Turning the policy- making process from circular to spiral: Building consensus and commitments within political parties to improve pubic health in Peru

Improving health care and health determinants for the poor in countries of high inequality like Peru will not only be achieved by technical interventions and traditional policy-making processes. Developing sustainable health policies have been hampered by post-electoral political transition. This frequently has lead to a lack of continuity of social policies, drawing a “circular” policy-making process: everything begins again with each newly appointed government. Significant change can only happen if the citizens have much greater involvement in shaping health policies, and in ensuring that what is agreed actually happens.

Since 2004, a Peruvian Health Rights Program has propelled citizen advocacy capacity building within ForoSalud, a major civil society network, for strengthening citizen participation for analysis and decision-making on health policies, through a bottom-up policy design process. Health policy proposals coming from all regions of Peru have been openly discussed at national and regional levels. Many became national and regional policies.

Along 2006, Peru has been engaged in electoral campaigns for the Presidency, and for regional and local governments. In order to avoid the possible loss of key policies negotiated through years with former public health authorities, and drawing on a previous experience of CARE Peru and its partners promoting political parties agreements at the national level, ForoSalud - working together with CARE Peru and United Nations Population Fund - implemented twelve series of regional policy dialogues inviting usually neglected actors of policy making processes: those political parties challenging for the regional governments. Policy dialogues produced participatory multiparty agreements and public commitments on health policies.

What has resulted includes increased politicians' awareness and multiparty agreements on key health policies; regional civil society networks positioned as vital actors for sustainable policy-making processes; expected continuity of health policies; social surveillance of agreed commitments on health policies. Overall, this advocacy process evidence cross-party consensus is possible in the health sector and makes clear that ignoring political parties in our advocacy work could be a huge missed opportunity.