1. Background - ndphs.org€¦ · Web viewThis document presents the main activities implemented...

Committee of Senior Representatives (CSR)

Thirty-first Meeting

Moscow, Russia

25-26 April 2019

Reference CSR 31/13

Title Draft NDPHS Progress Report for 2018

Submitted by Secretariat

Summary / Note

This document presents the main activities implemented by the NDPHS during 2018. Annexes 1-7 contain annual progress reports of the NDPHS Expert Groups.

Due to submission shortly before the CSR meeting, the Progress Report will be adopted through a written procedure after the meeting (unless the Meeting agrees that the report can be approved immediately).

Requested action

For initial comments

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Northern Dimension

Partnership in Public Health

and Social Well-being

NDPHS Progress Report for 2018

[Approved by the NDPHS Committee of Senior Representativeson ]

Table of Contents

1. Background....................................................................................2

2. Introduction...................................................................................3

3. Achievements of the Partnership during 2018..................................4

Annexes

Annex 1: AMR Expert Group Progress report........................................................8

Annex 2: ASA Expert Group Progress report.......................................................15

Annex 3: HIV, TB & AI Expert Group Progress report.........................................30

Annex 4: NCD Expert Group Progress report.......................................................49

Annex 5: OSH Expert Group Progress report.......................................................62

Annex 6: PH Expert Group Progress report.........................................................72

Annex 7: PHC Expert Group Progress report.......................................................86

Annex 8: Leadership and coordination in the Partnership EGs............................94

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1. BACKGROUND

The Northern Dimension Partnership in Public Health and Social Well-being (NDPHS) is a cooperative effort of ten governments, the European Commission and eight international organizations. The overall objective of the Partnership is to promote sustainable development in the Northern Dimension (ND) area by improving human health and social well-being.

The Partnership works according to the Declaration concerning the establishment of a NDPHS (the Oslo Declaration),1 which stipulates that the Partnership shall promote co-operation and internationally coordinated actions in order to fulfill specific objectives within the following two priority areas:

Reducing major communicable diseases and prevention of lifestyle related non-communicable diseases

The main focus shall be on HIV/AIDS, tuberculosis, sexually transmitted diseases and antibiotics resistance. Concerning non-communicable diseases, special attention shall be paid to the determinants of cardiovascular diseases and the risk factors associated with excessive consumption of alcohol, tobacco and illicit drug use.

Enhancing and promoting healthy and socially rewarding lifestyles

Under this objective, the Partnership shall focus on nutrition, physical activity, creating smoke-, alcohol-, and drug-free environments, the practice of safe sexual behaviors, and supportive social and work environment and constructive social skills.

From the beginning of 2007, the Northern Dimension process is defined by two documents: the Political Declaration on the Northern Dimension Policy2 and the Northern Dimension Policy Framework Document3 – both endorsed at the Northern Dimension Summit on 24 November 2006 in Helsinki, Finland.

The Northern Dimension policy puts a strong emphasis on cooperation between the EU and Russia, with the full participation of the other two partners, namely Iceland and Norway, in matters relevant to the ND. These four partners committed themselves to continuing and further developing cooperation within the framework of the NDPHS, which is a tool to pursue the ND policy objectives of one of the six priority sectors agreed upon in the ND Policy Framework Document, namely “social welfare and health care, including prevention of communicable diseases and life-style related diseases and promotion of cooperation between health and social services.”

During 2015 -2020 the work of the NDPHS is guided by the NDPHS Strategy4 and its accompanying Action Plan5, which were adopted by the NDPHS Committee of Senior Representatives (CSR) in June 2015 and September 2015. The NDPHS Strategy is based on the national priorities and strategies of the NDPHS Partner Countries and takes stock of global and regional policies, strategies and political agendas relevant for the Northern Dimension area, including e.g. the WHO Europe Health 2020 and the European Union Strategy for the Baltic Sea Region.1 www.ndphs.org/?doc,Oslo_Declaration.pdf.2 www.ndphs.org/?doc,Political_Declaration_on_Northern_Dimension_Policy.pdf.3 http://www.ndphs.org/internalfiles/File/Strategic%20political%20docs/ND_Policy_Framework_Document_(updated_28-05-2015).pdf 4 http://www.ndphs.org/internalfiles/File/About_NDPHS/NDPHS_Strategy_2020.pdf 5 http://www.ndphs.org/internalfiles/File/About_NDPHS/Action_Plan_accompanying_the_NDP HS_Strategy_2020.pdf

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http://www.ndphs.org/internalfiles/File/About_NDPHS/Action_Plan_accompanying_the_NDPHS_Strategy_2020.pdf

http://www.ndphs.org/internalfiles/File/About_NDPHS/NDPHS_Strategy_2020.pdf

http://www.ndphs.org/internalfiles/File/Strategic%20political%20docs/ND_Policy_Framework_Document_(updated_28-05-2015).pdf

http://www.ndphs.org/internalfiles/File/Strategic%20political%20docs/ND_Policy_Framework_Document_(updated_28-05-2015).pdf

http://www.ndphs.org/?doc,Political_Declaration_on_Northern_Dimension_Policy.pdf

http://www.ndphs.org/?doc,Oslo_Declaration.pdf

2. INTRODUCTION

This NDPHS annual progress report presents the main activities carried out by the Partnership during the year 2018. Information contained in these documents is provided with reference to the NDPHS Work Plan for 2018 adopted by the Committee of Senior Representatives on 1 December 2017.

Annexed to this report are the progress reports of the NDPHS Expert Groups (AMR EG, ASA EG, HIV, TB & AI EG, OSH EG, NCD EG, PH EG, PHC EG).

