National expertise and capacity

building approaches

Subgroup on HES, Luxembourg, 20 January 2010

Past national HESs in Europe

1960 1970 1980 1990 2000

Finland

Sweden

Norway

Netherlands

West Germany

Germany

UK - England

UK - Scotland

Ireland

Poland

Denmark

RomaniaSpainCroatia

France

Czech Republic

Italy

HES outside Europe

• USA: NHANES since 1959http://www.cdc.gov/nchs/nhanes.htm• Canada: Canadian Health Measures

survey launched in 2007http://www4.statcan.gc.ca/health-sante/fbs-rpe/fbs_r-rpe_r-eng.aspx• For more information on previous

surveys, see http://www.euhsid.org/

• 1968: G Rose. Cardiovascular Survey Methods• 1982-1996: WHO MONICA Project• 1999-2002: European Health Risk Monitoring

(EHRM) Project• 2006-2008: Feasibility of a European Health

Examination Survey (FEHES) Project• 2009-2011: European Health Examination Survey

(EHES) Pilot• Several other projects, measurement standards

and recommendations

Towards the standardized HESs

Difficulties in organizing HES (FEHES questionnaire 2007)

0 % 20 % 40 % 60 % 80 % 100 %

Raisin interest in HES among generalpopulation

Raising interest of organizations to carryout HES

Availability of expertise in nationalresearch and public health organizations

Accepting the value of health informationobtained only by HES

Recognizing the need to improve healthinformation

Obtaining national funding

Not difficult Some what difficult Very difficult

Importance of (FEHES questionnaire 2007)

0 % 20 % 40 % 60 % 80 % 100 %

Receiving international expertconsultation

International collaboration for qualityassurance and control

Continued use of national standards tofollow national time trends

Adoption of international standards

Very important Important Not important at all

Capacity building at national level

• Actions needed to build the national HES• National objectives• Preparation of the national manual• National training seminars• Piloting• Organizing the HES• Data management and analysis• Reporting and dissemination of results

• Involve Stakeholders: NGOs, ministries

National experts needed

• Policy experts• Needs and use of data for evidence based

health policy• Health care and other public services

• Needs of data for planning and evaluating health services and health promotion activities

• Scientists: Epidemiology, statistics, public health etc.• Use of the data for research

• Other experts• Fieldwork logistics and supervision, IT,

communication and dissemination etc.

Capacity building at the European level

• Subgroup on HES• EHES RC

• European manuals• Training seminars• Support to the countries organizing a national

HES• Final conference for all countries

• EHES Network of national experts• Other stakeholders: e.g. ECDC, Eurostat,

WHO, OECD

Collaboration

• Sharing of experiences is important in all phases of the planning and preparation both at EU and at national levels

• All feedback on feasibility of EHES standards and contents of the EHES manuals will be valuable

NHANES

• To assess the health and nutritional status of adults and children in the United States.

• Series of surveys focusing on different population groups or health topics.

• Since 1999, a continuous program with a changing focus on a variety of health and nutrition measurements to meet emerging needs.

• A nationally representative sample of about 5,000 persons each year.

NHANES is used • To determine the prevalence of major diseases

and risk factors. • To assess nutritional status and it’s association

with health promotion and disease prevention• As the basis for national standards for such

measurements as height, weight, and blood pressure.

• In epidemiological studies and health sciences research, which help develop sound public health policy, direct and design health programs and services, and expand the health knowledge for the Nation.

NHANES examinations

• Mobile clinics• All participants visit the physician. • Dietary interviews and body measurements for

everyone. • All but the very young have a blood sample taken

and will have a dental screening. • Depending upon the age of the participant, the

rest of the examination includes tests and procedures to assess the various aspects of health. In general, the older the individual, the more extensive the examination