IN my last column, I discussed the Essential Health Services Package (EHSP). I mentioned that healthcare systems act through three approaches: by preventing diseases and promoting health at population and individual levels; by providing curative health services at an individual level; and through intersectoral action addressing the determinants of health. All three are interconnected.

This is what we know about the third aspect — intersectoral health interventions.

The WHO Constitution (1948) and Ottawa Charter for Health Promotion (1986) have mentioned peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice, and equity as fundamental prerequisites. These are considered the distal determinants of health.

According to the DCP-3 (Disease Control Priorities), the more proximal risk factors are grouped into two categories: environmental and behavioural. Environmental risks include lead and other chemical contamination, climate change, occupational hazards, unsafe roads and vehicles, outdoor air pollution, indoor air pollution, unsafe water, and poor sanitation. Behavioural risks to health include inadequate nutrient intake, excessive nutrient intake, suboptimal breastfeeding, risky sexual behavior, physical inactivity, tobacco use, harmful alcohol use, harmful use of injectable drugs, and other addictive substances.

There are 30 high-priority intersectoral health interventions for Pakistan.

If not controlled, these risk factors result in a plethora of infections, injuries, cancers, cardiovascular, respiratory and other non-communicable diseases, and mental, neurological and substance use disorders.

Assessing the magnitude of........

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