27. Public health initiatives

Overall objective

Each programme that will be set up within the programme area 'Public health initiatives' will contribute to the overall objective of improved public health and reduced health inequalities. 

Expected outcomes

Each programme must have one or more 'expected outcomes', as listed below. The relevant expected outcomes for each programme is agreed either in the country-specific Memoranda of Understanding (MoU) on how the funds will be managed or determined in the programme development phase. 

• Reduced inequalities between user groups
• Developed resources for all levels of health care
• Improved governance in health care
• Strengthened financing systems
• National health registries and health information systems, data management and use improved
• Improved access to and quality of health services, including reproductive and preventive child health care
• Improved access to and quality of health services for elderly people
• Life-style-related diseases prevented or reduced
• Improved prevention and treatment of communicable diseases (including HIV/AIDS and TB)
• Improved mental health services
• Improved food safety and increased access to information about food safety and health for consumers, public authorities and industry

Suggested activities

Activities that may be supported within each programme will differ, depending on the chosen expected outcomes. Below are some examples to illustrate what may be supported:

• Strengthen health systems to face the challenges of the financial crisis and social inequalities in health
• National initiatives for the improvement of health systems, with a focus on marginalised groups
• National health registries and health information systems, monitoring and evaluation as a basis for improved governmental management with a focus on inequalities
• Review of and support for health financing systems to make them sustainable and equal
• Capacity-building and technical cooperation through staff development and infrastructure
• Refine health surveillance and complaint mechanisms
• Strengthen primary health care in terms of quantity and quality
• Document and develop strategies on:
  1. life-style-related and preventable diseases
  2. mental health suffering, in particular the reduction of suicides
  3. sexual and reproductive health
  4. communicable diseases
  5. ill-health among children
• Foster inter-sectoral cooperation
• Training in management of decentralised health services
• Activities on food safety and increased access to information about food safety and health for consumers, public authorities and industry (formal and informal markets):
  1. development of formal control labelling
  2. surveillance and support for ensuring food safety in informal markets
     

Relevance of support

Well-functioning and strong national health systems are a prerequisite for sustaining and improving the population’s standard of health, which in turn is a fundamental factor for a country’s economic well-being. The EU Health Strategy, “Together for Health: A Strategic Approach for the EU 2008-13”, places the emphasis on fostering dynamic health systems as a means of meeting the health challenges in Europe. The Tallinn Charter of 2008 calls for the strengthening of health systems in Europe and gives guidance on public health initiatives.

The aim of public health initiatives is to improve the health status in a population by focusing on access to health care, and the underlying determinants of health. In some areas, like formal maternal health, swift access to health services is vital, while for other major public health hazards, only a small share is directly shaped by health systems. Other sectors like education, nutrition, taxation and road safety have an important impact on public health.

Public health activities depend on documentation of the distribution (morbidity, mortality, life expectancy, etc.) and the determinants of health. Within health services, public health deals with preventive services, as well as health promotion and health care management. Concerns for equity and fair distribution have grown in importance in health policies. Life-stylerelated diseases, care for immigrants and national minorities (Roma people in particular), ageing of the population and low fertility rates represent special challenges in terms of health and health care in many countries in the EU. The diversity within the EU in terms of influences on health and health outcomes provides a promising basis for cooperation.

The financial crisis has impacted severely on several of the countries of Central and Eastern Europe. There is a risk that the financial crisis will adversely affect public health expenditure for years to come.

Programme area specificities

• Suitable for civil society involvement
• Suitable for small grant schemes

Photo: NMFA