1. Health Promotion in CR Věra Kernová National Institute of Public Health Prague Milena Kalvachová Ministry of Health, Czech Republic

2. Health - Definition State of full physical, mental and social well-being, not only absence of disease and disability (WHO, 1948) The reduction in mortality, morbidity and disability due to detectable disease or disorder, and an increase in the perceived level of health (WHO, 1999)

3. Health Promotion Process enabling individually and collectivelly increase control over determinants of their health, and improve health status. (WHO, 1998) It does not mean only responsibility of the health care system, but also individual responsibility for health expressed via life style. (Kebza, 2005)

4. Determinants of Health Life style (50%) Environment (cultural, economic, social and physical conditions of life) (20%) Genetic background (20%) Health care system (10%)

5. Components of Health Promotion Health protection implemented by public health policy Health education Intervention programmes

6. Health Promotion Important Policy Documents Ottawa Charter (1986) Health for All 21 and WHO key strategies European Health Policy ( 1999) National Health Programme (1995) National Environment and Health Action Plan of CR (1998) Law No. 258/2000 on Public Health Protection (2000) Longterm Programme on Improving Health Status of Inhabitants of CR – Health for All 21 (2002)

7. Ottawa Charter (1986) Health promotion should be a part of public policy, documents and measures. Health promotion should be a part of a community policy and practice. Environment should enable and promote health. People should be able to gain information, knowledge and skills enabling development of health. Health services should more orient on health promotion and support.

8. WHO - Key strategies of health promotion Strategy on environment and children health (2002) Global strategy on nutrition, physical activity and health (2003) Framework convention on tobacco control (2003) European action plan against alcohol (2003) Declaration on mental health for Europe (2005)

9. EU Health Policy (Amsterodam Treaty, art. 152) Goals: Eliminate risks affecting health, Strengthen health protecting factors, Improve life style and quality of health, Decrease incidence of diseases by screening, early detection a early treatment, Contribute to the reduction of costs on health care.

10. National Health Programme Short-term strategy approved by government in 19991 Middle-term strategy approved by government in 1992 Long-term strategy approved by government in 1995 Health for All 21 approved by government in 2002

11. National Health Programme Goals: Increase the knowledge of people on healthy life style Increase the knowledge of people on possibilities of disease prevention Encourage changes of behaviour Create coalitions for health promotion in the society

12. National Environment and Health Action Plan of CR - NEHAP Approved by government of CR in 1998 - System of monitoring of health status of population in relation to environment (National Institute of Public Health)

13. Law No. 258/2000 on Public Health Protection Impose duty on regional public health centres to contribute to the implementation of health policy of the region. Impose duty on public health institutes to implement the programme of health protection and promotion, ensure health education and counselling services.

14. 1183900 111314 9 625991 551650 304599 429113 populatio n 10,272.50 3 14 regions 508542 52101 9 1136689 641554 598057 1279951

15. Health Promotion Programmes – Priorities Life style u Nutrition u Physical activity u Tobacco u Alcohol u Accidents u HIV/AIDS Noncommunicable diseases (NCD) u Prevention of CVD u Prevention of cancer diseases u Prevention of metabolic diseases (obesity, diabetes)

17. Health 21 in CR – Report on implementation by government of CR (No. 1046/2002) Insufficient finantial resources Insufficient intersectoral collaboration Lower participation of public Slow regional implementation of Health 21

18. International Network of Health Promoting Hospitals u WHO Collaborating Centre – Copenhagen, Denmark u 38 national/regional HPH Networks (more than 800 hospitals in 40 countries) collaborating to reorient health care towards active promotion of health u Annual international conference and workshops (2013 in Sweden)

19. National Network of HPH in CR (WHO, MoH 2010-11) 1997 – Hospital in Šumperk – first contact 2003 – Teaching Hospital in Prague - Motol 2004 – Hospital in Šumperk - Masaryk Oncological Institute in Brno 2010 – General Teaching Hospital in Prague

20. Health Promoting Hospitals in CR u MAPA

21. Standards on Health Promotion in Hospitals u I. Guidelines for management of health promotion in the hospital u II. Assessment of patients needs in the field of health promotion u III. Information for patients on health promotion in the hospital u IV. Support of healthy working environment u V.Continual collaboration

22. Examples of successful projects in CR Baby Friendly Hospitals (breastfeeding support) Antismoking campaigns – League against Cancer, Healthy City Brno Care of environment and educational programs in Šumperk Hospital Healthy Hospital Motol Prague (patients well- being) Health Clowns at pediatric departments in 60 hospitals in CR Volunteer programs in hospitals – psychosocial support of patients

23. Biennial Collaborative Agreements (MoH CR – WHO Copenhagen) BCA 2010-11 Education of HPH coordinators BCA 2012-13 Development of the national network of HPH

24. References European Network of Health Promotion Agencies (ENHPA) – http://www.eurohealthnet.org http://www.eurohealthnet.org The International Network of Health Promoting Hospitals and Services, WHO CC - http://www.hphnet.org National Institute of Public Health Prague – http://www.szu.cz/ http://www.szu.cz/ World Health Organization - http://www.who.int/topics/health_promotio n/en/ http://www.who.int/topics/health_promotio n/en/