Это гос. программа оздоровления эст .нации (Для юзера Кирилла)
В ходе диалога в ЖЖ ув.Kototuj и ув. юзер Staryiy усомнился в пользе профилактики воспитания здоровья детей в школах. Я, разумеется не обвиняю никого в ханжестве и невежестве, но если родители устраняются, то государство обязано заботиться о людях.
Кирилл оказал неоценимую помощь, научив меня инетовским премудростям, за это спасибо
----------------------------------------
This publication provides a survey of the development of health promotion in Estonia and its actors. As in so many other areas, activities aimed at public health require long-term planning and improved organisation. Worldwide experience has shown that the best results in attaining healthy living environment can be achieved by self-initiative on a local level.
The Public Health Act that was adopted in 1995 needs amendment. This has provided a foundation for drafting a new Public Health Act and for opening a comprehensive debate on the structure of public health on all levels. Our society is now developing in a stable manner. It is no longer acceptable to adopt legal acts which require amendment promptly after they take effect or to implement national policies that are not based on situation analysis and national debate.
The Health Policy Conference held in association with WHO in April 1998 in follow-up of the Health Care Reform Conference took the debate to the level of municipalities and addressed all health-related sectors.
The Ministry of Social Affairs has begun cooperation with the Danish Ministry of Health for creating an optimal model for primary care and regional approach in health promotion. In August 1998 the Government of Estonia adopted the National Research and Development Programme in Public Health 1999-2009 that serves as a guideline for developing and implementing health policy in different levels for research and development activities financed in the future.
Health indicators have been improving in recent years. This is largely due to health promotion activities. Health as a sales argument has been discovered also by food producers. As a positive example mention should be made of Ryebread On Our Table, a project launched by food producers in 1998. Its aims is to value ryebread as a healthy Estonian-made food product and growing crops which provides subsistence for Estonians. The fact that health has become a popular topic is also shown by the increase in the number of health-related periodicals.
International cooperation has become notably more active as international health-promotion movements have extended to Estonia. Health promotion is being actively embraced by non-profit organisations and local governments. I hope that this publication will give you a survey of health promotion activities on national and local level as well as information on a whole range of other subjects in health care and Estonia today.
Tiiu Aro
Minister of Social Affairs
Introduction
The Public Health Act defines health promotion as the creation of behaviour and lifestyles which value and enhance health, and the purposeful development of a physical and social environment which is conducive to health.
What is the value of health? Does health have value or price? Our daily life consists of choices. How do we make them? Do we base our assumptions on price, accessibility, appearance or coincidence?
The common philosophy of health promotion and health economics is based on the selection theory. The objective of health promotion in its most general level is "to achieve in the society a situation where healthy choices are the most natural and available ones". Access in its modern meaning can be regarded as access to goods or services. Access can be made more complicated by geographical features, availability of transport, queues induced from limited supply as one of the mechanisms of regulation and resources and limit of payment means. It is why one of the most important factors of availability are the price of goods or service which influences direct choice.
Many political decisions may have an indirect impact on health if the decisions influence choices. For instance, the introduction of package tax is aimed at increasing national revenues by directly reducing environmental pollution.
Indirectly it influences the choice of consumption of disadvantaged population because packaged food products will cost more.
The package protects food from pollution and provides consumers and health inspectors with accurate information on its freshness and consistency.
Preference given to non-packaged food makes it difficult to keep the situation under control and protect the population from diseases. If the price of packaged goods notably exceeds that of non-packaged food product, the availability suffers.
Choices are influenced also by the availability of health information and skills of using and interpreting it.
The package of a food product must indicate information on the preserving time of the product and its ingredients, including additives which may influence more sensitive organisms. The skills and need of understanding such information comes from health education and health behaviour.
Health behaviour influences health and is expressed in our daily choices.
The availability of information lays a foundation for informed behaviour aimed at preserving or strengthening health. The stronger the focus on health the less the importance of price on the choice provided, of course, that there are sufficient means of payment. In case of limited resources the choices are taken within the limits of the budget (content of purse).