As regards the action lines, four of them were included in the NDPHS Work Plan for 2018=:

Action Line 1: Working toward implementing the NDPHS Strategy 2020

Action Line 2: Implementing new approaches for collaboration within the NDPHS

Action Line 3: Leading and coordinating the “Health” Policy Area in the EU Strategy for the Baltic Sea Region Action Plan

Action Line 4: Increasing the Partnership’s visibility

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3. ACHIEVEMENTS OF THE PARTNERSHIP DURING 2018

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SUMMARY OF ACHIEVEMENTS Implementation of projects, including:

- Better prevention, identification and reporting of work-related and occupational diseases and emerging risks.

- Northern Dimension Antibiotic Resistance Study (NoDARS).- Northern GLASS.- Surveillance of Alcohol and drug use among hospitalized somatic

patients.

Initiation, planning, participation in and following up on various regional initiatives, including:

- Development NDPHS flagship project on ageing.- Adoption of the NDPHS Declaration on Alcohol Policy.- Participation in the EU’s Joint Action HA-REACT (Joint Action on HIV and

Co-infection Prevention and harm Reduction).- Engagement in the Nordic Council of Ministers’ Thematic Programme for

Health Promotion and Prevention – Mobilizing Resources for Better Response: HIV and associated infections (2017-2018).

Contribution to regional events, including:

- Seminar “Epidemiology of socially relevant infections and co-morbidities in the Northwest Europe,” 4 June 2018, ST. Petersburg, Russia.

- Northern Dimension Future Forum on Ageing, 28 November 2018, Helsinki, Finland.

- Seminar “Hepatitis as a Co-Infection for HIV and Tuberculosis,” 3-4 December 2018, St. Petersburg, Russia.

Publications, including:- “Antimicrobial resistance of Escherichia coli isolates from outpatient

urinary tract infections in women in six European countries including Russia” in the Journal of Global Antimicrobial Resistance.

- “Large variation in ESBL-producing Escherichia coli carriers in six European countries including Russia” in the European Journal of Clinical Microbiology and Infectious Diseases.

- “Potential years of life lost (PYLL) caused by preventable premature deaths in the Northern Dimension Partnership countries 2003-2013” in the European Journal of Public Health

Collection and dissemination of information, including on: - Control of infectious diseases in prison, especially regarding HIV, TB and

Hepatitis.

4

This section of the Progress Report lists the Action Lines that have been included in the NDPHS Work Plan for 2018 and describes the progress towards achieving them in 2018.

Action Line 1. Working towards implementing the NDPHS Strategy 2020

Consistent with their Terms of Reference, all Expert Groups continued efforts to facilitate the implementation of activities and reaching the targets defined in the Action Plan accompanying the NDPHS Strategy 2020. The Progress Reports of the Expert Groups (Annexes 1-7) list their progress in detail.

Some of the examples include:

The ASA EG was actively engaged in finalizing the study “Surveillance of Alcohol and drug use among hospitalized somatic patients”. The aim of the study is to collect and analyze data on incidence of problematic alcohol use among hospitalized patients admitted to hospital in Oslo (Norway) and Moscow (Russia) and to prepare suggestions for a simple approach to reveal problematic alcohol use among acutely admitted patients and for intervention programmes. As of beginning of 2019, the data is collected and is being analyzed, the resulting publications and presentations at international conferences are under preparation.

The AMR EG completed the Northern GLASS project. At the World Health Assembly 2015, the WHO Member States adopted a resolution on a Global Action Plan to contain antimicrobial resistance (AMR). Among the five strategic objectives in the plan, one is to increase knowledge and evidence through surveillance. For this purpose a harmonized global antimicrobial resistance surveillance system (GLASS) was developed by the WHO and launched for enrollment in 2016. The aim of Northern GLASS was to collect feedback on the supportive material for early implementation of GLASS developed by the WHO, and on the countries’ process during 2016 of the early implementation of the surveillance system as such.

The HIV, TB & AI EG, together with the PH EG, have organized a joint meeting, which demonstrated success, and the practice of joint meetings with other NDPHS Expert Groups is suggested to be continued. The Group aims at enhanced international and multi-sectorial stakeholder cooperation on HIV, TB and AI-related issues in the Northern Dimension area, with inclusion of NGOs and broader society representatives, and the regular meetings of the EG constitute a well-functioning platform and offer opportunities to raise, discuss an agree on involvement into other relevant platforms. The Group is actively involved in various regional activities and programs, including the Nordic Council of Ministers’ Thematic Programme for Health Promotion and Prevention – Mobilizing Resources for Better Response: HIV and associated infections (2017-2018).

The NCD EG has contributed to two project applications submitted to the Interreg for funding: “A Platform to Strengthen Health Literacy in the Baltic Sea Region” and “Healthy Boost – Urban Labs for Better Health for All I the Baltic Sea Region – boosting cross-sectorial cooperation for health and wellbeing in the cities”. The Healthy Boost project was successful in obtaining the sought finding. Two scientific publications have been submitted – “Potential years of life lost (PYLL) caused by preventable premature deaths in the Northern Dimension

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Partnership countries 2003-2013” in the European Journal of Public Health and “Control of alcohol consumption in the countries of Northern Dimension Partnership in Public Health and Social Well-being” in the Cardiovascular Therapy and Prevention Journal.

The PHC EG focus has been on creating more in-depth knowledge among health and social care administrators on the resource allocation and incentives to support integrated and coordinated care for patients with multi-morbidities, including in the framework of a project “Assessment and development of recommendations to improve medical and social outpatient care for patients with chronic non-communicable comorbidity in the Northwest Federal District of the Russian Federation in cooperation with other countries operating within the NDPHS”.

