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PAN AMERICAN HEALTH
ORGANIZATION
Pan American Sanitary Bureau, Regional
Office of the
WORLD HEALTH
ORGANIZATION
SCHOOLS AS ENGINE FOR DEVELOPMENT AND
HEALTH, A NEW WAY TO PROMOTE COMMUNITY
DEVELOPMENT WITHIN THE FRAMEWORK OF THE
SOCIAL DETERMINANTS OF HEALTH FOR THE
ACHIEVEMENT OF THE MDGs
Dr. Sofialeticia Morales
Senior Advisor Millennium Development Goals
Team Leader Education and Health
Pan American
Health
Organization
Unit of Health Determinants and Public Policies
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MILLENNIUM DEVELOPMENT GOALS
HIGHEST LEVEL POLITICAL
CONSENSUS ON MEASURES TO
COMBAT POVERTY
HEALTH OCCUPIES A CENTRAL PLACE
OF IMPORTANCE FOR DEVELOPMENT
GOALS, TARGETS AND INDICATORS
ARE QUANTIFIABLE AND AMBITIOUS /
MEASURE THE PROGRESS AND
DEMAND PROGRESS
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¿WHY ARE THE MDGs
IMPORTANT?
Commitment to Action
• Consolidate progress, resolve problems
• Position health as a top public priority
IT IS POSSIBLE TO CALCULATE THE
COST OF ACHIEVING THEM,
WHAT IS AVAILABLE VERSUS WHAT IS
NECESSARY
GLOBAL PARTNERSHIP FOR
DEVELOPMENT EMPHASIZES
HUMAN SECURITY AND GLOBAL
PROSPERITY SAFETY AND WORLD
PROPOSPERITY
• Reduce inequities
• Respond to national and regional needs
Inequity and Poverty
HIV/AIDS
 Environmental Protection
Pan American
Health
Organization
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The Millennium Development Goals
•
•
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A set targets & indicators bound by a specific time frame for
completion (1990 2015)
A synergic and indivisible unit that requires intersectorial action for
their completion
Eradicate extreme poverty and hunger
Achieve universal primary education
Promote gender equality and empower women
Reduce child mortality
Improve maternal health
Combat HIV/AIDS, malaria, and other diseases
Ensure environmental sustainability
Pan American
Health
Organization
Develop a global partnership for development
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OBJETIVOS DE DESARROLLO DEL MILENIO
PAHO’s STAND ON THE MDGs
• Highlight the challenge of inequity in the world’s
most inequitable region.
• Go beyond advocacy and monitoring to become
Consideronthe
social, economic,
political,
directly• involved
interventions
at the municipal
environmental and cultural determinants and
level.
impact mapping
on health.exercises of the
• Carry outtheir
a regional
• Analyzemunicipalities,
and respond tobased
the multi-dimensionality
most vulnerable
on MDG
and level
multi-causality
the poverty
related local
indicators of
derived
from particularly.
• Work
at theand
municipal
level to work on all the
National
Censuses
Population.
MDGs respectingAgreement)
their indivisibility and synergy.
(ECLAC/CELADE/PAHO
• Launch the initiative Faces and Places of the
Pan American MDGs
Health
Organization
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The Social Determinants, Health
Promotion and the MDGs
“The social determinants
refer to the social conditions
in which people live, study,
work, and develop”
The MDGs recognize the
interdependence of health
and social conditions, and
offer an opportunity to
develop health policies that
address the social roots of
avoidable human suffering
arising from unjust social
conditions
.
Pan American
Health
Organization
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HEALTH
PROMOTION
PROTECTING & RISK
FACTORS
SOCIAL
DETERMINANTS OF
HEALTH
SCHOOLS
ENGINES FOR
DEVELOPMENT
MILLENNIUM
DEVELOPMENT
GOALS
TWO WAY
INTERACTION
WITH THE
MUNICIPALITY
Pan American
Health
Organization
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THE SOCIAL NATURE OF HEALTH
Health is not exclusively a bio-natural occurrence related
to the individual, but the result of complex and changing
relations and interactions between biological, individual,
environmental, and living conditions of economic,
environmental, cultural, and political order.
We get sick and we die in relation to the way we live,
eat, reproduce, work, relate to others, educate, develop
our capacities and face ours limitations .
This is the focus of
SOCIAL DETERMINANTS OF HEALTH
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Health
Organization
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Declaration on the
New Orientations for Primary Health Care
(Declaration of Montevideo)
Commitment to facilitate social inclusion and equity
in health.
Recognition of critical roles of both the individual and
community in the development of PHC-based
systems.
Orientation toward health promotion and
comprehensive and integrated care.
Development of intersectoral work.
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Health
Organization
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Renewing Primary Health Care in the Americas
Principles
Values
 Right to the highest
attainable level of health
 Equity
 Solidarity
Responsiveness to people‘s
health needs.
