Enablers and obstacles for designing and implementing intersectoral health policies: Lessons from Mexico.

Background: This study analyzes how national intersectoral public policy experiences have been adopted and implemented using a Health in All Policies (HiAP) approach in the past two decades. It seeks to provide evidence on enabling factors that triggered three effective intersectoral public policies to improve population health in Mexico by improving nutritional, educational, and healthcare access conditions, reducing road traffic injuries, and addressing obesogenic feeding practices. Methods: We followed a qualitative approach to analyze the three intersectoral public policies selected as case studies. First, we designed an analytical framework to assess how intersectoral public policies are adopted, implemented, and sustained. The proposed framework is based on peer-reviewed articles and gray public policy literature. Second, we used information from eleven semi-structured interviews with key stakeholders conducted in previous research to identify more specific enablers and barriers of the three intersectoral policies selected according to predefined analytical categories used in the questionnaire. Results: The analysis showed three overall key findings. First, sound empirical evidence is essential for adopting a HiAP approach. Second, effective intersectoral mechanisms enhance implementation feasibility. Third, results-based monitoring and evaluation contribute to the continuity of the analyzed intersectoral public policies. Finally, political support is needed throughout the policy process to maintain governance capacity and deliver results. Conclusion: We drew five global policy lessons that may be applicable in similar public policy settings in other countries. First, both technical and political enablers help set the intersectoral agenda. Second, effective communication is instrumental in convincing all stakeholders to address public health-related policy issues. Third, political support at the highest level possible and the federal government's capacity are essential to implement sound policies. Fourth, several enablers exist for enhancing collaboration between ministries during implementation. Finally, monitoring and evaluation results are necessary for sustaining intersectoral policies beyond administrations.