Integrated Health Systems in Latin America and the Caribbean (IHSLAC)

The Integrated Health Systems in Latin America and the Caribbean (IHSLAC) Project is a cooperation agreement between the Government of Canada’s Department of Global Affairs Canada (GAC) and the Pan American Health Organization (PAHO).  IHSLAC responds to priorities within maternal, newborn, child and adolescent health. It is implemented in 11 countries. The IHSLAC Project runs from 2016 to 2019. Its ultimate outcome is to contribute to improved health of children, young girls and women (including mothers) in situations of vulnerability in Latin America and the Caribbean (LAC).

 

“…thanks to the support of PAHO and Canada, children are not getting sick anymore.”

- Maria Beita Rodriguez, Community Member,
Yamaranguila, Honduras. 

Health-Thematic Focus Areas
  • Sexual, Reproductive, Maternal, Neonatal, Child, Adolescent Health  
  • Reduction of Maternal Neonatal Mortality
  • Mental Health
  • Blood Safety
  • Transmitted Infections (HIV, Syphilis, Malaria, Helminthiasis)
  • Nutrition
  • Immunization
  • Surveillance
  • Research and Data Analysis
  • Planning and Coordination 
  • Service Delivery and Medicines 
  • Environment (WASH)
  • Leadership, Participation, and Empowerment
  • Health Promotion and Prevention 
participating countries map

Four Cross-Cutting Themes:
Gender, Equity, Human Rights and Ethnicity

The IHSLAC Project is aligned with PAHO’s Gender Equality Policy, Policy on Ethnicity and Health, and Canada’s Feminist International Assistance Policy.  The Project serves as a vehicle to advance PAHO’s mandate for health equity, as well as gender and ethnic equality in health, within a human rights framework. Thus, four cross-cutting themes (CCTs), including Gender, Equity, Human Rights, and Ethnicity are promoted and well integrated in project interventions.  The sum of these efforts will help bring about transformative change in alignment with the Global Affairs Canada policy’s focus on the empowerment of women and girls as the most effective way to reduce poverty and build a more inclusive, peaceful and prosperous world.

Learn more about the IHSLAC Project

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PAHO serves as both the WHO Regional Office for the Americas and the specialized organization for health of the Organization of American States (OAS). With its hemispheric membership and strong convening power, PAHO is the principal regional organization able to mobilize and coordinate hemispheric action on regional health issues, including public health threats.

Canada has been a PAHO Member State since 1971, and PAHO has a long history of collaborations with the different international development agencies in the Government of Canada.

Currently PAHO and Canada partner through the IHSLAC PROJECT

In May of 2016, the Pan American Health Organization (PAHO) and Global Affairs Canada (GAC) launched the Integrated Health Systems in Latin America and the Caribbean Project 2016-2019 (IHSLAC) to improve the health and protect the rights of women (including mothers), adolescent girls and children living in situations of vulnerability in 11 countries in Latin America and the Caribbean.  From 25 to 27 May 2016, a planning meeting with the 11 countries and Canada was held in Lima, Peru.

This initiative has three main objectives: (1) strengthening health systems; (2) reducing the burden of communicable diseases; and, (3) improving nutritional practices in the targeted beneficiary populations. 

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As part of this initiative the Government of Canada, through its Department of Global Affairs has committed $18.5M CAD until 2019. The program activities are implemented in Bolivia, Colombia, Ecuador, Guatemala, Guyana, Haiti, Honduras, Nicaragua, Paraguay, Peru, and Suriname. 

The IHSLAC Project is aligned with and responds to Canada’s international development priorities in maternal, newborn, child, and adolescent health (MNCAH) and contributes to the achievement of PAHO’s Strategic Plan’s (2014-2019). More specifically, as an integral part of PAHO programming, the project contributes to the implementation of PAHO’s 2016-2017 and 2018-2019 Biannual Work Plans (BWP). In this regard, the project feeds into 11 Country BWPs and 7 Regional BWPs. The project is implemented on the basis of Annual Work Plans (AWP) – 11 countries AWPs and a regional AWP.

Towards achieving the ultimate outcome, the project invests in three programmatic areas:  Health Systems (intermediate outcome 1100); Disease Case Management and Prevention (intermediate outcome 1200); and Nutrition (intermediate outcome 1300). At an operational level, the project is focused on Increasing Access for All to Quality Health Care, Nutrition and Prevention Services through three strategic pillars, namely:  SP1 – Quality of health and Nutrition Services; SP2 – Evidence-Based Prevention, Health Promotion, and Visibility; SP3 – Governance. As a contextual backdrop and in line with PAHOs 2014-19 Strategic Plan, the IHSLAC project identifies Gender, Equity, Human Rights and Ethnicity as cross-cutting themes within its programmatic and strategic scope. 

The IHSLAC Project runs from 2016 to 2019. Its ultimate outcome is to contribute to improved health of children, young girls and women in situations of vulnerability in Latin America and the Caribbean.

For more information, please contact Dr. Guillermo Marquez (marquezgui@paho.org).


Below are the most recent collaboration initiatives between Global Affairs Canada and PAHO:

Find out more about Global Affairs Canada

The IHSLAC Project is guided by a programmatic set-up, an operational approach and 14 health thematic areas, which are all integral to the strategic implementation of activities and ensuring that the ultimate outcome of the project is always kept in sight.

framework diagram

The following elements constitute the project’s programmatic set-up:

  • 1 ultimate outcome – “Improved health of children, young girls and women (including mothers) in situations of vulnerability in Latin America and the Caribbean (LAC)”;
  • 3 intermediate outcomes. These represent the 3 programmatic areas the project focuses on i.e.
    • Health Systems (intermediate outcome 1100);
    • Disease Case Management and Prevention (intermediate outcome 1200); and,
    • Nutrition (intermediate outcome 1300);
  • 6 immediate outcomes. These contribute to Intermediate outcome targets;
  • 15 different outputs. These delineate the priority operational areas resources are invested upon;  
  • Gender, Equity, Human Rights and Ethnicity as cross-cutting themes that permeate the broader programmatic scope of the project.

