THE FRAMEWORK FOR A NEW PUBLIC HEALTH STRATEGY FOR THE REPUBLIC OF SERBIA Prof. Dr Snežana Simić School of Medicine Belgrade University Serbia and Montenegro The Role of Graduate Public Health Education in Addressing Health Challenges in CEE – NIS Countries Kyiv – Ukraine, July

PUBLIC HEALTH IN SERBIA TODAY Institutes of Public health (23) monitoring, investigation, assessment of the health status of population; environmental aspects of health; availability, organization and utilization of health services; surveillance of diseases; health promotion and health education; planning and development of health programs, monitoring and evaluation According to Health Care Law, the IPH should provide services at least in social medicine, epidemiology, microbiology, parazitology and virology, hygiene, environmental protection Health centers (160) providing Primary Health Care Inspectorate services (Ministry of Health) – health, sanitary and drug inspection

Public Health Professionals in Republic of Serbia (without Kosovo) Occupational medicine650 Epidemiology190 Social Medicine150 Hygiene and Medical Ecology130 Others (health economy, health law, psychology, sociology, organizational sciences 30 Community nurses – about /5800 1/3000

Assessment of public health network in Serbia (Belgrade, September 2002) Absence of integrated Public Health Policy; Rigid and out of date structure of IPHs; Overstaffing with administrative and technical personnel; Lack of multi-professional personnel; Unclear mechanism for financing Public Health Undeveloped information and communication systems Lack of knowledge and skills for new public health Belgrade – Federal Assembly

Ministry of Health Republic of Serbia BETTER HEALTH FOR EVERYONE IN THE THIRD MILENIUM Health policy Vision of the health care system in Serbia Strategy and action plan of the reform of health care system in Republic of Serbia by draft

INTERNATIONAL PARTNERS FOR STRENGTHENING PUBLIC HEALTH IN REPUBLIC OF SERBIA Support to the Public Health Development in Serbia - EAR Strengthening Preventive Health Care – EAR Programmes for Training and Research in Public Health - Stability Pact for South Eastern Europe Reform of Public Health Financing – WB Strengthening Essential Public Health Functions in the Balkans - CPHA Primary Health Care Basic Health Benefits in Kraljevo Municipality Health promotion on community level - OSI European Agency for Reconstruction - EAR ICRC – International Committee of Red Cross The WORLD Bank Group Canadian International Development Agency – CIDA; Canadian Public Health Association Open Society Institute - Belgrade 5

MILLENIUM DEVELOPMENT GOALS OUN Poverty Reduction Strategy Paper Action Plan for Children Empowerment of the Roma population MULTISECTORIAL STRATEGIES

CDC/ATSDR`s - A Global Health Strategy Working with Partners to improve Global Health The CDC Global Health Strategy defines goals in the following five critical areas for public health: Public Health Surveillance and Response, Public Health Infrastructure and Capacity Building, Disease and Injury Prevention and Control Applied Research for Effective Health Policies Exchange of Information and Lessons Learned

WB – PUBLIC HEALTH AT A GLANCE The Public Health at a glance fact sheets aim to provide easy access to the state of the art in basic public health, nutrition and population (HNP) preventive and curative services. The basic public health services include: Nutrition, Malaria, TB and HIV/AIDS prevention and control interventions, Reproductive health, IMCI and immunization, School health, Mental health, Tobacco control, indor air polution, road safety and water and sanitation

The European Commission – Public Health Politically important was the Commission's decision to place “health” as one of its key priorities; On 16 May 2000 the Commission adopted a Communication on the Health Strategy of the European Community and a proposal for a Decision of the EP and Council adopting a program of Community Action in the field of public health, The Commission takes account of the review of the existing situation and recent legal and political developments EU action in Public Health: Health promotion Health monitoring AIDS and communicable diseases Cancer Rare diseases Injury prevention Pollution related diseases Drug abuse

FUTURE ACTIVITIES IN REPUBLIC OF SERBIA Public Health Policy Framework and Strategy Paper - draft The School of Public Health Initiative – Postgraduate Public Health Training for Practice and Research Strategy on Tobacco Control – draft of the National Tobacco Control Commission New Model of Public Health Financing

PUBLIC HEALTH ASSOCIATION OF SERBIA Established in October public health professionals were present at October meeting in Belgrade

NATIONAL PUBLIC HEALTH STRTAEGY OF THE REPUBLIC OF SERBIA - draft Essential public health functions in Serbia: Health promotion – actions to affect overall health and wellbeing Prevention – of specific diseases, injuries and social problems Protection – preventive and emergency services Surveillance – keeping track of patterns of disease to enable timely action Population health assessment – measuring, monitoring and reporting on the status of the health in community Intersectorial collaboration in health

NATIONAL PUBLIC HEALTH STRATEGY – general aims 1. Establishment national priorities in area of public health and creation of effective interventions within community directed to health promotion; 2. Moving of intervention focus from disease to health determinants and risk factors; 3. Promotion of evidence based healthy public policy developments; 4. Providing valuable information on health and establishing minimal set of indicators for health status assessment; 5. Fast reaction in crisis including surveillance of communicable diseases and prevalence of risk factors in population

National public Health Strategy - next steps - To reach consensus on a new framework for public health in Serbia, To encourage a broad- based approach to public health, To develop public health oriented workforce, To define the roles and responsibilities of stakeholders – Ministry of Health, IPH, PHC and NGOs Central Serbia - country side