The choice between similarly priced goods is heavily influenced by advertising. Impulsive choice acts on the basis of information and behaviour recorded in human mind. Heavy advertising of the so-called junkfood makes it difficult to form healthy choices through health education.
For reaching a point where the society is dominated mainly by healthy choices it is necessary to simultaneously inform persons of health factors and eliminate health risks in the society. This is the essence of public health as science and art in promoting health and preventing diseases through the efforts of the society.
Piret Laur
Head of the Public Health Department Ministry of Social Affairs
ies and strategy
The Ministry of Social Affairs has the duty to develop health policy and strategy, legislation and to lay down priorities. National programmes are being prepared and financed by health insurance under a title of health-promotion projects in priority areas.
In implementing national projects in 1997 and
1998 the focus is on supporting four priority areas as
recommended by World Bank experts during the
Health Reform: prevention of traumas; coronary
health; sex health and reduction of smoking. Another
priority target group is schoolchildren.
The 1999 priorities laid down in 1998 were as follows: projects aimed at children, movement hobby, sex education, heart health, prevention of traumas and tobacco-free environment. Elderly will be in focus in
1999 according to the United Nations initiative.
The drafting of the Estonian health promotion strategy was begun by the Public Health Development Council at the end of 1997. The first draft will be completed by the end of 1998 and presented for public debate. The health promotion strategy is based on Health-21, the European programme of the World Health Organization, which outlines objectives of 21 directions and planned measures for achievement. Taking into account Estonian priorities, activities are being planned in 23 directions which are divided into the following five groups:
1) promotion of healthy lifestyle and diet, physical
exercise, physical activity, reduction of tension and
stress, reduction of smoking, alcohol and drug
abuse.
2) health promotion by age groups / healthy begin
ning of life, health of schoolchildren, health of
men and women and health of the elderly
3) prevention of wide-spread diseases / prevention
of dissemination of contagious diseases, preven
tion of non-contagious diseases, prevention of
accidents and violence and promotion of mental
health
4) environment and health / living environment and
health, work and health and home and health
5) society and human health / regional initiative,
health of the disabled persons, family doctor and
health promotion, health administration proce
dure, health policy in all sectors, education and
health.
Most counties have drawn up their health promotion priorities and strategies, usually as part of the county development plan. There are significant similarities between local and national priorities including activities to be carried out for achieving the objectives. For instance, many counties have opened a so-called heart room and are setting up county centres to provide a complex training and consultation service.
Jaanus Harro
Health Promotion Strategy Coordinator Faculty of Social Sciences University of Tartu
Structure and financing
By its structure and activities, health promotion began in Estonia in 1993. Two bodies were set up: the Public Health Department, by the Minister of Social Affairs, Professor Marju Lauristin, and the Estonian Health Education Centre.
Health promotion is being carried out nationally and by own initiatives. The national level includes national programmes and development plans as well as nationwide health promotion projects. Own initiative includes projects that are being carried out by citizens and organisations.
The loan applied from the World Bank for launching the health reform was made conditional on a provision of a fund based on local financial sources for financing health promotion projects. Since 1995 the projects financed from health insurance are tendered by a body which provides advice to the Minister and is known as the Public Health Development Council.
The composition and role of the Council has been developed and increased throughout the years. Since in selecting financing options preference is invariably given to certain directions, decision-makers need to be aware of their impact and the need of the whole development trend.
The key duties of the Council is to make recommendations on the main trends of health promotion development, strategy and priorities as well as to draw up a specific action plan based on strategy.
For ensuring appropriate allocation of financial resources the Council is empowered and obliged to commission expert studies and audits of projects as well as analysis and development projects.
The Estonian Health Education Centre is an umbrella organisation for the main implementators of projects which fall under the priority areas of health promotion. The Centre provides training for health promotion coordinators in counties whose duty is to forward their skills and knowledge locally and to be the local arms of national projects and programmes.
Public health and health promotion activities are mainly financed from the health insurance budget. Since 1995, between 0.5% and 1% have been allocated for health-promotion projects from the total health insurance budget.
National programmes cover the preparation of health-promoting legislation, methodical instructions and training programmes. National health programmes are financed by the state. In 1998 a total of 10.4 million EEK were allocated for five programmes.
