Plano Nacional de Saúde 2011-2016
“Comunidades, Autarquias & Saúde”
Lisboa, 28-29 Abril 2011
1. Experiências Europeias
Promover a saúde e reduzir as desigualdades em saúde: desafios, oportunidades - uma experiência
europeia Dr Erio Ziglio
European Office for Investment for Health and Development, Venice World Health Organization
5 Lições
5 Aspectos
Contexto
Health promotion is the process of enabling
people to increase control over their health and its determinants, and thereby improve their health.
Saúde Pública num mundo em rápida mudança…
Mudanças Climáticas
Source: Climate Change 2007: The Physical Science Basis http://www.ipcc.ch/pdf/assessment-report/ar4/wg1/ar4-wg1-chapter10.pdf
Um Mundo de Pessoas Urbanizadas
Rural
Urban
Source: World Urbanisation Prospects | 2005 Revision http://www.un.org/esa/population/publications/WUP2005/2005wup.htm
United Nations Projected Percentages of Global Population
Source: World Population Prospects: The 1996 Revision, Annex 2 (low-variant projection). UN Population Division.
1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 Year 0 5 10 15 20 % o f Glob al Po pu la tio n Age <5 Age 65+ Projected Actual
Na próxima vez que nos encontramos … Haverá mais pessoas com > 65 do que < 5
Contexto Europeu da Saúde em rápida mudança
HEALTH2020
Porquê uma Nova Política de Saúde para a Europa?
New era, with rapid
global and European changes
Increasing complexity of factors that shape health and health inequities
Uneven progress in achieving health goals to-date
New challenges/ opportunities for
health as an asset for development
These demand a new approach to Health Governance in 21st Century
5 Lições
5 Aspectos
1. Aumento de inequidades em
saúde
Source: WHO Europe, HFA Database, July 2010
65 70 75 80 1980 1990 2000 2010 Portugal European Region EU CIS
Inequidades em Saúde e Gradiente Social
Diferença de 8-10 anos em Esperança de Vida com picos acima dos 30 anos.
Copenhagen
Évora
www.who.int/social_determinants
A world where social justice
is taken seriously!
2. Necessidades de investimentos mais equilibrados
Promotion
Individual Population
Korányi Hospital, Budapest, Ungheria
Melhorar o desempenho através de prestação de serviços efectivos
4. Consistência de Acção pela Saúde e outros Sectores
Source: Adapted model from Diderichsen (2002) and from Morgan, Davis & Ziglio 2010
Decrease differential exposure
Decrease differential vulnerability
Decrease differential access
Decrease differential consequences
Consistência através dos diferentes sectores: Saúde em todas as Políticas
Social capital Social exclusion Economic security
Individual and community coping resources Physical environment
Community sense of frustration and failure Inequities and Inequalities
Adelaide Statement on Health in All Policies moving towards shared governance for health and well-being
5. Níveis de governança
Joint new policy
Adjusted + more efficient sectoral policies More efficient sectoral policies Cooperation Coordination Integrated Policies
Source: Adapted from Meijers E, Stead D. Policy integration: what does it mean and how can it be
achieved? A multi-disciplinary review. Delft University of Technology OTB Research Institute fir housing,
Melhorar o desempenho através de
“Stewardship”, Project MURA, Slovenia
IfH HEALTH CARE CENTERS HOSPITAL Schools Kindergartens Mayors Employment agency Regional & local development agencies Chamber of commerce NGOs Agricultural extension service Tourist association Food Industry
Health spa resorts Local coordinators
Regional park Goričko
Uma imagem vale mais do que 1000 palavras ...
- Sustained political commitment
- System rigidity
- Skilled human resources
- Develop integrated approaches
- Create incentives for intersectoral action
- Avoid fragile financing mechanisms - Avoid Isolated programmes
- Strengthen Organizational / Institutional capacity
5 Lições
5 Aspectos
Como podemos tornar a vida dos
Experiências Sub-nacionais
Slovenia
Czech Republic United Kingdom
MURA Project Liberec
South Moravia
South Bohemia
North West Region
Italy
Tuscany Veneto
1. Maior Capacidade (nacional/ local)
– sufficient capacity in terms of personnel; – with adequate training;
– and sufficient mandates and responsibilities
allotted to them.
Source: Adapted from Ståhl T, Wismar M, Ollila E, Lahtinen E, Leppo K, eds. (2006). Health in
Reduce Risk Factors Reduce Risk Conditions Maximize Assets
2. Gerir „Sistemas‟ não apenas intervenções isoladas
3. Um Modelo Integrado de Acção Source: NHS, Scotland LIFE CIRCUMSTANCES LYFESTYLE INDIVIDUAL BEHAVIOUR SETTINGS Programmes Policies
Health Economic Development Social Development 4. Reposicionamento da Saúde no desenvolvimento
5. Maximizar os recursos da comunidade local
