Presentation on theme: "Advisory Board Meeting Brussels"— Presentation transcript:
1Advisory Board Meeting Brussels 16.10.2012 Health Equity 2020: Action Learning & Capacity Building in EU10 Regions (WP 7 & 8)Advisory Board MeetingBrussels
2Aims of Presentation …with a focus on the situation in pilot regions. Brief introduction WP7 and WP8Relevance WPs for planning & implementation of regional policiesChallenges to link to wider regional development plansMain considerations to maximise effectiveness of work with regions…with a focus on the situation in pilot regions.
4WP 7 – Action Learning Programme (1) 4 workshops & virtual action learning sets (“Elluminate Live!”):Needs assessmentEntry pointsEconomic evidenceAction planning20 participants per workshopEach region gets travel costs & subsistence allowances: 700 € for one person, up to if more than one person participatesWorkshops hosted by Polish & Slovene pilot regions & two other EU10 locations
5WP 7 – Action Learning Programme (2) Target audience: Stakeholders in participating regionsApproach:Taking regions from their starting points (what has been achieved)Exchange between regions & of region-specific development scenariosTranslation of evidence & experience into actionStarting with pilot regions (see also WP8)
6WP 8 – Capacity BuildingPractical support to access/use knowledge & experienceKey elements:Capacity building audit & re-audit in participating regionsDevelopment & review of policy matrix (with key stakeholders)Creation and coordination of expert networks for workshops, virtual action learning sets, mentoring
7Cross-links with WPs 4-7 WP 4 WP 5 and WP 6 Conceptual framework health inequitiesApproaches to measure health inequitiesEvidence-based approaches to address health inequitiesTool boxPolicy matrixKey domains of needed expert knowledgeWP 5 and WP 6Baseline capacity audit conducted in pilot regionsDevelopment of self assessment tool for capacity auditInforming action learning processProvision of experiences and practical knowledge to prepare and “validate” content of workshopsIdentification & recruitment of experts for key policy domains identified in WP4Organization of two workshops / action learning activities
8Next step: Concept for capacity audit and capacity building Which capacities / fields for action / policies / actors should be taken into account?Health governance vs. governance for health (Kickbusch/Gleicher 2012)Universal vs. selective policiesNot place-based vs. place based policiesScreening existing tools for capacity audits and assessmentsCapacity Audit / Assessment ToolsHealth system Performance Assessment ToolsExchange of experiences with capacities, capacity assessment / capacity building in pilot regionsFormative evaluationEvidenceWhat works?Tool Box(WP4)Screening existing toolFormative evaluationKnow how of pilot regionsAnd now: capacities to address health inequities – status, experiences, challenges, opportunities -the perspective of the pilot regions.
11Time schedule: First year (2012/13) 7 July89101112123456 JuneRevision capacity audit toolXTest tool in pilot regions (incl. visit in region)Pilot regions preparing actions plans with UMRevision of capacity audit tool with feedback from pilot regionsShort guide on the process and use of toolTool and guide made available on Health 2020 website
12Time schedule: Second year (2013/14) 7 July89101112123456 JuneOnline workshop to introduce tool and guideXRegions conduct capacity buidling auditsRegions provide audit reportsAnalysis of reportsInterim capacity building reportRegions prepare action plans for improvements locally and via WP 7 and 8
13Time schedule: Third year (2014/15) 7 July89101112123456 June2 pilot regions conduct re-auditXFinal revision of capacity building tool and guide
14For Discussion: Policy Matrix Action spectrum on “inequalities” in healthIntervention map for comprehensive policies to reduce social inequalities in healthRegional capacities to address health inequities in a multilevel contextThe European context of Health Equity 2020
15Ad 1.: Action spectrum on inequalities in health MeasurementRecognitionAwareness raisingConcernDenial / indifferenceWhat about the situation in the pilot regions?Mental blockWill to take actionIsolated InitiativeMore structured developments(Whitehead 1998: 471)Comprehensive coordinated policy
