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Gaining health Analysis of policy development in European countries for tackling noncommunicable diseases By Anna Ritsatakis and Péter Makara Editors: Jill L. Farrington, Robert Geneau and Bosse Pettersson
Abstract There is no greater threat to the health of people in the WHO European Region than that of noncommunicable diseases, yet this is an area where the greatest health gains are available at relatively modest cost. This book gives a detailed insight into the policy development in eight European countries over several decades to address the challenge of noncommunicable diseases, and draws out the main themes to assist policy-makers in formulating their own response. While originally developed to support countries in the implementation of the WHO European Strategy for the Prevention and Control of Noncommunicable Diseases, the insights are likely to be of benefit to a much wider audience. Keywords CHRONIC DISEASE - prevention and control ISBN 978-92-890-4179-9 HEAlth PROmOTION health POlicy - analysis policy making NATIONAl HEAlth PROgrams PROgram DEvelopmENT euROPE Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe Scherfigsvej 8 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site (http://www.euro.who.int/pubrequest). © World Health Organization 2009 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization.
Page 1: Gaining Health Analysis of policy d
Page 5 and 6: Abbreviations The abbreviations sho
Page 7 and 8: vi Preface The WHO European Strateg
Page 9 and 10: Contributors Jill L. Farrington was
Page 11 and 12: Chapter 1 2 the European Region, sh
Page 14 and 15: Chapter 2 History and context of po
Page 16 and 17: tions and strategies to achieve the
Page 18 and 19: • Of the countries responding in
Page 20: Washington, D.C., US Government Pri
Page 23 and 24: Chapter 3 14 co-funded by the Publi
Page 25 and 26: Chapter 3 16 determine policy outco
Page 27 and 28: Chapter 3 18 • policies for older
Page 29 and 30: Chapter 3 20 developing methodologi
Page 31 and 32: Chapter 3 22 References 1. Gaining
Page 33 and 34: Appendix 1 Key informants interview
Page 35 and 36: Chapter 4 26 Albania Péter Makara
Page 37 and 38: Chapter 4 28 The strategy was final
Page 39 and 40: Chapter 4 30 for these organization
Page 41 and 42: Chapter 4 32 The directorates are a
Page 43 and 44: Chapter 4 34 etc. will continue to
Page 45 and 46: Chapter 4 36 thinking is still domi
Page 47 and 48: Chapter 4 38 Finland Anna Ritsataki
Page 49 and 50: Chapter 4 40 Both the state and the
Page 51 and 52: Chapter 4 42 2.1. Broad policy for
Page 53 and 54:
Chapter 4 44 • the principle of u
Page 55 and 56:
Chapter 4 46 Broad use is made of
Page 57 and 58:
Chapter 4 48 MSAH prepares for appr
Page 59 and 60:
Chapter 4 50 private donation. Ther
Page 61 and 62:
Chapter 4 52 2.4.4. National demons
Page 63 and 64:
Chapter 4 54 been the case at the E
Page 65 and 66:
Chapter 4 56 materials or to check
Page 67 and 68:
Chapter 4 58 The employer, in both
Page 69 and 70:
Chapter 4 60 2.8. Broad intersector
Page 71 and 72:
Chapter 4 62 was medically and econ
Page 73 and 74:
Chapter 4 64 adequate, whereas that
Page 75 and 76:
Chapter 4 66 planning philosophy an
Page 77 and 78:
Chapter 4 68 any meaningful attack
Page 79 and 80:
Chapter 4 70 In the overall improve
Page 81 and 82:
Chapter 4 72 15. Strategies for soc
Page 83 and 84:
62. International evaluation of the
Page 85 and 86:
Chapter 4 76 The low cardiovascular
Page 87 and 88:
Chapter 4 78 A characteristic featu
Page 89 and 90:
Chapter 4 80 • cancer • CVD •
Page 91 and 92:
Chapter 4 82 INPES carry out data c
Page 93 and 94:
Chapter 4 84 the fight against canc
Page 95 and 96:
Chapter 4 86 published in early 200
Page 97 and 98:
Chapter 4 88 information was not su
Page 99 and 100:
Chapter 4 90 intoxication, improves
Page 101 and 102:
Chapter 4 92 research (see section
Page 103 and 104:
Chapter 4 94 on public health repre
Page 105 and 106:
Chapter 4 96 groups and the health
Page 107 and 108:
Chapter 4 98 19. Chauliac M. Progra
Page 109 and 110:
Chapter 4 100 recent years, Greece
Page 111 and 112:
Chapter 4 102 the wake of political
Page 113 and 114:
Chapter 4 104 telecommunications, h
Page 115 and 116:
Chapter 4 106 2.3.3. Setting the ag
Page 117 and 118:
Chapter 4 108 They were asked to se
Page 119 and 120:
Chapter 4 110 been responsible for
Page 121 and 122:
Chapter 4 112 companies. Neverthele
Page 123 and 124:
Chapter 4 114 comparative analysis
Page 125 and 126:
Chapter 4 116 an important effect o
Page 127 and 128:
Chapter 4 118 2.8. Policies for spe
Page 129 and 130:
Chapter 4 120 public health service
Page 131 and 132:
Chapter 4 122 in defining inequalit
Page 133 and 134:
Chapter 4 124 5.3. From awareness b
Page 135 and 136:
Chapter 4 126 15. Draft Development
Page 137 and 138:
Chapter 4 128 Hungary Péter Makara
Page 139 and 140:
Chapter 4 130 The main functions of
Page 141 and 142:
Chapter 4 132 management at an appr
Page 143 and 144:
Chapter 4 134 The Public Health Pro
Page 145 and 146:
Chapter 4 136 • tobacco control
Page 147 and 148:
Chapter 4 138 • positive changes
Page 149 and 150:
Chapter 4 140 Finally, a Platform f
Page 151 and 152:
Chapter 4 142 • health care and g
Page 153 and 154:
Chapter 4 144 to be sharp. The prop
Page 155 and 156:
Chapter 4 146 able reasons, the Min
Page 157 and 158:
Chapter 4 148 2. Kopp M, Réthelyi
Page 159 and 160:
Chapter 4 150 1.3. The main feature
Page 161 and 162:
Chapter 4 152 from outside the DoHC
Page 163 and 164:
Chapter 4 154 to incorporate an exp
Page 165 and 166:
Chapter 4 156 In 2004, there was an
Page 167 and 168:
Chapter 4 158 ing socioeconomic var
Page 169 and 170:
Chapter 4 160 The strategy is seen
Page 171 and 172:
Chapter 4 162 2.5.2. Nutrition Some
Page 173 and 174:
Chapter 4 164 The national lifestyl
Page 175 and 176:
Chapter 4 166 A first policy for ol
Page 177 and 178:
Chapter 4 168 In addition, many of
Page 179 and 180:
Chapter 4 170 The strategy calls fo
Page 181 and 182:
Chapter 4 172 tional policies. At t
Page 183 and 184:
Chapter 4 174 the office of the Pri
Page 185 and 186:
Chapter 4 176 28. Towards a tobacco
Page 187 and 188:
Chapter 4 178 Kyrgyzstan Péter Mak
Page 189 and 190:
Chapter 4 180 In the case of Kyrgyz
Page 191 and 192:
Chapter 4 182 The active involvemen
Page 193 and 194:
Chapter 4 184 disease prevention at
Page 195 and 196:
Chapter 4 186 The existing, often f
Page 197 and 198:
Chapter 4 188 ment. One part of the
Page 199 and 200:
Chapter 4 190 fell rapidly from 199
Page 201 and 202:
Chapter 4 192 the health field were
Page 203 and 204:
Chapter 4 194 An attempt was made t
Page 205 and 206:
Chapter 4 196 iour of schoolchildre
Page 207 and 208:
Chapter 4 198 Lithuania reports reg
Page 209 and 210:
Chapter 4 200 risk factors have bee
Page 211 and 212:
Chapter 4 202 closer state control
Page 213 and 214:
Chapter 4 204 of industrial disease
Page 215 and 216:
Chapter 4 206 ensure that in the lo
Page 217 and 218:
Chapter 4 208 in order to deal with
Page 219 and 220:
Chapter 4 210 added weight of being
Page 221 and 222:
Chapter 4 212 2. World development
Page 224 and 225:
Chapter 5 Reflections on experience
Page 226 and 227:
whether lifestyles can be affected
Page 228 and 229:
over the years. In these countries,
Page 230 and 231:
In countries where the process has
Page 232 and 233:
Policy formulation This section dis
Page 234 and 235:
Capacity mapping The policy formula
Page 236 and 237:
during policy formulation. Naturall
Page 238 and 239:
civil servants have a degree of per
Page 240 and 241:
It can be quite a challenge for the
Page 242 and 243:
• the extent of the health proble
Page 244 and 245:
example, improving health literacy
Page 246 and 247:
The policy content The content of s
Page 248 and 249:
With the possible exception of Finl
Page 250 and 251:
tation, and an important investment
Page 252 and 253:
We would add that more use needs to
Page 254 and 255:
On the whole, “revised” policy
Page 256 and 257:
arguments for applying an integrate
Page 258 and 259:
the most appropriate prerequisites
Page 260:
(http://www.euro.who.int/document/e
Page 263 and 264:
Chapter 6 254 As premature deaths f
Page 265 and 266:
Chapter 6 256 goods”, including f
Page 267 and 268:
Chapter 6 258 be conflicting, and t
Page 269 and 270:
Chapter 6 260 effectiveness of inte
Page 271 and 272:
Chapter 6 262 • Examining the cos
Page 273 and 274:
Chapter 6 264 ments/ev_060302_rd06_
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