The PH EG has developed a draft report on prison health1 based on a survey of several countries (Latvia, Russia, Germany and Finland). The report covers countries with different social economic situations, thus providing objective information about the real situation in the region. Next steps will be the drafting of recommendations as well as the distribution to policy makers as well as national institutes.

Action Line 2. Implementing new approaches for collaboration within the NDPHS

All Expert Groups have been engaged in developing a common NDPHS flagship project, which for the first time in the NDPHS history involves all NDPHS Expert Groups. The central topic to be addressed will be health of senior citizens. This NDPHS umbrella project will contribute to the process of advancing health and well-being of people in their older age and ensuring enabling and supportive environments for that. The unique method of cooperation within the Partnership where experts and policy makers engage in a direct dialogue, would be a key foundation to make this joint ambition to become a reality. In 2018 two workshops with participation of all Expert Groups and the NDPHS Secretariat have been organized to further develop the flagship idea: one workshop on 14 May 2018 in Stockholm, Sweden and the second one on 24 October 2018 in Oslo, Norway. In late 2018 the Swedish Institute’s Seed Money Funding became available and the Secretariat prepared a seed money project application “Roadmap to improve health and wellbeing of ageing population in the BSR: AgeFLAG,” which was submitted to the Swedish Institute for funding on 6 February 2019.Action Line 3. Leading and coordinating the Health Policy Area in the EU

Strategy for the Baltic Sea Region Action Plan

The role of the NDPHS as the “Health” Policy Area Coordinator within the EUSBSR allows for making health more integrated and inclusive in the regional cooperation. Most of the EUSBSR-related activities are coherent with the NDPHS mission and strategic aims, with the main focus on increased visibility and better influence in processes related to allocation of funding for regional cooperation. The instrument of the EUSBSR enables the Partnership to strengthen the message that improving and promoting people’s health and well-being is an important precondition for ensuring sustainable and healthy societies and economic growth.

In 2018 the NDPHS Secretariat completed the implementation of the EU co-financed project “Support to coordination and implementation of activities within the EUSBSR 1 Available at: https://www.ndphs.org/?mtgs,ph_6__copenhagen.document.docx 6

https://www.ndphs.org/?mtgs,ph_6__copenhagen

Policy Area “Health” (“PA Health Support 2”) and successfully submitted an application for an EU co-financed “PA Health Support 3” project.

The revision of the EUSBSR Action Plan was initiated in 2018 and the CSR held the first exchange of opinion on the importance of health remaining included in the revised EUSBSR Action Plan.

Action Line 4. Increasing the Partnership’s visibility

In 2018 efforts continued to increase the Partnership’s visibility by including provisions regarding the NDPHS in relevant high-level and other documents and making presentations at national and international conferences and other events.

The NDPHS’ visibility was promoted during various events, including:

26th Meeting of the BEAC Joint Working Group on Health and related Social Issues, 22-23 March 2018, Kirkenes, Norway;

9th Annual Forum of the EU Strategy for the Baltic Sea Region, 4-5 June 2018, Tallinn, Estonia;

“Health Systems for Prosperity and Solidarity – leaving no one behind”High-level regional meeting, 13–14 June 2018, Tallinn, Estonia;

27th Baltic Sea Parliamentary Conference, 26-28 August 2018, Mariehamn, Åland Islands;

E-health for Regions Network Executive Steering Committee; E-health Innovation Days, 6-7 September 2018, Flensburg, Germany;

68th session of the WHO Regional Committee for Europe, 17-20 September 2018, Rome, Italy;

Northern Dimension Future Forum on Healthy Ageing, 28 November 2018, Helsinki, Finland.

The NDPHS visibility was further promoted via different publications, including in scientific journals, as presented in the individual Expert Groups’ Progress Reports.

The NDPHS Secretariat continued maintaining the NDPHS website and the NDPHS Chair Country and co-Chair Countries continued reaching out both to Partner Countries and other stakeholders to promote the visibility of the Partnership.

At the end of 2018 an NDPHS Facebook and LinkedIn pages have been created to share the NDPHS’ work with a larger audience.

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Annex 1

AMR EG

Policy document/project name: Progress report for AMR-EG

1. Summary of activity

NDPHS Strategy 2020 objectives (list the relevant Strategy objectives to which the policy/project contributes)

NDPHS Objective 2: Contained antimicrobial resistance – through inter-sectoral efforts supporting the implementation of regional and global strategies and/or action plans

NDPHS Strategy 2020 cross-cutting themes (list the relevant Strategy cross-cutting themes to which the policy/project contributes)

Not applicable

Horizontal results (list NDPHS Action Plan horizontal results toward achievement of which the policy/project contributes)

Horizontal result 2. Strengthened support and involvement of other stakeholders in the

NDPHS-facilitated activities (WHO Euro, the ECDC)

Immediate objectives (list immediate objectives, such as: development and dissemination of policy recommendations, a report, a review, a strategy, a thematic paper, etc.)

AMR-EG reported on two projects (NoDARS and NorthernGLASS) related to the first (out of three) work-streams in the action plan: “More representative and comparable AMR surveillance systems developed for implementation in the NDPHS Partner Countries” in 2018.

NorthernGLASS

The project was finalized in 2018 and one of the results, a technical report, was circulated to participants and stakeholders, mainly the WHO and ECDC. The report from Northern

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GLASS has also been included into the background material for the upcoming revision of GLASS. A project summary has been published on the web (https://www.folkhalsomyndigheten.se/publicerat-material/publikationsarkiv/e/early-implementation-of-the-who-global-antimicrobial-resistance-surveillance-system-glass/) and shared with WHO EURO. The project was funded by the Swedish Institute.

