Strategic Direction Four: Promote Healthy Populations

The WHO defines health as “the state of complete physical, mental and social wellbeing, and not merely the absence of disease and infirmity”. The right to health is fundamental for every human being and enshrined in Article 29 in the constitution of Seychelles52.
The conditions in which people are born, grow, live, work and age are known as the social determinants of health (SDHs) and include factors like socioeconomic stability, education, neighbourhood and physical environment, employment, and social support networks, as well as access to health care.

Addressing social determinants of health is not only important for improving overall health, but also for reducing health disparities that are driven by social and economic disadvantages. Higher income and social status are usually linked to better health. The greater the gap between the rich and the poor in society, the greater the differences between their health53. In regards to education, low education levels are linked with poor health, more stress and lower self-confidence.

Additionally, the MPI report of 2019, published by the NBS, showed that factors such as large household/ overcrowding, substance abuse, unemployment, and low education level, strongly contributed to multidimensional poverty, thereby also impacting the health status of individuals.

A healthy, productive population forms the pillar of the country’s sustained growth and prosperity. The health and wellbeing of the people of Seychelles continuously faces major threats. The double, and increasing, burden of infections (like HIV, Viral Hepatitis, and pneumonia), as well as chronic noncommunicable diseases (like diabetes, hypertension, cancer, and cardiovascular disease), combined with social and mental health problems (like injection drug use, psychological disorders), are creating an unprecedented challenge to maintain and improve health, as well as to maintain sustainability of livelihoods and economic growth.

Harmful use of alcohol is one of the four modifiable and preventable risk factors for NCDs. Excessive alcohol consumption has been associated with negative social impacts such as interpersonal violence, unemployment, poor academic performance, and in addition, child and elderly neglect. These collective factors have devastating impact on individuals and their families further affecting overall health.

Strong political leadership is essential to address social determinants of health. Promoting healthier population requires improving the physical and mental health and wellbeing of the population. This can be extremely challenging as it requires intensive, coordinated long term efforts, across many government departments and sectors.

The HiAP is an approach that promotes collaboration between government sectors and non-government stakeholders to maximize the health benefits of government policies and reduce health inequalities, such as differences in life expectancy between different population groups. The approach also aims at minimizing any harmful consequences of public policies on determinants of health and health system.

The Government of Seychelles has pledged to the HiAP approach in 2017 and committed to engage all sectors of the government and non-governmental organizations through leadership, partnership, and advocacy to achieve improved health outcomes.

Climate change is an insidious but very real threat to health and the wider society. Its impacts on health can be direct (through extreme weather events and related injuries and deaths), indirect (through changes to quality of air, water and nutrition) or through disruption of social and economic activity (which lead to adverse health outcomes).

Evidence for the extreme health consequences of climate change are already evident – increased rates of cardiovascular disease, kidney disease, diabetes, malnutrition, etc. The poorest countries, countries in hotter climates, and coastal and small-island states will be impacted the hardest from these changes.

Even though Seychelles is only a minor contributor to climate change, we will bear the brunt of the consequences of climate change, emphasising the importance of elaborate and timely evidence-based mitigation and adaptation strategies, including in the health sector.

SD4 Outstanding Issues

Health in All Policies Approach (HiAP)
Although the HiAP approach was endorsed by the Cabinet of ministers (from previous administration) in 2017, not a lot has been done since. There is a strong need for the endorsement of the current administration and re-integration of the HiAP in all government sectors, private entities, and civil societies. MoH needs to build linkages with other government entities and ensure that there are health considerations in their policies and projects.

Communication strategy (for addressing risks to health)
A coordinated advocacy and communication plan to guide the ongoing efforts at reaching out to communities and households is not yet in place. Communication strategies are needed to address behavioural, environmental, and metabolic risk factors.

Health Promotion
Some of the NHSP 2016-2020 objectives and expected outcomes were not achieved, like behaviour change communication advocacy. There is also weak national coordination system for health promotion activities. Inadequate access to finance makes it difficult to plan impactful interventions.

Cancer and mental health
Outstanding needs include the development and implementation of a National Cancer Control Plan, and finalisation and implementation of the National Mental Health Policy, with participation of other sectors, as well as the community.


  • Create a supportive environment for breastfeeding in workplaces, and fully implement code of marketing of breast-milk substitutes, to protect and promote breastfeeding.
  • Develop and implement policies that protect children from the harmful effects of marketing of unhealthy products on media.
  • Integrate regulatory reforms to improve food environments.
  • Develop appropriate policies to facilitate introducing nutrition and environmental standards for public institutions.
  • Build capacity of health and community workers as food system agents of change everywhere when developing and implementing solutions.
  • Conduct operational research to assess barriers to behaviour change.
  • Fully implement strategies outlined in the National NCD Strategy (2016-25).
  • Enforce policies and regulations for quality of foods and drinks that are sold in commercial outlets.
  • Finalize and implement school nutrition policy, policy for nitrites and trans-fatty acid.

Health in Educational settings

  • Build capacity of those working in School Health Programme.
  • Child and Adolescent Health areas deficient in life-course approach to health promotion.
  • Ensure health policies cover educational institutions at all levels (pre-primary, primary, secondary and post-secondary).
  • Need for strict bans on fast-food outlets in proximity of schools, need to finalize and implement school health policy.

SD4 Priority Areas

  1. Promote healthy living for different age groups.
  2. Address key risk factors for health.
  3. Revitalize the health in all policies approach.
  4. Promote prevention and management of substance abuse and mental health.
  5. Transform Health Promotion.
  6. Promote/ advocate for Effective Public Health.

SD4 General Objective

Support the creation of a conducive environment to:

  • Support healthy living.
  • Reduce and control risk factors for health.
  • Promote safe and healthy neighbourhoods.
  • Engage MDAs and other stakeholders to promote and improve health and wellbeing of people.

SD4 Specific Objectives

View the Promote Healthy Populations: Specific Objectives

52 Constitution of the Republic of Seychelles, 1994.
53 Marmot, Michael, and Ruth Bell. “Fair society, healthy lives.” Public health 126 (2012): S4-S10.

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