Findings from the thematic review and several of the case studies stress the need for a more cohesive approach, bringing together multiple sectors. One shortcoming of the intervention to address NCDs in Khayelitsha was the focus on individual behaviours or risk factors for NCDs instead of addressing the broader social, cultural, structural and environmental determinants identified in the research. Active involvement of different sectors was required in order to prevent and address the multi-factorial risk factors for NCDs.
The case study of the Philani intervention recognised that women living in newly-urbanised areas often lack social support systems, can be exposed to urban violence, and experience social exclusion and a denial of basic reproductive rights. While individual level interventions to improve maternal mental health are essential, the Philani intervention acknowledges that this cannot be done at the expense of addressing structural determinants such as poverty and adverse living conditions.
At the time of the case study on SRHR and ICT in South Africa, there were no policies which addressed both SRH and ICT, despite much activity on ICT innovation and the use of mobile phones for health (mHealth), and little interaction between the government departments of health and communication. However, shortly after publication, South Africa launched a mHealth strategy laying the foundation for the integration and coordination of both public and private sector mHealth initiatives in the country. This recognition of the need to provide multi-sectoral policy guidance is a positive step in supporting and promoting the integration of ICT for health into existing health systems and programmes.
- Ill-health is just one of the challenges poor women and girls face in low-income urban settlements, alongside many other social, economic and structural determinants of health. In order to adequately address the health challenges of women and girls in these urban spaces, it is essential to look beyond the health sector and adopt policy responses that are multi-sectoral and take a broader approach to addressing the structural determinants of ill-health.
- Policymakers, governments, and donors need to ensure that health policies and programmes are seen in conjunction with other sectoral concerns, including water and sanitation, urban planning, gender equality, and nutrition, among others.