NoDARS

Two scientific papers have been published:

1/ Ny S, Edquist P, Dumpis U, Gröndahl-Yli-Hannuksela K, Hermes J, Kling AM, Klingeberg A, Kozlov R, Källman O, Lis DO, Pomorska-Wesołowska M, Saule M, Wisell KT, Vuopio J, Palagin I; NoDARS UTIStudy Group. Antimicrobial resistance of Escherichia coli isolates from outpatient urinary tract infections in women in six European countries including Russia. J Glob Antimicrob Resist. 2018 Nov 15;17:25-34. doi: 10.1016/j.jgar.2018.11.004.

2/ Ny S, Kozlov R, Dumpis U, Edquist P, Gröndahl-Yli-Hannuksela K, Kling AM, Lis DO, Lübbert C, Pomorska-Wesołowska M, Palagin I, Vilde A, Vuopio J, Walter J, Wisell KT; NoDARS ESBL-carrier working group.

Large variation in ESBL-producing Escherichia coli carriers in six European countries including Russia. Eur J Clin Microbiol Infect Dis. 2018 Dec;37(12):2347-2354. doi: 10.1007/s10096-018-3382-8.

The project was co-funded by the European Commission.

AMR-EG, with Germany as the lead country, also developed a project “Network to improve use of AMR surveillance data for treatment guidelines” which was submitted to JPIAMR for funding, but was not accepted.

Immediate & ultimate beneficiaries (immediate beneficiaries are the

The immediate beneficiaries from the NoDARS results are stakeholders concerned with the effects of AMR, those developing treatment guidelines and thus ultimately the

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groups/entities who will be directly positively affected by the action, e.g. policy makers; ultimate beneficiaries

are those who will benefit from the action in the long term at the level of the society or sector at large)

population of the Baltic Sea region.

Immediate beneficiaries from Northern GLASS are participating countries working on implementation of GLASS. Ultimate beneficiaries include the WHO, ECDC and all countries, not only in the region, but also in all of Europe and worldwide e.g. policy makers of the member countries as GLASS will be implemented world-wide.

Area covered

(list countries/regions/municipalities, etc.)

All AMR-EG member states

Implementing organization (list the NDPHS structures/other organizations, institutions and experts leading the implementation of the activity)

None other than the EG and identified technical focal points in each country, respectively.

Essential partners (list organizations, institutions and experts engaged in the activity)

Russia: The Institute of Antimicrobial Chemotherapy (IAC), Smolensk State Medical University (SSMU)Latvia: Centre for Disease Prevention and Control, Ministry of HealthLithuania: Institute of Hygiene and The National Public Health Surveillance LaboratoryPoland: Institute of Occupational Medicine and Environmental Health, SosnowiecFinland: National Institute for Health and Welfare (THL) and University of TurkuGermany: The Robert Koch-Institut (RKI)

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Norway: Norwegian Institute of Public Health and University Hospital of North Norway (Tromsö)

Sweden: Public Health Agency of Sweden (PHAS) Estonia: Public Health Department and the Ministry of Social Affairs Iceland: Natural Resources and Environmental Affairs, Directorate for International and Security Affairs

Budget (specify the budget of the activity in EUR)

All expenses incurred by the representatives to attend Expert Group meetings have been covered by their respective countries or organizations.

Financing agency (specify financing agency/agencies and the amount of funding (in EUR) granted by each financing agency)

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2. Progress in the implementation in 2018

Expected result(as specified in

the NDPHS Action Plan)

Target(as specified in the NDPHS Action Plan)

Progress toward target

(use the indicator as specified in the NDPHS

Action Plan)

Further action required, obstacles,

comments

Sustainability and expected long-term impact

(Describe: 1) how the results of the NDPHS activity are/will be

used and how the follow-up and sustainability of the results will

be ensured, and 2) expected impact of the

NDPHS activity)

1. More representative and comparable AMR surveillance systems developed for implementation in the NDPHS Partner Countries

1.1 Each country should have 50% population coverage of EARS-Net or CEASAR

1.1 Partly achieved

Present in: Finland (>98% coverage), Latvia, Lithuania, Norway and Estonia (100% coverage)

Sweden >70% coverage.

Target 1.1. is difficult to assess for many countries according to ECDC experiences.

Implementation of GLASS will support reaching this target eventually, but at a future horizon. Accordingly, the AMR-EG has agreed to focus on the support of early implementation of GLASS.

Activities within the project align with the original target “Support

1/ All efforts made within workstream 1 contribute to the realization and impact of objective 2 in the NDPHS Strategy 2020 i.e., contained antimicrobial resistance - through inter-sectoral efforts supporting the implementation of regional and global strategies and/or action plans.

Results from expanded surveillance of AMR will increase knowledge about the problem in different settings in the region, inform treatment guidelines for common

1.2 Data on ESBL carriage rate should be in place

1.2 Partly achieved

Available in: Finland, Germany, Latvia, Norway Poland, Russian Federation and Sweden

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the development of methodology for CAESAR/EARS-NET and other systems/network of laboratories”, and also with target 1.3 resistance data on E. coli causing uncomplicated UTI.

infections of public health importance and guide interventions to contain AMR at all levels; from regional to national and local.

2/ The lessons learned from NorthernGLASS will be very useful for further implementation not only in the region but also in the rest of Europe and worldwide. The best use of the experience will be through close collaboration with the WHO and its partners for implementing GLASS globally. They have informed the ongoing revision of GLASS led by the WHO.