Health promotion also receives smaller contributions from the gambling tax fund and other state funds such as Road Administration campaigns or the activities within the framework of the National Programme on Criminal Prevention.
Health-related projects are financed also by other non-state funds such as the Open Estonian Fund and by international organisations WTO and UNICEF.
By 1999 Estonia has made the necessary preparations for joining the European Union Health Promotion and Information Programme. Further plans include participation in other larger health promotion projects.
Piret Laur
Head of the Public Health Department Phone (+372) 626 9785, Fax (+372) 626 9738
In organising public health, the Ministry of Social Affairs has the duty to guide, coordinate and organise for the public the provision of medical and medicinal aid, health promotion, prevention of diseases, health protection and prevention of contraction of diseases, to guide the implementation of modern forms of disease prevention, health promotion, health protection, diagnostics and medical care; to form public opinion aimed at giving value to health and healthy lifestyles.
The Public Health Department was set up in 1993 and consists of the Bureau of Health Promotion and the Bureau of Disease Prevention. The statutory duties of the Department are to organise activities in the field of health promotion and prevention of diseases.
At present the Public Health Department coordinates five national healthcare programmes and provides support services to programme councils.
In democracy, decisions are made based on a wide consensus. Reality checks are made through advisory bodies which avoids the proliferation of bureaucratic ideas. Since the field of public health itself covers multiple sectors, it employs a large number of interdisciplinary specialists. To ensure quality decisions it is vital to involve a whole range of sectors and bodies from the start. Of course, a multitude of specialists means a multitude of opinions. Since time is a factor, the objective is to reach a timely decision which would be acceptable to various counterparts.
Providing technical support to such bodies involves complicated routines and management. However, progress has been considerable and results speak for themselves.
Decisions which have evolved from national programmes receive comprehensive support from the specialists of the Department and in time develop into legal acts.
Pi ret Laur
Head of the Public Health Department
Public Health Development Council
The Council is an advisory body set up at the Ministry of Social Affairs that consists of the representatives of various ministries and organisations.
Council members represent the Ministry of Social Affairs, Ministry of Education, Ministry of Culture, Parliamentary Social Commission, University of Tartu, Central Sick Fund, Health Insurance Council, Estonian Medical Association, Estonian representation of WHO and non-profit organisations who are involved in health promotion.
The Council provides advice on health promotion policies and strategies in the field of public health as well as on financing of health-promotion projects from health insurance funds.
The main duties of the Council are to make recommendations on the main trends, strategy and priorities of the public health development plan and to draw up specific action plans.
The activities of the Council are governed by the Public Health Act, Health Administration Act and Health Insurance Act as well as on the priorities outlined in the concept of health policy.
The work of the Council includes development of procedures for using health promotion funds in health insurance, tender health promotion projects, select the winning bids, recommend the financing options and monitor the suitability and performance of the projects as well as carry out quality evaluation activities.
To ensure its autonomy, the secretariat of the Public Health Development Council moved from the Estonian Centre for Health Education and Promotion to the Ministry of Social Affairs in the summer 1997.
The Council is authorized to use up to 20% of funds allocated for health promotion projects for financing development work including commissioning of research, surveys, analysis and audits, participation in and organisation of conferences, exhibitions and workshops and cooperation with other institutions, including international organisations.
The Council has developed a national health promotion strategy and made preparations or launching national programmes for the prevention of alcohol and drug abuse and for research and development in the field of public health.
Development work also focuses on organising training to key stakeholders.
For ensuring the quality of health promotion, project terms of reference include performance measurement criteria. The Council has commissioned an audit of randomly selected health promotion projects that were financed in 1998 from auditors trained in the Centre for Health Education and Promotion.
In the spring of 1998, in cooperation with Joana Mira Godinho, a World Bank expert, the Council draw up a project for selecting the best foreign expert to assess the quality of health promotion in Estonia. The winning bid was made by Canadian experts led by Irwin Rootmann.
Health Promotion in Estonia, a nationwide research conference, and Health Promotion, an overview of health promotion projects, have become traditional events in the annual calendar and have drawn an increasing number of participants.
It is also an important venue for the exchange of knowhow and training opportunities.