16Ad 2: Intervention map for comprehensive policies to reduce social inequalities in health Social reform UpstreamRisk reduction MidstreamEffect reduction DownstreamUniversal measuresPublic system for education, taxes, labour market policies etc.Working and living environment, broad lifestyle measures etc.Health systemsSelective measuresMeans-tested social benefits etcTargeted lifestyle measuresTargeted health services123What are the current priorities in the pilot regions?(Torgersen et al. 2007: 8)
17Ad 3: Combining relevant policies in a multilevel context (draft) Where to look for what kind of capacities?Territorial Policies EUTerritorial Policies MSIntra-Regional Governance for Adressing Inequities in Regions and at the Local LevelRegional PlanningNot Place-based Policies of EUNot Place-based Policies of MSRegional AdministrationRegional Policies: Actors in RegionsRegional Policies MSRegional Policies EUHorizontal Regional CooperationWhat is going on in the pilot regions?Horizontal regional networks in MSHorizontal Regional Networks in EU
18Ad 4: The European Context of Health Equity 2020 … EU and “Europe 2020”7 Flagships“Health is Growth” ProgrammeEU SF: direct and indirect investments in health (infrastructure)… WHO and “Health 2020”2 goals4 policy priorities6 proposed targets10 EPHOs10 know-how areasHow are the activities framed in pilot regions?
20Europe 2020 – 7 flagships initiatives SmartInnovation UnionYouth on the MOVEDigital AgendaSustainableResource efficiencyIndustrial policyInclusiveAgenda for new skills and jobsPlatform against poverty(How) Will this influence the Health Programme?COM (2010) 2020 final
21The New Proposal for the “Health for Growth” Program Driver for growthEconomic relevance ofhealthy populationresearch and developmenthealthcare sectorPromoting good health as an ”integral part of the smart and inclusive growth objectives
22Proposal Health for Growth Program Direct links with flagship agendasInnovation UnionDigital AgendaNew Skills and New Jobs
23Proposal Health for Growth Program Objective 1:“to develop common tools and mechanisms at EU level to address shortages of resources, both human and financial and to facilitate up-take of innovation in healthcare in order to contribute to innovative and sustainable health systems”Health Technology Assessment in the context of patients’ rights in cross-border healthcareInteroperability of e-Health applicationsSustainability of EU health workforce (planning, recruitment)Expertise for health system reformsEuropean Innovation Partnership on Active and Healthy Ageing (Innovation Union)EU legislation (medical devices, e-Health, Health Technology Assessment in cross border healthcare)Health knowledge system
24Proposal Health for Growth Program Objective 2:“to increase access to medical expertise and information for specific conditions also beyond national borders and to develop shared solutions and guidelines to improve healthcare quality and patient safety in order to increase access to better and safer healthcare for EU citizens”European Reference NetworksRare diseasesPatient safety, quality of healthcare (information to patients, exchange of best practices, guidelines)Use of antimicrobials (resistance)EU legislation (tissues and cells, blood, organs, medicinal products in cross-border healthcare)Health knowledge system
25Proposal Health for Growth Program Objective 3:“to identify, disseminate and promote the up-take of validated best practices for cost-effective prevention measures by addressing the key risk factors, namely smoking, abuse of alcohol and obesity, as well as HIV/AIDS, with a focus on the cross border dimension, in order to prevent and promote good health”Exchange of best practices on key issues (smoking, alcohol, obesity)Prevention of chronic diseases including cancer (sharing knowledge, best practice, joint activities)EU legislation (tobacco products and advertisement)Health knowledge system