1.3 Countries should have data on resistance levels in E. coli causing uncomplicated UTIs in place

1.3 2 Partly achieved through NoDARS project in: Finland, Germany, Latvia, Poland, Russian Federation and Sweden

NoDARS article published

1.4 All countries should have registered for GLASS

1.4 Almost achieved

All countries but Estonia have registered

1.5 All countries should upload data to GLASS.

1.5 Partly achieved

Done by: Finland, Germany, Latvia, Norway, Russian Federation and Sweden

2. Improved measurement and monitoring of antibiotic use in the Northern Dimension Area

80% of the NDPHS Partner Countries should have national data on antibiotic consumption gathered according to international standards (e.g. ESACNet/ WHO

Achieved by all countries

Due to limited capacity in partner countries, the AMR-EG have only managed to update the present situation according to progress indicators in each country, respectively, but no specific activities were undertaken.

1/ As for AMR surveillance, coordinated harmonized surveillance of antibiotic use and antibiotic consumption according to standard indicators is essential to identify areas for interventions needed nationally and regionally.

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ESAC Working group methodology) Targets defined in the

2015-2017 action plan: to collect and analyze data and disseminate information on antibiotic use in the NDPHS

Partner Countries, and implementation of activities to measure antibiotic use against existing key indicators, will be actions more specifically addressed during 2018-2020.

2/ Findings will help to guide interventions to reach a more prudent use of antibiotics in the region, thereby hopefully reducing the speed at which AMR is increasing.

3. Increased awareness of Prescribers and policymakers on the antibiotic resistance situation in the Northern Dimension area and on specific measures to be taken

3.1 80% of the NDPHS Partner Countries should have a dedicated governmental budget where AMR prevention and control is acknowledged and supported

3.1 The target has partly been achieved as all partner countries have developed national strategies aligned with the WHO Global Action Plan to contain AMR. Most countries also have corresponding action plans, but financing of these action plans are still an issue for some countries.

Due to limited capacity in partner countries, the AMR-EG has so far only managed to update the present situation according to progress indicators in each country, respectively.

A project proposal addressing this area was developed and submitted to JPI AMR for funding.

1/ The NDPHS may provide an opportunity to create a forum, or platform, to share and agree on some guidelines for diagnosis and treatment (and when to refrain from treatment) of common infections in primary care.

2/ Good examples of how to develop, implement and follow-up compliance to treatment guidelines can promote a

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There is also a need to raise more awareness about the differences and unequal access to key antibiotics used for treatment of common infections in general practice in the partner countries.

prudent use of antibiotics in the region.

3.2 All countries should have a national action plan on AMR

3.2 Partly Achieved

Present in: Finland, Germany, Lithuania, Norway, Russia and Sweden

Annex 2

ASA EG

Progress report for 2018

Policy document/project name: Surveillance of Alcohol and drug use among hospitalized somatic patients



Reduced social and health harm from alcohol, tobacco and illicit use of drugs - through strengthening and promotion of multi-sectoral approaches

NDPHS Strategy 2020 cross-cutting themes (list the relevant Strategy cross-cutting themes to which the

Health equity and social cohesion in all actions

Innovative approaches and technologies

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policy/project contributes)


- Strengthened support and involvement of other stakeholders in the NDPHS facilitated activities

- Increased and strengthened policies to improve health and social well-being through regional cooperation

- Increased and strengthened project-to-policy cycle approach in regional cooperation in the area of health and social well-being


- Collect and analyze data on incidence of problematic alcohol use among hospitalized patients admitted to hospital in Oslo (Norway) and Moscow (Russia)

- To come up with suggestions for a simple approach to reveal problematic alcohol use among acutely admitted patients and for intervention programmes

- Develop project report, publish peer-reviewed articles on the project results, present findings at the Conferences and disseminate findings among the partner countries (including the NDPHS web page )

Immediate & ultimate beneficiaries (immediate beneficiaries are the groups/entities who will be directly positively affected by the action, e.g. policy makers; ultimate beneficiaries


Immediate beneficiaries: National Health Authorities. Hospital and primary health care institutions.

Ultimate beneficiaries: Patients treated for somatic illness in hospitals

Area covered

(list countries/regions/municipalities,

Norway and Russia

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etc.)


Oslo University Hospital (OUH) and Moscow Research and Practical Centre on Addictions (MRPCA)


ASA EG, experts from OUH and MRPCA

Budget 2.3 mln NOK


Royal Norwegian Ministry of Health and Care Services

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2. Progress in the implementation of activity in 2018



Target(as specified in



(use the indicator as

specified in the NDPHS Action

Plan)

Further action required, obstacles, comments


(Describe: 1) how the results of the NDPHS activity are/will be used and how the follow-up and sustainability of the results will be ensured, and 2) expected impact of the NDPHS

activity)

1.Improved implementation of early identification and brief intervention programs/measures to reduce alcohol- and drug use-related harm

Two countries with drafted/adopted national guidelines on early identification and brief intervention

During the study, blood samples from 3191 patients were collected, and 3085 of them also agreed to participate in the study. An agreement was signed to implement the third round of the project, mainly analyze of collected data and development of the study report. In 2018 the dataset on both sites were cleaned, and analysis of data began. First manuscript was submitted in November 2018, and is now under review. Two more papers

1) The so-called AUDIT system (for the brief interventions) was evaluated to define some major questions that are necessary to define the harmful use of alcohol. The practical recommendations in this respect will be developed and presented to the practitioners. 2) To validate the AUDIT questionnaire and to provide some guidelines for the GP, on how they can discover the alcohol problems among their patients. Therefore introduction of more targeted approach in early detection and prevention among the people with somatic illness and problematic alcohol use. Agreement reached with the WHO Euro office in Moscow, that the study results will be used by the WHO for this purposes

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were initiated in 2018 and will be submitted in 2019. Preliminary findings have been presented to stakeholders both in Norway and Russia.

The results of the project were presented and discussed at the NDPHS meetings, inviting other interested countries to introduce the same type of research.

