PORTUGUESE HEALTH PROFILE EUMAPH/ETC PH-HP 7 th Masters on Public Health National School of Public Health 2004 A HEALTH PROMOTION PERSPECTIVE

Historical Introduction Early 70’s - precarious situation on the health care sector, evidenced by high infant mortality rates (58,6‰). April's Revolution in 1974 – implementation of democracy implementation of Health Care Centers followed by National Health Service (NHS). Free and universal Improvement of the Portuguese health conditions are associated with financial, material and human resources development. Nowadays, the main problems faced by NHS, besides financial crises, are the iniquity in access to health care.

National Health Plan Recently approved after a public consultation, the National Health Plan (NHP) aims to integrate and make easier the coordination and collaboration of all society sectors. Defines strategic guidelines for the activities that other institutions linked o the health ministry should assure in the context of health gains and efficiency. The main goals are inspired by the action areas of the Ottawa Charter.

Health Promotion Programmes and Projects

A Health Promotion Perspective The several health promotion programmes and projects presented here, were chosen by the 7 th Masters Students on Public Health, in order to built the Portugal Health Profile – a Health Promotion perspective, using the HIA-Net support project (coordinated by Maurice Mittelmark, Bergen University).

NATIONAL PROGRAMMES

National Programme of Integrated Intervention on the Health Determinants Related with Life-Styles Main goal: Reducing prevalence of risk factors of non transmissible chronic diseases; Increasing prevalence and strength of health protective factors related with life-styles trough a social integrated approach.

Proposals and Recommendations from the National Council of Mental Health This project gives the guidelines that every health mental services should follow – reorientation of services. National strategic orientations for mental health promotion by these different sectors: education, media, individual and family counselling, crisis early intervention, occupational health improvement, social care providers training, civil society programmes

National Strategy Against Drugs National Action Plan Against Drugs and AddictionDrugs Addiction Primary Prevention Municipal Plan In the scope of the National Action Plan Against Drugs and Addiction there has been instituted the Drugs Addiction Primary Prevention Municipal Plan which aim to assemble efforts between the Institute of Drugs and Addiction, the municipalities and the civil society. Priority areas: school environment, family environment, school abandon, leisure sports events.

National Programme for Prevention and Control of Cardio-Vascular diseases Goals: Increasing the epidemiological vigilance of risk factors and cardio-vascular diseases; Promoting healthy lifestyles, reducing risk factors; Empowering the citizens decision-making on health; Improving the organization of medical care – regular check- up’s.

Asthma and Chronic Obstructive Pulmonary Disease (COPD) Main goals: To contribute to the self-control and empowerment of patients; To promote the adherence to the pharmacological therapy; To promote a correct use of the several inhalers devices; To reduce the use of health care services (hospitalisations and urgencies); To improve quality of life

Diabetic Guide An Empowering National Tool Aims health promotion and co-responsibility of diabetics self-treatment with the participation of health professionals.

Regional Programme

Regional Health Plan (e.g. Azores) Regional Health Plan (e.g. Azores) Strategic orientations: To promote an efficient, integrated health system; To invest in health promotion and disease prevention; To influence the citizens for the responsibility of their health and use of health services. Health promotion investment will be safeguarded by: Promoting healthy lifestyles; Promoting health education programmes in school; Implementing campaigns against the risk factors; Promoting healthy lifestyles inside of the health services; Influencing citizens for the better use of the health services.

Local Programmes

Community intervention project for maternal and infant health and family planning Developed in two Lisbon’s Health Care Centers, in socially deprived communities Main goals: To establish an effective link between the Health Centers and the population; To increase the population’s awareness and promote their capacity to solve their own health problems; To develop methods, techniques and materials for ethnic minorities groups.

“Better Activity, More Health” Programme Several local initiatives developed by an urban cities (Oeiras, Tomar), which goal is to alert the townspeople for the adoption of a healthy lifestyle during life-span. It is a set of initiatives seeking health promotion, general well- being e personal accomplishment.

Municipal Programme of Prevention of Alcohol Abuse (City Council of Azambuja) Integrates strategic interventions: informative, educative participative actions. The objectives and the actions should offer continuity and support for other programmes that are already in development through the Municipal Plan of Prevention of Drug Addiction.

Accessibilities Project Accessibilities Project Viana do Castelo (healthy city) developed the Accessibilities Project, which is based on “Health for All in the XXI Century” document and on the strategic guidelines of “Ottawa Charter”. Principal purpose: Make city accessible to all individuals and situations, by adapting and eliminating obstacles and barriers, alerting and preventing future situations, and promote the coordination between health promotion institutions.

Project of humanization, improvement and quality of the medical care given to patients Main Goal: to place the patient into the centre of the organisation, humanization and quality of the medical care. Pre-Surgery Visit in a Hospital (Egas Moniz) Implementing Pre-Surgery Visit in a Hospital (Egas Moniz): To promote the quality of nursing care by a closer contact with patients; To establish empathic relation nurse/patient/family; To clarify doubts and concerns; To develop the nurses skills.

“...if people in all walks of life, nongovernmental and voluntary organizations, governments, the World Health Organization and all other bodies concerned join forces (...) Health For All (...) will become a reality.” (Ottawa Charter, 1986)