Sirje Vaask
Secretary of Public Health Development Council Gonsiori 29, Tallinn Phone (+ 372) 626 9739 Fax (+ 372) 626 9738
Кирилл оказал неоценимую помощь, научив меня инетовским премудростям, за это спасибо
----------------------------------------
This publication provides a survey of the development of health promotion in Estonia and its actors. As in so many other areas, activities aimed at public health require long-term planning and improved organisation. Worldwide experience has shown that the best results in attaining healthy living environment can be achieved by self-initiative on a local level.
The Public Health Act that was adopted in 1995 needs amendment. This has provided a foundation for drafting a new Public Health Act and for opening a comprehensive debate on the structure of public health on all levels. Our society is now developing in a stable manner. It is no longer acceptable to adopt legal acts which require amendment promptly after they take effect or to implement national policies that are not based on situation analysis and national debate.
The Health Policy Conference held in association with WHO in April 1998 in follow-up of the Health Care Reform Conference took the debate to the level of municipalities and addressed all health-related sectors.
The Ministry of Social Affairs has begun cooperation with the Danish Ministry of Health for creating an optimal model for primary care and regional approach in health promotion. In August 1998 the Government of Estonia adopted the National Research and Development Programme in Public Health 1999-2009 that serves as a guideline for developing and implementing health policy in different levels for research and development activities financed in the future.
Health indicators have been improving in recent years. This is largely due to health promotion activities. Health as a sales argument has been discovered also by food producers. As a positive example mention should be made of Ryebread On Our Table, a project launched by food producers in 1998. Its aims is to value ryebread as a healthy Estonian-made food product and growing crops which provides subsistence for Estonians. The fact that health has become a popular topic is also shown by the increase in the number of health-related periodicals.
International cooperation has become notably more active as international health-promotion movements have extended to Estonia. Health promotion is being actively embraced by non-profit organisations and local governments. I hope that this publication will give you a survey of health promotion activities on national and local level as well as information on a whole range of other subjects in health care and Estonia today.
Tiiu Aro
Minister of Social Affairs
Introduction
The Public Health Act defines health promotion as the creation of behaviour and lifestyles which value and enhance health, and the purposeful development of a physical and social environment which is conducive to health.
What is the value of health? Does health have value or price? Our daily life consists of choices. How do we make them? Do we base our assumptions on price, accessibility, appearance or coincidence?
The common philosophy of health promotion and health economics is based on the selection theory. The objective of health promotion in its most general level is "to achieve in the society a situation where healthy choices are the most natural and available ones". Access in its modern meaning can be regarded as access to goods or services. Access can be made more complicated by geographical features, availability of transport, queues induced from limited supply as one of the mechanisms of regulation and resources and limit of payment means. It is why one of the most important factors of availability are the price of goods or service which influences direct choice.
Many political decisions may have an indirect impact on health if the decisions influence choices. For instance, the introduction of package tax is aimed at increasing national revenues by directly reducing environmental pollution.
Indirectly it influences the choice of consumption of disadvantaged population because packaged food products will cost more.
The package protects food from pollution and provides consumers and health inspectors with accurate information on its freshness and consistency.
Preference given to non-packaged food makes it difficult to keep the situation under control and protect the population from diseases. If the price of packaged goods notably exceeds that of non-packaged food product, the availability suffers.
Choices are influenced also by the availability of health information and skills of using and interpreting it.
The package of a food product must indicate information on the preserving time of the product and its ingredients, including additives which may influence more sensitive organisms. The skills and need of understanding such information comes from health education and health behaviour.
Health behaviour influences health and is expressed in our daily choices.
The availability of information lays a foundation for informed behaviour aimed at preserving or strengthening health. The stronger the focus on health the less the importance of price on the choice provided, of course, that there are sufficient means of payment. In case of limited resources the choices are taken within the limits of the budget (content of purse).
The choice between similarly priced goods is heavily influenced by advertising. Impulsive choice acts on the basis of information and behaviour recorded in human mind. Heavy advertising of the so-called junkfood makes it difficult to form healthy choices through health education.
