Many local governments around the world promote health through intersectoral action, but to date there has been little systematic evidence of these experiences. To bridge this gap, the World Health Organization Centre for Health Development conducted a study in 2011-2013 on intersectoral action for health (ISA) at local government level. A total of 25 cases were included in the final review. Various approaches were used to carry out ISA by local governments in low-, middle- and high-income countries. Several common facilitating factors and challenges were identified: national and international influences, the local political context, public participation and use of support mechanisms such as coordination structures, funding mechanisms and mandates, engaging sectors through vertical and horizontal collaboration, information sharing, monitoring and evaluation, and equity considerations. The literature on certain aspects of ISA, such as monitoring and evaluation and health equity, was found to be relatively thin. Also, the articles used for the study varied as regards their depth of information and often focused on the point of view of one sector. More in-depth studies of these issues covering multiple angles and different ISA mechanisms could be useful. Local governments can offer a unique arena for implementing intersectoral activities, especially because of their proximity to the people, but more practical guidance to better facilitate local government ISA processes is still needed.

International financial institutions have played an increasing role in the formation of social policy in Latin American countries over the last two decades, particularly in health and pension programs. World Bank loans and their attached policy conditions have promoted several social security reforms within a neoliberal framework that privileges the role of the market in the provision of health and pensions. Moreover, by endorsing the privatization of health services in Latin America, the World Health Organization has converged with these policies. The privatization of social security has benefited international corporations that become partners with local business elites. Thus the World Health Organization, international financial institutions, and transnational corporations have converged in the neoliberal reforms of social security in Latin America. Overall, the process represents a mechanism of resource transfer from labor to capital and sheds light on one of the ways in which neoliberalism may affect the health of Latin American populations.

This article presents an update on the characteristics and performance of Venezuela's Bolivarian health care system, Barrio Adentro (Inside the Neighborhood). During its first five years of existence, Barrio Adentro has improved access and utilization of health services by reaching approximately 17 million impoverished and middle-class citizens all over Venezuela. This was achieved in approximately two years and provides an example of an immense "South-South" cooperation and participatory democracy in health care. Popular participation was achieved with the Comités de Salud (health committees) and more recently with the Consejos Comunales (community councils), while mostly Cuban physicians provided medical care. Examination of a few epidemiological indicators for the years 2004 and 2005 of Barrio Adentro reveals the positive impact of this health care program, in particular its primary care component, Barrio Adentro I. Continued political commitment and realistic evaluations are needed to sustain and improve Barrio Adentro, especially its primary care services.

The walk-to-school practice has helped combat childhood obesity by providing regular physical activity. Recommendations to cities promoting walking to school are (1) base interventions on the existing network of schools and adapt the provision to other local organizations, (2) establish safety measures, and (3) respond specifically to local characteristics. Besides the well-established safety interventions, the policy's success may also be associated with Japan's low crime rate.

Following the recommendations of the Commission on Social Determinants of Health (2008), the World Health Organization (WHO) developed the Urban Health Equity Assessment and Response Tool (HEART) to support local stakeholders in identifying and planning action on health inequities. The objective of this report is to analyze the experiences of cities in implementing Urban HEART in order to inform how the future development of the tool could support local stakeholders better in addressing health inequities.The study method is documentary analysis from independent evaluations and city implementation reports submitted to WHO. Independent evaluations were conducted in 2011–12 on Urban HEART piloting in 15 cities from seven countries in Asia and Africa: Indonesia, Iran, Kenya, Mongolia, Philippines, Sri Lanka, and Vietnam.Local or national health departments led Urban HEART piloting in 12 of the 15 cities. Other stakeholders commonly engaged included the city council, budget and planning departments, education sector, urban planning department, and the Mayor's office. Ten of the 12 core indicators recommended in Urban HEART were collected by at least 10 of the 15 cities. Improving access to safe water and sanitation was a priority equity-oriented intervention in 12 of the 15 cities, while unemployment was addressed in seven cities.Cities who piloted Urban HEART displayed confidence in its potential by sustaining or scaling up its use within their countries. Engagement of a wider group of stakeholders was more likely to lead to actions for improving health equity. Indicators that were collected were more likely to be acted upon. Quality of data for neighbourhoods within cities was one of the major issues.As local governments and stakeholders around the world gain greater control of decisions regarding their health, Urban HEART could prove to be a valuable tool in helping them pursue the goal of health equity.