Although ESI Funds offer great opportunities to improve health equity, the public health sector has so far not been involved to a great extent. Raising awareness is therefore crucial.
Raise awareness among themselves of the Structural Funds as a potential co-funding mechanism for initiatives that can promote public health objectives and improve health equity.
Public health professionals at all levels of government must raise awareness among themselves, as well as the wider health sector, of the untapped potential to use the Funds to contribute to public health goals and improve health equity. This can be done through briefing papers, workshops, events, and presentations to high-level public health officials at national, regional, and local levels.
Raise its profile vis-à-vis Structural Fund managers and other sectors, and make the necessary contacts and links
National, regional, and local health authorities should identify how ESI Funds priorities are being developed in their countries and aim to become more involved in these processes. They should advocate for action on health and health equity as a means of fulfilling their country and regions’ ESIF programming objectives. They should also strengthen the links between public health and other sectors, by demonstrating to other sectors how they affect public health and health equity.
Conditionality provisions and the partnership principle across sectors when negotiating the programmes maximise the strategic effectiveness of ESI Funds. It is therefore important that the public health sector is involved in the strategic planning processes of other sectors, to identify linkages between intended initiatives, public health, health inequalities and sustainable development. This can facilitate the public health sector’s ability to secure funds for projects and programmes financed through different Operational Programmes that can contribute to health equity.
Advocate for systematic approaches to take health inequalities into account.
An ambitious but effective way to ensure that ESI Funds contribute to reducing health inequalities is to make health equity impact a selection criterion for initiatives applying for the Funds, and to make it an indicator of successful implementation. Health inequalities can also be incorporated into concepts like ‘social sustainability’, which could in turn be a selection or evaluation criteria, or a cross-cutting theme.
Developing new cross-sectoral partnerships or building upon existing partnerships is key to making use of ESI Funds for health equity.
Identify and work through existing partnerships or develop new cross-sectoral partnerships
While the public health sector can develop their own initiatives for co-financing under the ESI Funds, it should also seek out opportunities to take part in projects and programmes being led by other sectors and widen the scope for health equity action, such as regeneration programmes or those that aim to enhance access to employment. Public health could get involved in order to maximise the health and health equity related impacts of such initiatives. This implies being proactive in networking, identifying and contacting relevant organisations within other sectors that are developing or implementing such projects and programmes. The public health sector could get involved as a partner from the outset of such projects, and help with their design, or they could become involved in projects that are already receiving financing, to bring in or strengthen their health element.
Learn and use the language of others
It is up to public health professionals to learn the language of other sectors, rather than assuming they understand and prioritise concepts like the social determinants of health and health inequalities, and to demonstrate how efforts to improve health and reduce health inequalities are also in others’ interest. When engaging with other sectors it is prudent to talk about health in terms of wellbeing, sustainability, resilience, and other social determinants.
Share knowledge and experiences
Information on successful approaches, arguments, proposals and compelling evidence for intersectoral engagement can provide ideas and inspiration to other regions across the EU and serve as a basis for action. The Structural Funds Review for Equity Action includes various projects, which can also be found among the Success Stories. By joining EuroHealthNet’s Practice Platform, you will be able to exchange experiences and expertise with other experts and organisations.
Public health should build capacities within the sector as the process of applying for funds requires expertise.
Build capacities of sub-national public health authorities to apply for ESI Funds, based on Health in All Policies principles and health equity
This could be done by organising workshops and training sessions to inform public health professionals working at the regional and local level about the opportunities available to use ESI Funds to promote public health objectives and reduce health inequalities. They could invite representatives of projects and programmes that have or are receiving ESI Funds to discuss their experiences. They could also invite Managing Authorities to present on relevant Operational Programmes that offer opportunities and to speak about procedural issues.
Invest in fostering health experts who understand Cohesion Policy and ESI Funds, as well as the social determinants of health and health equity, and who can convey this to others
Both the social determinants of health as well as applying for and implementing ESI Funds require expertise. Public health authorities should invest in fostering experts that are able to bring these two areas of expertise together. These experts can act as champions for health within Cohesion Policy, as well as professionals who can help assess and enhance the health equity impacts of different projects and programmes that receive ESI Funds.
Pursue opportunities available within the ESI Funds to build capacities
The public health sector should design initiatives under the ESI Funds Thematic Objective 11 ‘Enhancing Institutional Capacity’ to build capacities within health systems to improve health equity. They should aim to get funding to train public health professionals to systematically monitor health inequalities and to incorporate a focus on health equity in the design, implementation and evaluation of all relevant policies and programmes. They should also aim to get funding to build the capacities of public health professionals to work with other sectors to promote health and ensure a fairer distribution of opportunities for health.
Identify regional policy priorities and establish links between potential initiatives and the objectives of ESI Funds
Identify what regions, areas within regions and target groups in their countries have the worst health status and monitor ESI Funds spending to ensure that it is reaching those in need (e.g. Roma)
The public health sector should push for and support efforts of poverty mapping in their countries and regions to ensure that the most deprived localities and target groups are those that benefit from ESI Funds. They can do this by identifying what localities in regions have particularly poor levels of health and should be considered for prioritising, and by exploring how micro-mapping of deprivation (including health-related outcomes as an indicator) is or isn’t being used to allocate ESI Funds. Public health actors can also identify which groups in their Member State are considered to be marginalised, and which department is responsible for defining this, to see to what extent this accords with vulnerable and excluded groups from a health perspective. They should then identify and pursue funding opportunities and develop initiatives to improve health status in those regions, micro regions or amongst target groups in their countries in most need.
The European Commission is particularly committed to supporting Member States on national Roma integration strategies. These should include improving access to health services and reducing the gap in health between the Roma and the general population. Public health officials should therefore identify whether their countries have Roma integration strategies and whether health-related measures are adequately incorporated. Since a significant proportion of ESF funds must be allocated for Roma integration, the public health sector should identify how they can contribute to efforts in this area.
Identify opportunities to use ESI Funds to leverage existing regional level priorities and activities that relate to health equity
ESI Funds can be used to co-finance existing or planned regional actions or initiatives that can contribute to greater health equity. Public health authorities should investigate ESI Fund priorities in their countries and regions and compare them to their regional policy priorities in the areas public of e.g. public health, health promotion, equity and social welfare, to identify how they could be used to advance these existing priorities. Before taking action and developing initiatives for funding, the public health sector should investigate and establish links between potential initiatives and the objectives of a relevant Operational Programme, their Country-Specific Recommendations and with their Managing Authority.