For reaching a point where the society is dominated mainly by healthy choices it is necessary to simultaneously inform persons of health factors and eliminate health risks in the society. This is the essence of public health as science and art in promoting health and preventing diseases through the efforts of the society.
Piret Laur
Head of the Public Health Department Ministry of Social Affairs
ies and strategy
The Ministry of Social Affairs has the duty to develop health policy and strategy, legislation and to lay down priorities. National programmes are being prepared and financed by health insurance under a title of health-promotion projects in priority areas.
In implementing national projects in 1997 and
1998 the focus is on supporting four priority areas as
recommended by World Bank experts during the
Health Reform: prevention of traumas; coronary
health; sex health and reduction of smoking. Another
priority target group is schoolchildren.
The 1999 priorities laid down in 1998 were as follows: projects aimed at children, movement hobby, sex education, heart health, prevention of traumas and tobacco-free environment. Elderly will be in focus in
1999 according to the United Nations initiative.
The drafting of the Estonian health promotion strategy was begun by the Public Health Development Council at the end of 1997. The first draft will be completed by the end of 1998 and presented for public debate. The health promotion strategy is based on Health-21, the European programme of the World Health Organization, which outlines objectives of 21 directions and planned measures for achievement. Taking into account Estonian priorities, activities are being planned in 23 directions which are divided into the following five groups:
1) promotion of healthy lifestyle and diet, physical
exercise, physical activity, reduction of tension and
stress, reduction of smoking, alcohol and drug
abuse.
2) health promotion by age groups / healthy begin
ning of life, health of schoolchildren, health of
men and women and health of the elderly
3) prevention of wide-spread diseases / prevention
of dissemination of contagious diseases, preven
tion of non-contagious diseases, prevention of
accidents and violence and promotion of mental
health
4) environment and health / living environment and
health, work and health and home and health
5) society and human health / regional initiative,
health of the disabled persons, family doctor and
health promotion, health administration proce
dure, health policy in all sectors, education and
health.
Most counties have drawn up their health promotion priorities and strategies, usually as part of the county development plan. There are significant similarities between local and national priorities including activities to be carried out for achieving the objectives. For instance, many counties have opened a so-called heart room and are setting up county centres to provide a complex training and consultation service.
Jaanus Harro
Health Promotion Strategy Coordinator Faculty of Social Sciences University of Tartu
Structure and financing
By its structure and activities, health promotion began in Estonia in 1993. Two bodies were set up: the Public Health Department, by the Minister of Social Affairs, Professor Marju Lauristin, and the Estonian Health Education Centre.
Health promotion is being carried out nationally and by own initiatives. The national level includes national programmes and development plans as well as nationwide health promotion projects. Own initiative includes projects that are being carried out by citizens and organisations.
The loan applied from the World Bank for launching the health reform was made conditional on a provision of a fund based on local financial sources for financing health promotion projects. Since 1995 the projects financed from health insurance are tendered by a body which provides advice to the Minister and is known as the Public Health Development Council.
The composition and role of the Council has been developed and increased throughout the years. Since in selecting financing options preference is invariably given to certain directions, decision-makers need to be aware of their impact and the need of the whole development trend.
The key duties of the Council is to make recommendations on the main trends of health promotion development, strategy and priorities as well as to draw up a specific action plan based on strategy.
For ensuring appropriate allocation of financial resources the Council is empowered and obliged to commission expert studies and audits of projects as well as analysis and development projects.
The Estonian Health Education Centre is an umbrella organisation for the main implementators of projects which fall under the priority areas of health promotion. The Centre provides training for health promotion coordinators in counties whose duty is to forward their skills and knowledge locally and to be the local arms of national projects and programmes.
Public health and health promotion activities are mainly financed from the health insurance budget. Since 1995, between 0.5% and 1% have been allocated for health-promotion projects from the total health insurance budget.
National programmes cover the preparation of health-promoting legislation, methodical instructions and training programmes. National health programmes are financed by the state. In 1998 a total of 10.4 million EEK were allocated for five programmes.
Health promotion also receives smaller contributions from the gambling tax fund and other state funds such as Road Administration campaigns or the activities within the framework of the National Programme on Criminal Prevention.