Quality – oriented
Government accountability
Sustainability
Participation
Intersectoriality
Pan American
Health
Organization
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The Causes of the Causes
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SOCIAL CONTEXT
CULTURE, RELIGION, SOCIAL SYSTEM
HUMAN RIGHTS, LABOUR MARKET,
EDUCATIONAL SYSTEM
GLOBALIZATION
ARISE FROM THE CONFIGURATION OF THE SOCIAL ESTRATIFICATION
AND DETERMINE THE DIFFERENCES OF EXPOSITION AND
VULNERABILITY TO THE CONDITIONS UNHEALTHY CONDITIONS
BIOLOGICAL PROCESSES
Pan American
Health
Organization
HEALTH/ILLNESS
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SOCIAL PROTECTION
INTERMIDIATE DETERMINANTS
HEALTH SYSTEMS
PRIMARY HEALTH CARE
PRODUCE SOCIAL STRATIFICATION AND INCLUDE TRADITIONAL
FACTORS SUCH AS EDUCATION AND INCOME, AS WELL AS GENDER,
ETHNIC ORIGIN AND SEXULITY
HEALTH PROMOTION
STRUCTURAL DETERMINANTS
Determinants of Health and the Millennium Development Goals
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Structural
Determinants
+
Intermediate
Determinants
Poverty and
Inequality
Economic
Political
Environmental
Degradation
Environmental
Styles of
Life not
Healthy
Technological
Biological
Pan American
Health
Organization
=
Results
in the Health
Negative
Impacts
On Health
Morbidity
Social
Structural
Determinants
+
Risk Factors
+
Intermediate
Determinants
Hunger &
Malnutrition
Limited
Access
to health
Services
& Education
Quality
Unemployment
Contamination
and Climate
Change
Addictions
Obesity
Reduction of
Factors of
Risk
Vulnerability
Maternal and
Child`
Diseases
Communicable
Diseases
Chronicles
Mental Health
Problems
HIV-AIDS
=
Millennium Development Goals 1990-2015
Better
Results
in the Health
Mortality
Reduce
Life
Expectancy
Low
Quality
of
Life
(-)
Negative
On Health
Impact
Positive
in the Health
and the Quality
of Life
DETERMINANTES SOCIALES DE LA SALUD Y SU
IMPACTO EN LA ESCUELA Y EN LA COMUNIDAD
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•Bad Quality
Education
ECONOMIC
•Bad Quality Health
Services
• Morbidity and
Mortality
•Materno-Adolescent
Mortality
POVERTY
MARGINATION
MINIUMUM WAGE
INCOME
COMPENSATIONS
FACES, VOICES
& PLACES SOCIALES Y
SCHOOLS CULTURALES
AMBIENTALES
AIR AND WATER QUALITY
• Poor basic sanitationSANITATION
CHEMICAL SUBSTANCES
•Parasites
CONTAMINATION
•Enfermedades infecciosas
OZONE LAYER DEPLETION,
•Respiratory InfectionsCLIMATE CHANGE
Pan American
Health
•Diahreal Diseases
Organization
•Malaria, Dengue
• Access to
education and
POLITICAL health services
•Social Security
COMMITMENT TO HEALTH,
and Protection
SOCIAL POLICYL, LAWS
Programs
REGULATIONS
•Health and
Education as a
right
• Discrimination
STRATIFICATION FACTORS
Obesity
ETHNIC GROUP, •GENDER,
SEXUAL ORIENTATION.
• Prevention Culture
HEALTH HABITS
• Stress
PERCEPTIONS HEALTH/
ILLNESS
• Sedentarism
• Cardio Vascular and
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metobolic pathologies
• Violence
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SOCIAL DETERMINANTS OF HEALTH AND EDUCATION
Diagnosis and Context
ECONOMIC
•
To what socioeconomic group the students belong to?
•
What economic problems have and how these affect their education
and health?
SOCIAL
•
Are their parents are illiterate or university graduates?
•
Do they have access to culture at home?
CULTURAL
•
What is the value that their culture assigns to the education and
health?
ENVIRONMENTAL
•
Where is the school located?
•Pan American
What are the environmental problems in the municipality?
Health
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•Organization
How do these problems affect their health?
Quality Education and teaching
capacities for life
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SELF UNDERSTANDING
How to help students to understand
themselves better?
CREAT AND SUSTAIN RELATIONSHIPS
How to educate to create and sustain
healthy relationships?
With
themselves
EMOTION CONTROL
How to educate them to control their
emotions?
EMPATHY
HANDLING STRESS
How to make students empathetic?
How to teach them to control their stress?
SEXUAL RELATIONS
Providing relevant information and respect
for themselves and others?
With others
TRANSFORMING THEIR SORROUNDINGS
How to commit students to improving their
social sorroundings?
DECISION TAKING
PROBLEM SOLVING
CRITICAL THINKING
CREATIVE THINKING
Pan American
Health
Organization
With the
community
Education
for freedom
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What is the role of Schools in community development?
