, a comprehensive plan, with a clear budget and an integrated monitoring framework, makes possible a coherent national policy response required to attain national targets.
National action plans are more likely to be implemented effectively if they are developed in collaboration with a full range of partners, both within and outside the health sector, who can significantly contribute to implementation. These include all non-state actors: communities, grass-roots advocates, professionals, nongovernmental and civil society organizations, academia, the media and the private sector (2).
Q: Why is a multisectoral approach needed to prevent and control noncommunicable diseases?
Given the magnitude of the burden, no one party alone can prevent and manage noncommunicable diseases effectively. Collaboration between governments, nongovernmental organizations, industries, WHO and other organizations is essential and very much needed. This approach ensures that resources are used efficiently and efforts are not duplicated. Thus, efforts would complement each other rather that conflict or compete with each other. One of the strategic interventions under governance in the Regional framework for action is to establish a multisectoral strategy/plan and set of national targets and indicators for 2025 based on the national situation and WHO guidance (3).
Q: What are the main challenges to successful multisectoral action in the prevention and control of noncommunicable diseases?
Multisectoral action for the prevention and control of noncommunicable diseases faces the following key challenges:
- engaging the non-heath sector systematically across government and with other sectors to address the health dimensions of their activities;
- establishing institutionalized processes which value cross-sector problem-solving and addressing power imbalances;
- providing the leadership mandate, incentives, budgetary commitment and sustainable mechanisms that support the health sector to work collaboratively on solutions to prevent and control noncommunicable diseases.
Q: What should be the focus of multisectoral action for the prevention and control of noncommunicable diseases?
Multisectoral action should focus on:
- creating mechanisms to achieve whole-of-government action in order to tackle noncommunicable diseases; securing political commitment at the highest levels;
- integrate specific health concerns into relevant sectors’ policies, programmes and activities, where possible.
- reinforcing responsible stewardship, while safeguarding public health from any potential conflict of interest and recognizing the fundamental conflict of interest between the tobacco industry and public health;
- establishing sustainable and predictable financing mechanisms;
- investing in an appropriate workforce;
- promoting access to safe, effective, good-quality medicines and technologies;
- promoting the development and use of impact assessment methods to monitor and evaluate multisectoral action.
Q: Are conflicting interests considered a barrier for multisectoral planning and action in preventing and controlling noncommunicable diseases?
Conflicting interests usually exist among the different parties, each having a different vested interest. It is crucial to manage and resolve any conflicts of interest to be able to manage the burden of noncommunicable diseases and put forward concerted efforts (4).
Q: Which non-health sectors could be involved in the prevention and control of noncommunicable diseases?
The following table gives some examples of non-health sectors that could be involved in the prevention and control of noncommunicable diseases (4).
|
Sector |
Tobacco |
Physical inactivity |
Harmful use of alcohol |
Unhealthy diet |
|
Sectors involved (examples) |
Legislature Stakeholder ministries across government, including ministries of agriculture, customs/revenue economy, education, finance, health, foreign affairs, labour, planning, social welfare, state media, statistics and trade |
Ministries of education, finance, labour, planning, transport, urban planning, sports, and youth Local government
|
Legislature Ministries of trade, industry, education, finance and justice Local government
|
Legislature Ministries of trade, agriculture, industry, education, urban planning, energy, transport, social welfare and environment Local government |
References
2. Global status report on noncommunicable diseases 2014. Geneva: World Health Organization; 2014.
