Session 3
Session 3: Fostering public health policies and response in territorial context: the role of NPHIs
The session was moderated by Prof. Felix Rosenberg, Itaborai Forum Director, Fiocruz, Brazil, and Jean-Claude Desenclos, IANPHI Senior Strategic Adviser.
Mexico Experience in the inter sectorial and community participatory mapping of public health program at territorial level
Dr. Bernardo Hernandez Prado, Dean of the School of Public Health, Instituto Nacional de Salud Pública, Mexico
Dr. Hernandez Prado presented an experience in inter-sectorial and community mapping in Xochitepec, Morelos, Mexico. This community health research project was led by Dr. Tonatiuh Barrientos, and is part of a larger initiative in Latin America also mentioned by Carlos Hernandez Avila (El Salvador) in session 2.
Participatory mapping techniques were used to obtain information at the local level and better understand health and social issues in local Mexican communities, where data is often lacking. Traditional public health methods were enhanced by participatory techniques like exploratory walks, group discussions, and community-drawn maps to identify local issues, both strengths and vulnerabilities.
These techniques were useful to generate proposals to reduce health inequalities that could be potentially used in other settings.
The project demonstrated that these participatory methods are fast, informative, and useful for gathering insights directly from community members. There's strong potential to integrate these tools into Mexico's public health education and broader health system reforms, especially as the country emphasizes community engagement and primary care.
Bernardo Hernandez Prado's presentation (PDF)
Supporting Public Health within Canada's Indigenous Communities
Dr. Theresa Tam, Chief Public Health Officer, Public Health Agency of Canada
Dr. Tam explained that the COVID-19 pandemic has underscored and exacerbated health inequities, drawing attention to the crucial need to addressing health disparities experienced by marginalized communities, including the Indigenous Peoples in Canada (e.g. : they face higher rates of disease, food insecurity, and limited access to services).
She highlighted Public Health Agency of Canada's efforts to support Indigenous health and address long-standing inequities, which requires meaningful and multi-faceted collaboration with jurisdictions, various sectors, and with Indigenous communities that respects Indigenous knowledge, sovereignty, and self-determination.
In her presentation, she contextualized the challenges, approaches, and incremental progress in delivering public health support to Indigenous Peoples in Canada.
Key initiatives include Indigenous-led health programs, culturally safe practices, and a focus on Indigenous data sovereignty through principles like OCAP.
Dr. Tam closed by stressing the need for humility, trust-building, and ongoing commitment to reconciliation and health equity.
Theresa Tam's presentation (PDF)
Lessons learned from responding to the Chido hurricane in the Indian Ocean: experience at the territorial scale, France (Mayotte Island) and Mozambique
Dr. Alvaro Ernesto, Provincial Delegate at Cabo Delgado, Instituto Nacional de Saúde, Mozambique
Dr. Ernesto started with an overview of the impact of the hurricane Chido in Cabo Delgado (northern region of Mozambique). It affected over 400,000 people and caused significant damage to health infrastructures. It created an even more complicated situation as Cabo Delgado has been under a state of emergency since 2017 due to ongoing conflict.
The National Institute of Health of Mozambique (INS) played a key role in surveillance, laboratory work, and coordination with other agencies. Activities included early disease detection, rapid deployment of health teams, outbreak monitoring, and data reporting. Fortunately, post-hurricane weather helped prevent major disease outbreaks, though a localized conjunctivitis outbreak was confirmed due to contaminated water.
Key takeaways include the value of preparedness, community-level training, improved risk communication, and the importance of local coordination. The response was guided by experience from past disasters and highlighted the need for better logistics, evacuation planning, and investment in resilient infrastructure.
Alvaro Ernesto's presentation (PDF)
Dr. Youssouf Hassani, Mayotte Regional Office Director, Santé publique France
To begin with his presentation, Dr. Hassani first introduced the Mayotte Island. It is a small French island in the Indian Ocean with over 321,000 residents. This territory faces major public health challenges including poverty, overcrowded housing, limited access to clean water, and low medical capacity. It also experiences a double burden of malnutrition and obesity, and frequent infectious disease outbreaks like typhoid and cholera.
In this context, the hurricane Chido impact was worsened. It caused massive destruction to homes and infrastructure, including hospitals and communication networks. Most formal health surveillance systems became non-functional. To respond, more than 100 health reservists were deployed. They supported hospitals and helped restore a manual, paper-based health surveillance system, using WhatsApp and field data collection.
In parallel, a community-based surveillance system was implemented. Local mediators, health reservists, and epidemiologists visited households weekly to collect data on health symptoms, injuries, psychological stress, and water access. Results showed high levels of trauma, infections, malnutrition, and stress, particularly among vulnerable groups like children.
Despite fragile systems and logistical challenges, the combined hospital and community surveillance allowed real-time tracking of post-disaster health needs.