Developing Cross Sectoral, Healthy Public Policies: A Case Study of the Reduction of Highly Toxic Pesticide Use among Small Farmers in Ecuador

Agricultural development is a health determinant for small-scale farmers. This article examines the process of developing health and agricultural policy at the municipal level. Operational research was conducted in three rural, Andean municipalities in Ecuador. Policy development involved four steps: 1) proposal of a political agenda, 2) political analysis, 3) consultation, and 4) design and implementation of a political strategy. Our study of stage 2 included in-depth interviews with institutional and community leaders in each municipality. We also reviewed secondary sources and took field notes of observations made during the process. Content analysis was used for textual materials. We observed that institutional actors used a functionalist logic with respect to agricultural production processes; this – along with their individual attitudes and aptititudes – limited progress in policy development. On the other hand, social participation tended to facilitate the development of intersectoral programs. The promotion of cross-sectoral policy development fosters cross-sectoral approaches to action on the social determinants of health.