TAI

National Health Programme for Children and Youth - start for the future

Iisi Saame
Chief Specialist, Department for Public Health
Ministry of Social Affairs of Estonia

At the beginning of 1996, the public health department of the Ministry of Social Affairs initiated the development of principles for a proposed national programme to improve the health of children and youth. The aim was to obtain solutions to problems through the joint activity of various offices.
On July 4, 1996 the government approved the ‘National Health Programme for Children and Youth 2005’ (protocol no. 44, agenda item 27). On Feb. 15, 2000, the government approved the supplement to the National Health Programme for Children and Youth (order no. 124) which defined objectives and activities from 2000 to 2005.
The strategic aims and activities of the programme were divided into three stages:

1996-1998 analysis of the current situation and legislation, implementation of sub-projects as pilot projects, development of training plans and materials
1999-2002 involvement of national agencies in project activities, proposals for organisation of legislation
2003-2005 health programme delivery stage, submission of the activity plan generated by the programme to institutions specified by legislation and local governments

The programme aims were specified as follows:
1. Prevention of mental disorders and psychological problems in children, early detection and access to quality psychiatric and psychological counselling;
2. Balanced and quality meals in nursery schools and schools for the all-round development of children and youth. Training healthy eating habits in children;
3. Physically active lifestyle training for children. Reduce injuries caused by external origins and traumas and increase safety of the environment;
4. Prevention of health disorders in children, early detection, access to quality health services in nursery schools and schools;
5. Provide a healthy nursery school and school routine and environment which protects children’s health;
6. Improve the quality of the children’s health programme, evaluation of the programme’s efficiency.

The health programme for children and youth began in 1996 with 6 subprojects – school environment, physical activity and trauma prevention, mental health, school health services, school meals, development project. The National Health Programme for Children and Youth is significant in that in 1996 representatives of various areas of activity recognized the need for co-operation to improve child health and were able to agree upon the necessary actions at the government level. Unfortunately the programme did not run as smoothly as planned. The main factors diminishing the effectiveness of the programme have been financing, which was half of what was required and a lack of consistency due to changes in the managing body.

A thorough analysis of the activities of the previous years should be undertaken by the Ministry of Social Affairs and National Institute for Health Development at the close of the National Health Programme for Children and Youth 2005 to provide information on the effectiveness of the work done and to avoid possible mistakes in future interventions in planning and management.

In the following years, success in improving the health of children and youth is aided by the broader understanding today that the key to improving the health of children and the entire population lies not only within the public health system and the Ministry of Social Affairs but also within many other fields and ministry administrative domains and in accompanying activities. A larger role in the implementation of activities promoting good health and disease prevention should be given to county authorities.
Municipal governments, citizen groups and business associations may be able offer additional options and resources for managing activities and achieving goals. It is important hereafter to unite the knowledge and actions of already functioning national systems for improving child health (rehabilitation system).

Actions directed at improving child health will continue in 2006 focusing on the Children’s Rights Strategy. The programme will be put into action by the National Institute for Health Development under the direction of the Ministry of Social Affairs. Child environmental health issues are integrated into the health section of the National Environmental Strategy. The national health education study programme will be updated in co-operation with the Ministry of Education and Research. The Estonian Health Insurance Fund finances school health services as a part of its disease prevention and health promotion projects and covers over 190,000 children and youth in 2006.

The Ministry of Social Affairs would like to thank all who have dedicated their energy to improving the health of Estonian children. The aim of the compilation dedicated to the 10th anniversary of the National Health Programme for Children and Youth is to provide a record of the work done and to pass on experiences gained over the years for incorporation with successful future actions.

Main goal: To create preconditions improving environment in order to protect and promote infants' and adolescents' health and their health related fitness.

Programme objectives:

To prevent/decrease the problems and psychic disturbances related to children's mental health, to provide diagnose at early stage and high-quality psychiatric-psychological service;
To take care that children get good quality food in schools and pre-schools, teaching healthy eating habits;
To make children physically active, to prevent injuries and increase the safety of the environment;
To compile the optimal model of health care for pre-schools and schools, to improve the qualification level of public health authorities and the service they provide;
To provide healthy environment and working style for children in pre-schools and schools.

Target group: The programme is aimed at the children and adolescents (up to age 18), including adults and institutions responsible for the same goals.