(validation of the AUDIT)

3) The results can be used to improve the somatic healthcare for patients with problem alcohol or drug use. The results show that many patients would have benefited from some sort of intervention or at least information about how alcohol or other substances might impact their health. So the specialist healthcare service is the right place to identify the problem, and it is foreseen that the study result might improve the coordination between other care providers. As treatment of these problems has best effect in e.g. primary healthcare.

4) A report will be published in late 2019 with key results and description of possible measures, to improve the healthcare for these patients. Before the summer, we will decide how to move forward with new projects based on the results of the current.

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Policy document/project name: NDPHS Declaration on Alcohol Policy






Innovative approaches and technologies

The ‘Health in All Policies’ approach


Increased visibility of the NDPHS in the Partner Countries

Increased and strengthened policies to improve health and social well-being through regional cooperation


Development of the NDPHS Declaration on Alcohol Policy, adopted by the partner countries and organizations

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Immediate beneficiaries: Policy makers of the member countries

Ultimate beneficiaries: General population

Area covered


NDPHS


ASA EG


ASA EG, The Swedish Council for Information on Alcohol and Other Drugs (CAN), WHO, National Institute for Health and Welfare (THL, Finland), Nordic Alcohol and Drug Policy Network (NordAN), Polish governmental agency PARPA (The State Agency for the Prevention of Alcohol-Related Problems)

Budget (specify the budget of the

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activity in EUR)


Norwegian Ministry of Health and Care Services

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Progress toward target(use the

indicator as specified in the NDPHS Action Plan)



(Describe: 1) how the results of the NDPHS activity are/will

be used and how the follow-up and sustainability of the

results will be ensured, and 2) expected impact of the

NDPHS activity)

Strengthened knowledge base for the planning of public health policies on alcohol and drugs

PAC side event Organized, declaration developed

Declaration adopted

Countries follow up on their decisions and actions elaborated at the declaration.

Information sharing and communication on policies and best practices related to the prevention of harmful use of alcohol

ASA EG develops tool to monitor the implementation of the declaration.

1) Advocacy by the NDPHS structures (Secretariat, CSR, EGs) in order to get the attention of the High Political level.

2) Recognizing that the harmful use of alcohol is a problem for all Partner Countries that requires multi-sectorial action and regional co-operation

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Policy document/project name: Response to problem use of cannabis and cannabis dependence in ND countries








Strengthened and more visible role of health and social well-being on the regional agenda in the Northern Dimension area

Increased and strengthened project-to-policy cycle approach in regional cooperation in the area of health and social well-being



Situational review and the development of the report

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Immediate & ultimate beneficiaries (immediate beneficiaries are the groups/entities who will be directly positively affected by the action, e.g. policy makers; ultimate beneficiaries are those who will benefit from the action in the long term at the level of the society or sector at large)



Area covered


Estonia, Lithuania, Latvia, Poland, Sweden, Finland, Norway and Russia


ASA EG


ASA EG members, The Institute of Psychiatry and Neurology (Poland), EMCDDA


Financing agency (specify financing agency/agencies and the amount of funding (in EUR) granted

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by each financing agency)








Action Plan)


comments



activity)


No. of countries having available and comparable data on responses to illicit drug challenges

a) Questionnaire developed

b) Five areas to be covered by the report are identified: supply reduction, prevention, treatment, public debate and policy management

Finalization of the questionnaire, distribution among the ASA EG member countries, collection of answers, analyze and development of the first draft of the report.Unfortunately not all countries responded in time, that lead to the delay in the preparation of the report

1)It will provide an overview of evidence and current practice in the NDPHS partner countries for those with an interest in this topic as well as to inform debate

2) To organize in cooperation with the WHO Euro, a seminar to discuss the dynamic and complex policy related to Cannabis.

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Policy document/project name: Development of the third Thematic report on Alcohol policies in the NDPHS Countries








Strengthened and more visible role of health and social well-being on the regional agenda in the Northern Dimension area

Increased and strengthened project-to-policy cycle approach in regional cooperation in the area of health and social well-being



Situational review and the development of the report

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Area covered


Estonia, Lithuania, Latvia, Poland, Sweden, Finland, Norway and Russia


ASA EG


The Institute of Psychiatry and Neurology (Poland), Moscow Research and Practical Center on Addictions, ASA EG members


7000 Euro

Financing agency (specify financing agency/agencies and the

Royal Norwegian Ministry of Health and Care Services

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amount of funding (in EUR) granted by each financing agency)








Action Plan)


comments



activity)


No. of countries having available and comparable data on:

(a) Drinking habits and patterns

Questionnaire developed.

Three areas to be covered by the report Prevention of Alcohol consumption among the Pregnant women, Prevention of alcohol consumption at the work place and prevention among

Questionnaire developed and distributed among the ASA EG and OSH EG members (part related to the prevention at the work place) collection of answers, analyze and development of the first draft of the report. Relevant publications and best experiences

1) It will provide an overview of general situation in Alcohol consumption based on the RARHA study and the current practices in the three specific topics identified by the report.

2) To compare policies implemented by the NDPHS countries, share the results and to develop a better policies.

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the elderly population from around the

world and for international sources have been summarized Unfortunately not all countries responded in time, that lead to the delay in the preparation of the report

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Annex 3

HIV/AIDS & AI EG


Policy document/project name: Regular meetings of Expert Group on HIV, TB and AI



Objective 1: Reduced impact of HIV, TB and associated infections among key populations at risk, including prisoners, through strengthened prevention and access to treatment



Inclusion of people in vulnerable situations in all actions of relevance


Increased visibility of the NDPHS and of the Expert Group in the Partner Countries

Immediate objectives (list immediate objectives, such as: development and dissemination of policy recommendations, a report, a review, a strategy, a

Country overviews or presentations prepared by experts of general character or on a special theme. A meeting may decide about actions/assignments to be implemented by EG experts in between meetings, including preparation of special material (articles, briefs, posts, etc.)