26Proposal Health for Growth Program Objective 4:“to develop common approaches and demonstrate their value for better preparedness and coordination in health emergencies in order to protect citizens from cross-border health threats”Strengthen preparedness and response for serious cross border health threats;Risk assessment capacity (scientific expertise, mapping existing assessments)Capacity building against health threats in Member States (planning and coordination, vaccination, medical countermeasures)EU legislation (communicable diseases, other health threats)
28WHO Health 2020: Main strategic objectives Improving health for all and reducing health inequalitiesImproving leadership and partcipatory governance for health
29WHO Health 2020: Priority action areas Investing in health through a life-course approach and empowering peopleTackling Europe´s major health challenges of noncommunicable and communicable diseasesStrengthening people-centred health systems, public health capacity and emergency prepearedness, surveillance and responseCreating resilient communities and supportive environment
30WHO Health 2020: Proposed targets Broad target area TargetLinks 1. Burden of disease and risk factors1. Reduce premature mortality in Europe by 2020Linked with strategic objective 1 and policy priority 22. Healthy people, well-being and determinants2. Increase life expectancy in EuropeLinked with strategic objective 1 and policy priorities 1 and 43. Reduce inequities in health in Europe4. Enhance the well-being of the European population3. Processes, governance and health systems5. Universal coverage and the right to healthLinked with strategic objective 2 and policy priority 36. National tarets/goals set by Member States
3110 Essential Public Health Services Monitor health status to identify and solve community health problems.Diagnose and investigate health problems and health hazards in the community.Inform, educate, and empower people about health issues.Mobilize community partnerships and action to identify and solve health problems.Develop policies and plans that support individual and community health efforts.Enforce laws and regulations that protect health and ensure safety.Link people to needed personal health services and assure the provision of health care when otherwise unavailable.Assure competent public and personal health care workforce.Evaluate effectiveness, accessibility, and quality of personal and population-based health services.Research for new insights and innovative solutions to health problems.(Centers for Disease Control and Prevention)… and health inequities?
32WHO Health 2020: 10 Essential Public Health Operations (EPHOs) Surveillance of population health and well-beingMonitoring and response to health hazards and emergenciesHealth protection including environmental, occupational, food safety and othersHealth promotion, including action to address social determinants and health inequityDisease prevention, including early detection of illnessAssuring governance for health and well-beingAssuring a sufficient and competent public health workforceAssuring sustainable organizational structures and financingAdvocacy, communication and social mobilization for healthAdvancing public health research to inform policy and practice… and health inequities?(WHO Regional Office for Europe 2012b)
33WHO RHN: Know-how areas … and health inequitiesHow to foster and sustain regional commitment?How to secure policy coherence?How to develop skilled human resources?How to scale up from isolated regional projects?How to foster long-term regional investment?How to strengthen regional health systems?How to increase capacity for regional health diplomacy?How to create incentives for a regional whole of government approach?How to develop knowledge transfer among regions?How to reposition health within regional development?
