Analysis of country reviewsBulgaria-Netherlands-Portugal (group 4)

Brussels, February 20th 2015

Marieke Hendriksen (NL)

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Acknowledgements

• Djoeke van Dale (NL)

• Astrid Vicente (PT)

• Claudia Niza (PT)

• Natercia Miranda (PT)

• Luciana Costa (PT)

• Mirela Strandzheva (BUL)

• Plamen Dimitrov (BUL)

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Q1. Comparison of health promotion and primary prevention landscapes (1/2)

• Very different government organization, health system types and health administration at national, regional and local levels

• PT and BUL have Ministry of Health, NL has Ministry of Health, Welfare and Sports

– NL: More possibilities for collaboration

• All countries have extensive and comprehensive national health policies translated into health strategies and specific programmes (national and local levels)

– NL: Good example of Health in all Policies

• NPP “All about Health” (2014-2016) is a joint effort of six ministries

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Q1. Comparison of health promotion and primary prevention landscapes (2/2)

• Type and dimension of local intervention is reflection of countries political and administrative organization

– NL: municipalities have broad responsibility on health issues

– PT: the National Health Service is main performer

– BUL: GP is responsible for health promotion and National Health Inspectorates at regional level

• Funding for health promotion activities is limited

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Q2. Approaches to identify and share good practices (1/2)

• Approaches are very different

• NL: Recognition system to identify good practices (= good practice?)

– Assessment system for quality of interventions

– Database of good practice interventions in health promotion

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Q2. Approaches to identify and share good practices

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Q2. Approaches to identify and share good practices (2/2)

• Approaches are very different

• NL: Recognition system to identify good practices (= good practice?)

– Assessment system for quality of interventions

– Database of good practice interventions in health promotion

• PT and BUL have criteria for funding purposes. No databases of good practices

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Q3. Forecasting studies

• NL and PT have health forecasting studies at national level

– Serve as input and insight for policy development and evaluation

• BUL does not have forecasting studies

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Q4. Cost-effectiveness studies

• NL has database on cost-effectiveness studies, based on studies published in literature

• BUL and PT no such system exists

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Q4. Cost-effectiveness studies

• NL has database on cost-effectiveness studies, based on studies published in literature

• BUL and PT no such system exists

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Q5. Similarities and differences in gaps and needs (1/3)

Common needs and gaps identified:

•Expressive and dedicated funding, allowing for long-term planning and evaluation

•More funding for implementation of best practices

•More experienced and interested work force in health promotion

•An effective leadership for advocacy of public health/health promotion

•More training and capacity building in health promotion

•Intersectoral collaboration in public health/health promotion, as well as effective partnerships with other sectors related to SE determinants

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Q5. Similarities and differences in gaps and needs (2/3)

Leadership and strategic vision

NL

•Financing of health promotion not structural

PT

•Health promotion is inscribed in national, regional and local plans, but improvement between public sectors and society

BUL

•Need for effective strategic vision (lack of sustainable and long-term planning process and cross-sectoral coordination)

•Need to shift focus from secondary prevention to primary prevention

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Q5. Similarities and differences in gaps and needs (3/3)

Cross governmental action

•BUL: better cross-sectoral coordination

•PT: lack of targets to reduce SES reduction, NL: much more advanced (NPP, and use of HIA with equity focus)

•Some intersectoral collaboration (PT and NL) based on risk approach, but no established concerted intersectoral actions for prevention of NCDs

Data and programme monitoring

•All countries existence of data for monitoring NCDs

•In NL, monitoring is not structural and comparison difficult

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Q6. Areas for exchange and potential support

Mutual support

•Dutch recognition system to identify good practices

•Dutch example of ‘Health in all Policies’

Mutual learning

•Effective and efficient ways for more:

– Integrative policy development

– Monitoring

– Capacity building

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Thank you for your attention!