Health-related projects are financed also by other non-state funds such as the Open Estonian Fund and by international organisations WTO and UNICEF.
By 1999 Estonia has made the necessary preparations for joining the European Union Health Promotion and Information Programme. Further plans include participation in other larger health promotion projects.
Piret Laur
Head of the Public Health Department Phone (+372) 626 9785, Fax (+372) 626 9738
In organising public health, the Ministry of Social Affairs has the duty to guide, coordinate and organise for the public the provision of medical and medicinal aid, health promotion, prevention of diseases, health protection and prevention of contraction of diseases, to guide the implementation of modern forms of disease prevention, health promotion, health protection, diagnostics and medical care; to form public opinion aimed at giving value to health and healthy lifestyles.
The Public Health Department was set up in 1993 and consists of the Bureau of Health Promotion and the Bureau of Disease Prevention. The statutory duties of the Department are to organise activities in the field of health promotion and prevention of diseases.
At present the Public Health Department coordinates five national healthcare programmes and provides support services to programme councils.
In democracy, decisions are made based on a wide consensus. Reality checks are made through advisory bodies which avoids the proliferation of bureaucratic ideas. Since the field of public health itself covers multiple sectors, it employs a large number of interdisciplinary specialists. To ensure quality decisions it is vital to involve a whole range of sectors and bodies from the start. Of course, a multitude of specialists means a multitude of opinions. Since time is a factor, the objective is to reach a timely decision which would be acceptable to various counterparts.
Providing technical support to such bodies involves complicated routines and management. However, progress has been considerable and results speak for themselves.
Decisions which have evolved from national programmes receive comprehensive support from the specialists of the Department and in time develop into legal acts.
Pi ret Laur
Head of the Public Health Department
Public Health Development Council
The Council is an advisory body set up at the Ministry of Social Affairs that consists of the representatives of various ministries and organisations.
Council members represent the Ministry of Social Affairs, Ministry of Education, Ministry of Culture, Parliamentary Social Commission, University of Tartu, Central Sick Fund, Health Insurance Council, Estonian Medical Association, Estonian representation of WHO and non-profit organisations who are involved in health promotion.
The Council provides advice on health promotion policies and strategies in the field of public health as well as on financing of health-promotion projects from health insurance funds.
The main duties of the Council are to make recommendations on the main trends, strategy and priorities of the public health development plan and to draw up specific action plans.
The activities of the Council are governed by the Public Health Act, Health Administration Act and Health Insurance Act as well as on the priorities outlined in the concept of health policy.
The work of the Council includes development of procedures for using health promotion funds in health insurance, tender health promotion projects, select the winning bids, recommend the financing options and monitor the suitability and performance of the projects as well as carry out quality evaluation activities.
To ensure its autonomy, the secretariat of the Public Health Development Council moved from the Estonian Centre for Health Education and Promotion to the Ministry of Social Affairs in the summer 1997.
The Council is authorized to use up to 20% of funds allocated for health promotion projects for financing development work including commissioning of research, surveys, analysis and audits, participation in and organisation of conferences, exhibitions and workshops and cooperation with other institutions, including international organisations.
The Council has developed a national health promotion strategy and made preparations or launching national programmes for the prevention of alcohol and drug abuse and for research and development in the field of public health.
Development work also focuses on organising training to key stakeholders.
For ensuring the quality of health promotion, project terms of reference include performance measurement criteria. The Council has commissioned an audit of randomly selected health promotion projects that were financed in 1998 from auditors trained in the Centre for Health Education and Promotion.
In the spring of 1998, in cooperation with Joana Mira Godinho, a World Bank expert, the Council draw up a project for selecting the best foreign expert to assess the quality of health promotion in Estonia. The winning bid was made by Canadian experts led by Irwin Rootmann.
Health Promotion in Estonia, a nationwide research conference, and Health Promotion, an overview of health promotion projects, have become traditional events in the annual calendar and have drawn an increasing number of participants.
It is also an important venue for the exchange of knowhow and training opportunities.
Sirje Vaask
Secretary of Public Health Development Council Gonsiori 29, Tallinn Phone (+ 372) 626 9739 Fax (+ 372) 626 9738