34References (to be accomplished) Bertollini, Roberto/Brassart, Celine/Galanaki, Chrysoula (2012): Review of the commitments of WHO European Member States and the WHO Regional Office for Europe between 1990 and Copenhagen: WHO Regional Office for Europe (www.euro.who.int/__data/assets/pdf_file/0020/171902/Review-of-the-commitments-of-WHO-European-Member-States-and-the-WHO-Regional-Office-for-Europe-between-1990-and-2010.pdf) WHO Regional Office for Europe (2012): Executive summary of the European health report 2012: Moving Europe towards health and well-being. Information document. Regional Committee for Europe, Sixty-second session, Malta, 10–13 September 2012 (EUR/RC62/Inf.Doc./1, 29 June 2012) (www.euro.who.int/__data/assets/pdf_file/0017/170108/RC62-id01-Eng.pdf)Kickbusch, Ilona/Behrendt, Thorsten (2012): Interim report Supporting Health 2020: governance for health in the 21st century. WHO Regional Office for Europe (www.euro.who.int/__data/assets/pdf_file/0019/171901/Interim-report-Supporting-Health-2020-governance-for-health-in-the-21st-century.pdf)Kickbusch, Ilona/Gleicher, David (2012): Governance for health in the 21st century. Copenhagen: WHO Regional Office for Europe (www.euro.who.int/__data/assets/pdf_file/0019/171334/RC62BD01-Governance-for-Health-Web.pdf)McQueen, David V./Wismar, Matthias/Lin, Vivian/Jones, Catherine M./Davies, Maggie (ed.) (2012): Intersectoral Governance for Health in All Policies. Structures, Actions and Experiences. Observatory Studies Series 26. Copenhagen: World Health Organization 2012, on behalf of the European Observatory on Health Systems and Policies (http://www.euro.who.int/__data/assets/pdf_file/0005/171707/Intersectoral-governance-for-health-in-all-policies.pdf)Whitehead, Margaret (1998): Diffusion of Ideas on Social Inequalities in health: A European Perspective. The Milbank Quarterly 76 (3):Whitehead, Margaret/Dahlgren, Göran (2006): Levelling up (part 1): a discussion paper on concepts and principles for tackling social inequities in health. Studies on social and economic determiants of population health No. 2. Copenhagen: WHO Regional Office for EuropeWhitehead, Margaret/Dahlgren, Göran (2006): Levelling up (part 2): a discussion paper on concepts and principles for tackling social inequities in health. Studies on social and economic determiants of population health No. 3. Copenhagen: WHO Regional Office for EuropeWHO Regional Office for Europe (2012): Implementing Health Information document. Regional Committee for Europe, Sixty-second session, Malta, 10–13 September 2012 (EUR/RC62/Inf.Doc./3, 23 July 2012) (www.euro.who.int/__data/assets/pdf_file/0017/170504/RC62-id03-Eng.pdf)WHO Regional Office for Europe (2012): Monitoring framework for Health 2020 targets and indicators. Information document. Regional Committee for Europe, Sixty-second session, Malta, 10–13 September 2012 (EUR/RC62/Inf.Doc./4, 9 July 2012) (www.euro.who.int/__data/assets/pdf_file/0010/170110/RC62-id04-Eng.pdf)WHO Regional Office for Europe (2012): Report on social determinants of health and the health divide in the WHO European Region. Executive Summary. Copenhagen: WHO Regional Office for Health (http://www.euro.who.int/__data/assets/pdf_file/0004/171337/RC62BD05-Executive-summary-Report-on-social-determinants-of-health-and-the-health-divide-in-the-WHO-European-Region.pdf)WHO Regional Office for Europe (2012): Strengthening public health services across the European Region – a summary of background documents for the European Action Plan. Information document. (EUR/RC62/Inf.Doc./5, 27 August 2012). Regional Committee for Europe, Sixty-second session, Malta, 10–13 September 2012 (www.euro.who.int/__data/assets/pdf_file/0017/172016/RC62-id05-final-Eng.pdf)WHO Regional Office for Europe (2012): The evidence base of Health Information document. Regional Committee for Europe, Sixty-second session, Malta, 10–13 September 2012 (EUR/RC62/Inf.Doc./2, 23 July 2012) (www.euro.who.int/__data/assets/pdf_file/0015/170502/RC62-id02-Eng.pdf)WHO Regional Office for Europe (2012): Web consultation on the Global Monitoring Framework for Noncommunicable Diseases. Information document. Regional Committee for Europe, Sixty-second session, Malta, 10–13 September 2012 (EUR/RC62/Inf.Doc./6, 5 September 2012) (http://www.euro.who.int/__data/assets/pdf_file/0004/172678/RC62-id06-Eng.pdf)WHO Regional Office for Europe (2012a): Addressing the social determinants of health: the urban dimension and the role of local government. Copenhagen: WHO Regional Office for EuropeWHO Regional Office for Europe (2012b): Healthy cities tackle the social determinants of inequities in health: a framework for action. Copenhagen: WHO Regional Office for Europe