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thematic paper, etc.)



NDPHS CSR members

Policy makers from NDHPS area

Area covered


NDPHS members


EG on HIV, TB and AI


EG experts

Budget (specify the budget of Travel and participation costs by experts and host organizationdocument.docx 33

the activity in EUR)

Financing agency None

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(use the indicator as specified in the

NDPHS Action Plan)



(Describe: 1) how the results of the NDPHS activity are/will be used and how

the follow-up and sustainability of the results will be ensured, and

2) expected impact of the NDPHS activity)

1. Enhanced international and multi-sectoral stakeholder cooperation on HIV, TB and AI-related issues in the Northern Dimension area, with inclusion of NGOs and broader society representatives

2-3 more HIV, TB and AI stakeholder cooperation platforms involving NGOs and representatives of other sectors

The regular meetings of the EG constitutes a well-functioning platform and offers opportunities to raise, discuss and agree on involvement into other relevant platforms

In spring, a joint meeting with the Prison Health EG was organized and demonstrated success. The practice of joint meetings with other EGs should continue.

The activity seems to be sustainable as the EG experts are nominated by respective NDPHS members and have budgets for participation at EG meetings. Meeting reports are prepared and decisions made at meetings are followed up by the EG leadership. Besides, the EG meeting is the key body to agree on EG’s yearly plans of actions. The range of such actions may vary from development of policy recommendations to participation at an event to making an article for the NDPHS news bulletin.

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Policy document/project name: Participation in EU’s Joint Action HA-REACT (Joint Action on HIV and Co-infection Prevention and Harm Reduction)



Reduced impact of HIV, TB and associated infections among key populations at risk, including prisoners, through strengthened prevention and access to treatment


- Health equity and social cohesion in all actions- Innovative approaches and technologies- Inclusion of people in vulnerable situations in all actions of relevance




Regular update of EU’s Joint Action HA-REACT on developments in EG on HIV, TB and AI and relevant NDPHS news, and vice versa

Consideration of HA-REACT’s results and activities for possible use by the EG experts


Immediate: EG experts

Ultimate: people living with HIV, TB and AI and populations at risk

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Area covered(list countries/regions/municipalities, etc.)

NDPHS Partners


Chair and ITA are nominated by Finland. All ND partners nominate their experts to the Expert Group and ensure their work as members of the EG and attendance of events organized or promoted by the EG.


Poland and Latvia hosted the EG meetings in 2018.


Own resources related to participation at meetings

Financing agency (specify financing agency/agencies and the amount of funding (in EUR) granted by each financing

Travel budget allocated for Chair/nominated representative of EG on HIV, TB and AI

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agency)

document.docx 38








NDPHS Action Plan)






Enhanced international and multi-sectoral stakeholder cooperation on HIV, TB and AI-related issues in the Northern Dimension area, with inclusion of NGOs and broader society representatives.

Enlarging the number of HIV, TB and AI stakeholder cooperation platforms involving NGOs and representatives of other sectors

No. of HIV, TB and AI stakeholder cooperation platforms involving NGOs and representatives of other sectors

- EG Chair participated at the meetings of the Advisory Board and the Final Conference of the HA-REACT, and coordinator of HA-REACT attends

- Linkage with the HA-REACT Project is strong and sustainable

-At the moment, the EG has no nominated experts from the WHO or ECDC

Results, achievements and news of the HA-REACT Joint Action are disseminated through the EG network, and vice versa. The place on the advisory board gives a strong voice and resonance to produced advice.

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meetings of the EG

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Policy document/project name: Engagement into implementation of the Nordic Council of Ministers’ Thematic Programme for Health Promotion and Prevention - Mobilizing Resources for Better Response: Immunodeficiency virus and associated infections (HIV&Co) 2017-2018





- Innovative approaches and technologies- Inclusion of people in vulnerable situations in all actions of relevance


- Strengthened support and involvement of other stakeholders in the NDPHS-facilitated activities

- Increased and strengthened policies to improve health and social wellbeing through regional cooperation


Contribution of NDPHS Partners (mainly from Nordic Countries) to the Programme implementation through advice provision and expertise sharing

Immediate & ultimate NCM Programme’s partners and EG expert organisations from Nordic Countries

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beneficiaries (immediate beneficiaries are the groups/entities who will be directly positively affected by the action, e.g. policy makers; ultimate beneficiaries


Area covered


Nordic Countries and Northwest Russia


THL as the Lead Partner, Swedish Public Health Agency as Nordic Partner


See above (THL Finland and Public Health Agency of Sweden)

Pavlov Medical State University, St. Petersburg

NW Russian regional health authorities (ministries of health)

Budget (specify the budget of Approx. 800,000 euros

document.docx 42

the activity in EUR)

Financing agency (the amount of funding (in EUR) granted by each financing agency)

Nordic Council of Ministers

document.docx 43








NDPHS Action Plan)


comments



activity)

Improved effectiveness of HIV, TB and AI prevention actions in the Northern Dimension area

3-4 prevention actions supported by 2020

No. of national prevention actions supported

- THL was responsible for planning the Programme

- EG experts from Nordic Countries contributed to the planning process

EG Chair participated at the final conference of the NCM Programme on 3 October in St. Petersburg and delivered a presentation about the NDPHS and EG activity and encouraged further cooperation on communicable disease control in the ND area. In spring 2019, the Nordic Council of Ministers will launch an open call for proposals, which can be used as a financial instrument for smaller projects

It is assumed that the EG experts and their organisations will tighten cooperation with NW Russia on communicable disease control.