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School Engines for Development play
a key role in community transformation.
 They promote health through knowledge, understanding, and reassessing the students immediate context.
 The educational community is certain of the context where its
everyday life takes place and can describe it by identifying the social
determinants of health and analyzing how these social determinants
play a key role in school life
 An initial analysis takes place from the school and about the school
to identify the interplay of the school and community and how its
location limits or promotes educational quality and the school as
motor for community transformation beyond classroom walls.
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Health
Organization
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What is the role of Schools in development, health
promotion and addressing the determinants
 The initial context analysis exercises is endogenous and
centered around the school and mindful of the elements that
promote or limit the provision of quality education.
 The secondary level analysis is exogenous in nature and
centered on the municipality as a geographical, jurisdictional
and political entity. The analysis is based on the history, its
peculiarities, and its cycles; sources of employment, economy,
Pan American
politics,
and environment
Health
Organization
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SCHOOLS AS AN ENGINE FOR DEVELOPMENT
Human Development:
Sustainable / Equitable
Millennium Development Goals &
other relevant national agendas
Social Policy
Health
Promotion,
Renewed
Primary
Health Care
TARGET
Children,
Teenagers, Young
Adults,
Pan American
Health
Organization
Social Determinants of Health
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The Pedagogy of Development
 Schools and Engines for Development base their strength in the
pedagogy of development that has as its axiological foundation the
value of human life as a fundamental right.

Takes on the paradigm of Education for Freedom, where education
occurs through dialogue. This approach requires the development of
alternatives and critical visions. Where the analysis of various points
of view is essential for evaluating, transforming conceptions,
attitudes,
substantiate
beliefs,
and
worldviews.
Pan American
Health
Organization
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The Pedagogy for Development and Education
 The pedagogy of the development in the classroom where the
educational act allows the transformation of the student’s
understanding of community’s reality through dialogue and an
analysis of the problems being faced.
 The pedagogy of the development in the school implies a collegiate
action that leads the students and the educator to develop a school
project that involves the whole school.
 Learning will take place by doing and the transformation of an aspect
of the school.
 The pedagogy of the development in the community through an
action
of co responsibility between the educational community and
Pan American
Health
the key
actors of the community.
Organization
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Schools Engines for Development and Health

Arises from the analysis of the social determinants of health and aims
advancing toward the achievement the Millennium Development Goals
and other pertinent agendas with the understanding that schools are
the engine for development.

The commitment implies first creating or consolidating the national,
provincial and local networks of schools and later to promote the
international networks.

The national Networks become solid foundations for the sharing of
experiences, success stories and challenges in making that schools
become promoters of development. It is necessary to link the
schools with the first level of care within the framework of Primary
Health Care to ensure that the local development is consolidated
Pan American
through
Health the partnerships between schools and health services.
Organization
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SUPPORTING TECHNICAL PARTNERSHIPS
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Social Protection
and Education
Workers Health
UNESCO/OREALC/
PAHO/ILO
Health and
Occupational Health
Virtual Network
•Health Promoting
Schools(1995),
•Programs
Educational
Environments
Responding to
Violence
Violence in SchoolsHealthy and
Free
settings
Network of Healthy
•HIV/AIDS preventionEnvironment For
Children
Health Promotion and Prevention
Primary Health Care
Provision of Health Services
Training and Education Strategies
Pan American
Health
Organization
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Other methods to promote health
within the framework of the
determinants
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The promising introduction of programs that
combine financial assistance with the human
resources development and the improvement of
health and living conditions
Pan American
Health
Organization
Bolsa Familia - Brasil
Oportunidades - México
Chile Solidario/ Chile Puente
Barrio Adentro - Venezuela
Familias en Acción - Colombia
Bono de Salud - Bolivia
Beca escolar - Ecuador
Programa de Asignación Escolar Honduras
Bono Alimentario y Escolar Nicaragua.
Red de solidaridad y oportunidades El Salvador
 Plan Familia - Argentina
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EMPHASIS:
EQUITY IN THE RESPONSE TO THE SOCIAL DETERMINANTS Education
with gender and intercultural perspective
SCHOOLS ENGINES FOR DEVELOPMENT IN RELATION TO THE
SCHOOL PROYECT AND THE MUNICIPALITY TO ADVANCE THE MDGs
THE PEDADOGY OF DEVELOPMENT
CAPACITIES FOR LIFE AS A TEACHING-LEARNING PROCESS
AND EDUCATION’S 4 DIMENSIONS: LEARNING TO BE, LEARNING TO
KNOW, LEARNING TO DO, AND LEARNING TO CO-EXIST
IN TERMS OF LEVELS THE EMPHASIS IS PLACED ON INITIAL
EDUCATION, PRE-SCHOOL, PRIMARY, SECONDARY, AND VOCATIONAL
OR TECHNICAL. THE ROLE OF HEALTH AND DEVELOPMENT
Pan American
PROMOTING
UNIVERSITIES
Health
Organization
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