The following elements define the project operational approach:

  • A common operational target (the why) of project investments i.e. Increasing Access for All to Quality Health Care, Nutrition and Prevention Services;   
  • Three (3) common strategic approaches through which entities are working towards targets (the how) i.e.  
    • SP1 – Quality of Health and Nutrition Services; 
    • SP2 – Evidence-Based Prevention, Health Promotion, and Visibility; 
    • SP3 – Governance.

Project action is focusing on the following 14 different health-thematic areas:

  1. Sexual, Reproductive, Maternal, Neonatal, Child, Adolescent Health
  2. Reduction of Maternal Neonatal Mortality
  3. Mental Health
  4. Blood Safety
  5. Transmitted Infections (HIV, Syphilis, Malaria, Helminthiasis)
  6. Nutrition
  7. Immunization
  8. Surveillance
  9. Research and Data Analysis
  10. Planning and Coordination 
  11. Service Delivery and Medicines 
  12. Environment
  13. Leadership, Participation, and Empowerment
  14. Health Promotion and Prevention

Gender, Equity, Human Rights and Ethnicity, as cross cutting themes for PAHO, were integrated within the project from its conception. 

In light of the government of Canada’s (GAC) recent adoption of its Feminist International Assistance Policy in July 2017, an effort was made to find potential Project alignment to this Policy. It is important to note that, unlike GAC’s dedicated focus on results related to women and girl’s empowerment, PAHO’s work on the CCTs aims at mainstreaming related concerns into work across the organization, including, and indeed principally, work that is not primarily aimed at impacting upon women and girl’s empowerment. That said, it is hoped that the sum of these mainstreaming efforts will help bring about such transformative change in alignment with the GAC policy.

To help illustrate, below are key examples that tangibly demonstrate the ways in which the four cross-cutting issues are being reflected in project activities.

For Gender:

In Suriname, a qualitative data collection exercise conducted highlighted differential male/female vulnerabilities and needs by exploring, among other aspects, the differences in mothering practices for baby girls in contrast to baby boys, and male involvement in reproductive task responsibilities. Findings informed tailored messages for a variety of target audiences for an exclusive breastfeeding behavior change communications effort, within the country’s National Infant and Young Child Feeding and Essential Care Strategy.

In Bolivia, through the Project, PAHO supported the development of a guide for local health authorities to facilitate participatory processes for the analysis of community health conditions.  These guides enable gender-based assessments and analysis of barriers to health service access and, more specifically, to reflect upon the drivers of women’s health conditions in target communities with a women’s rights approach.

Dialogues on breastfeeding and water, hygiene and sanitation with community members from indigenous communities in Colombia represented efforts to incorporate effective women participation and inclusive dialogue in health-related decision making. Activities included participation of women from target indigenous communities with a balanced male participation and the inclusion of girls and boys resulting in increased autonomy and women empowerment.

In the Amazonian indigenous region in Peru, community planning exercises were conducted with a focused effort to involve the women’s organized movement of Women’s Alto Amazonas Federation (“Federación de Mujeres del Alto Amazonas”).  This has resulted in prioritization of women’s rights and an implementation of strategies to diminish adolescent pregnancy.

In Paraguay, IHSLAC Project activities during 2017 concentrated on strengthening health service delivery in the districts Carmelo Peralta, Bahía Negra, Puerto Casado, and Puerto Peñasco, all on the Paraguay- Brazil border. The Project focused on improving treatment and diagnosis of priority diseases with a focus on gender-sensitive health service delivery models. This included, for instance, support for an ultrasound and a clinical diagnosis laboratory in order to offer care and treatment for pregnant women of the border districts, previously non-existent.

In 2017, an example of women and girls' empowerment for health was reported in the Yamaranguila province in Honduras through the promotion of active women’s participation in order to consolidate their role as community leaders.  Activities focused on strengthening women´s empowerment at all levels, specifically enabling decision-making at municipal level and integrating women as fundamental actors in multi-sectoral dialogues and planning processes.

In Nicaragua, with the maternity waiting homes initiative, women’s stays in the homes are used as an opportunity to empower women and address the issue of unpaid work.  Skills in entrepreneurship and food self-sufficiency are transferred during this time and go beyond the health aspects of maternal health care they receive.

On 9 June 2017, Canada adopted a feminist international assistance policy to advance gender equality and the empowerment of women and girls. This approach is viewed by Canada as being most effective in reducing poverty and building a more inclusive, peaceful, and prosperous world. To learn more, visit the Government of Canada's website.

In the international assistance policy, Canada affirms that "committing to a feminist approach to international assistance represents a significant shift in what we do and how we do it".

ACTION AREAS

To most effectively champion gender equality and the global empowerment of women and girls, Canada will fund initiatives that:

  • enhance the protection and promotion of the human rights of women and girls;
  • increase the participation of women and girls in equal decision-making, particularly when it comes to sustainable development and peace; and
  • give women and girls more equitable access to and control over the resources they need to secure ongoing economic and social equality.

To ensure that Canada’s international assistance is best able to achieve the goals of gender equality and the empowerment of women and girls, Canada will focus its efforts on six action areas.

  • Core Action Area: Gender Equality and the Empowerment of Women and Girls
  • Human Dignity (health and nutrition, education, humanitarian action)
  • Growth That Works for Everyone
  • Environment and Climate Action
  • Inclusive Governance
  • Peace and Security