Health 2020 and Health Promotion and Health Education Dr Zsuzsanna Jakab Regional Director WHO Regional Office for Europe Bucharest, Romania, 24 February 2016
Health is a political choice
Long history of excellent collaboration between WHO and Romania
BETTER HEALTH FOR EUROPE: MORE EQUITABLE AND SUSTAINABLE
Inequalities in life expectancy: declining, but gap persists Maximum Regional Minimum value average value
Inequality in life expectancy are declining but gap persists Maximum Regional Minimum value average value
Region is on track towards reducing premature mortality Maximum Regional Minimum value average value
litres of pure alcohol is of the population is of the population drunk per person per year overweight or obese uses tobacco
European countries are strengthening their policies all answers (n=31 and 36 for 2010 and 2013, respectively) Yes, comprehensive health 2013 policy 2010 Yes, another strategy 0% 10% 20% 30% 40% 50% 60% 70%
Strategic directions of Health 2020 remain relevant
Investing in health pays off Photos: Malin Bring
RETURN ON INVESTMENT Reproductive, maternal and child health US$ 20 per US$ 1 spent Photo: Malin Bring
RETURN ON INVESTMENT Reproductive, maternal and child health US$ 20 per US$ 1 spent Photo: Malin Bring
Health is an investment (not an expense): we need to invest more
Health is central to development
Transforming our world: the 2030 Agenda for Sustainable Development
The formulation of the health goal - fully aligned with Health 2020
HEALTH AS A TARGET HEALTH GOAL IN OTHER GOALS 3.9 Hazardous chemicals 3.8 3.1 & pollution Universal Reduce health maternal coverage mortality Goal 3: 3.7 Access to 3.2 End sexual and preventable Ensure healthy reproductive diseases lives and health promote well- being for all at 3.3 End all ages 3.6 Road epidemics traffic of AIDS, accidents TB, etc. 3.4 3.5 Mortality Substance for NCDs abuse
Health targets will only be reached by joining up policy action with other SDG’s Example : The Health target to reduce premature mortality from NCDs will need to be implemented in partnership between health, and sectors and policies responsible for Education (SDG4) and Economic Growth and Employment (SDG8)
RENEWED POLICY ENVIRONMENT FRAMED BY HEALTH 2020
Intersectoral action requires political commitment
European environment and health process
Social determinants of health: a strategic priority Second High-level Meeting of Small Countries, Promoting intersectoral and interagency action for Andorra health and well-being in the WHO European Region, France
Health situation in Romania
Life expectancy trends
Health situation and trends in Romania Maternal and infant mortality
Premature mortality (0-64 years), by broad cause
AIDS incidence and tuberculosis mortality trends
Overweight and obesity (WHO estimates)
Alcohol consumption: total and spirits
Proportion of children of official primary school age not enrolled, both sexes Proportion of children of official primary M mmm school age not enrolled, both sexes 25 20 15 Romania E uropean Region E U 10 5 0 1990 1995 2000 2005 2010 2015 2020
Life satisfaction
Health expenditures
Public sector and out-of-pocket health expenditures
A number to remember: keep OOPs low 15%
Source: WHO Global Health Expenditure Database for 2011 10 15 20 25 30 35 40 45 50 55 60 65 70 0 5 Netherlands high by income country groups (high, upper-middle, lower-middle and low) OOPs as a share (%) of total expenditure on health ranked from low to Financial protection in Romania: OOPs at 19 % Monaco Alarming zone France UK Luxembourg Slovenia Germany San Marino Denmark Norway Croatia Czech Republic Ireland Austria Sweden Andorra Iceland Estonia Finland Belgium Italy Spain Poland Slovakia Israel Hungary Switzerland Lithuania Greece Portugal Malta Russian Federation Latvia Bulgaria Cyprus Turkey Belarus Romania Bosnia and Herzegovina TFYRM Montenegro Turkmenistan Serbia Kazakhstan Albania Azerbaijan Kyrgyzstan Ukraine Uzbekistan Republic of Moldova Armenia Georgia Tajikistan
Health situation and trends in Romania Findings and summary - main messages Romania has made substantial progress in selected areas of health like e.g. tuberculosis and maternal mortality; However, major challenges remain in other areas like noncommunicable diseases and availability of health system resources; National policies have been aligned with Health 2020 and this will, together with the determination to continue health reforms, result in accelerated health improvements and reduced health inequalities in future; Major global and European challenges like migrant crisis and global emergencies need to be taken into account when considering future developments.
Health situation and trends in Romania Findings and summary - main messages More efforts are needed to tackle the underlying health determinants by addressing population health through whole-of- society and whole-of-government approaches via Health 2020 strategic steps as incorporated in the Romanian National Health Strategy 2014-2020; Emphasis need to be made on improving overall governance for health and propose paths and approaches for more equitable, sustainable and accountable health development in Romania; Improved health indicators, overall level of health of Romanian population and life satisfaction can be attained by reaching above and beyond the health sector while achieving greater coherence across national sectors and their comprehensive responses to inequalities.
Priorities in Romania in coming years 2009 & 2013 Oslo conference: Impact of crisis 2000 Introduced core health system functions: governance; services delivery; financing; resource generation Tallinn Charter: 1978-96 Health 2020 priority area: health systems strengthening people-centred for health and wealth Alma-Ata Declaration; health systems and public health Ljubljana Conference on Reforming Health Care 2012 2008 and 2013
New vision for health-systems strengthening and work on health determinants reaches out to people
Mulțumesc pentru atenție WHO High-level Conference Working together for better health and well-being Paris, 11th - 12 th July, 2016
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