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between organisations in Nordic Countries and NW Russia.

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Policy document/project name: Seminar “Hepatitis as a Co-Infection for HIV and Tuberculosis”, 3-4 December 2018, St. Petersburg





- Inclusion of people in vulnerable situations in all actions of relevance- Innovative approaches and technologies



- Increased visibility of the NDPHS in the Partner Countries


Sharing information, practices and experiences about hepatitis prevention, diagnostics and treatment in ND area (Nordic, Baltic countries, Germany and NW Russia)

Immediate & ultimate beneficiaries (immediate

Immediate: Infectious disease doctors from NW Russia (St. Petersburg, Pskov Region, Kaliningrad Region, Murmansk Region, Republic of Karelia, Republic of Komi, Vologda

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beneficiaries are the groups/entities who will be directly positively affected by the action, e.g. policy makers; ultimate beneficiaries


Region, Novgorod Region, Leningrad Region and Arkhangelsk Region). Experts from Finland, Sweden, Norway, Lithuania, Germany.

Ultimate: patients and at-risk population

Area covered(list countries/regions/municipalities, etc.)

Finland, Norway, Sweden, Lithuania, Germany and particularly Russia


Consulate of Finland to St. Petersburg


Expert Group on HIV, TB and AI


about 8,000 euros

Financing agency (specify financing agency/agencies and the amount of funding (in EUR) granted by each financing

Finnish Ministry of Foreign Affairs

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agency)

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NDPHS Action Plan)






Improved evaluation of interventions, monitoring, data collection and reporting of the situation of HIV, TB and AI among key populations at risk and policy/action response in the Northern Dimension area

At least 2 monitoring and best practice reports produced and disseminated to decision-makers and general public

Updated information about the epidemiological situation and practices in various ND countries and NW Russian regions was collected for further analysis

Hepatitis is often shaded by HIV and TB, though it produces heavy burden on public health and health expenditures. Hep. C is frequently diagnosed among IDUs. The discourse of co-morbidity should include hepatitis in addition to HIV and TB.

Presentations with epidemiological profiles and practices prepared by experts from Finland, Sweden, Norway, Lithuania, Germany and Russia and delivered to a big audience of Russian professionals from different regions and uploaded to the net and disseminated further.

There are discussions in Russia about integration of HIV and TB services into the infectious disease control service.

The cooperation may receive continuation in 2018.

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Policy document/project name: Seminar “Epidemiology of socially relevant infections and co-morbidities in the northwest Europe”, 4 June 2018, St. Petersburg





- Inclusion of people in vulnerable situations in all actions of relevance- Innovative approaches and technologies



- Increased visibility of the NDPHS in the Partner Countries


Sharing latest information about HIV situation in Nordic Countries and activity of the NDPHS EG on HIV, TB and AI

Immediate & ultimate Immediate: Infectious disease doctors and epidemiologists from NW Russia

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beneficiaries (immediate beneficiaries are the groups/entities who will be directly positively affected by the action, e.g. policy makers; ultimate beneficiaries


Area covered


HIV situation in Finland, Norway, Sweden is presented


Pasteur Institute in St. Petersburg / Northwest Russian AIDS Centre


Expert Group on HIV, TB and AI, particularly from Finland, Sweden and Norway, who provided updates about HIV situation and interventions in their respective countries


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Financing agency

document.docx 52








NDPHS Action Plan)






Enhanced international and multi-sectoral stakeholder cooperation on HIV, TB and AI-related issues in the Northern Dimension area

Enlarging the number of HIV, TB and AI stakeholder cooperation platforms involving NGOs and representatives of other sectors

Firm bonds are forged with the Pasteur Institute in St. Petersburg, where the Northwest Russian AIDS Centre is stationed.

The EG is regularly invited to conferences and seminars organized by Pasteur Institute in St. Petersburg. The EG is also interested in inviting experts from Pasteur Institute but their attendance is hampered by lack of funds for travels.

It is expected that Pasteur Institute will organize 1-2 events in St. Petersburg in 2019, and the EG will be invited. The conferences provide a good opportunity to share updates and news, and promote visibility of the NDPHS.

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Annex 4

NCD EG


1. Summary of activity of the NCD EG

Policy document NCD EG.

Goal: to reduce the impact of non-communicable diseases (NCDs) – through strengthening prevention and addressing lifestyle- related risk factors.


Objective:

3. To reduce the impact of non-communicable diseases (NCDs) – through strengthening prevention and addressing lifestyle- related risk factors;


1. Health equity and social cohesions in all actions.

2. Innovative approaches and technologies.

3. The “Health in All Policies’ approach”.

4. Inclusion of people in vulnerable situations in all actions of relevance.


Horizontal result 1. Strengthened and more visible role of health and social well-being on the regional agenda in the Northern Dimension area;

Horizontal result 2. Strengthened support and involvement of other stakeholders in the NDPHS-facilitated activities;

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Horizontal result 3. Increased and strengthened policies to improve health and social wellbeing through regional cooperation

Horizontal result 4. Increased visibility of the NDPHS in the Partner Countries;

Horizontal result 5. Ensured coherence and mutual support in addressing regional challenges and opportunities in the area of health and social well-being through a successful leadership of the EU Strategy for the Baltic Sea Region’s Health Policy Area.


Development and dissemination of the NCD EG two-year work plans for 2017 and 2018;

- Publishing the Manuscript in the International Journal “Potential years of life lost (PYLL) caused by preventable premature deaths in Northern Dimension partnership countries 2003 – 2013” (in English)

- Publishing the Manuscript “Control of alcohol consumption in the countries of Northern Dimension Partnership in Public Health and Social Well-being”. Cardiovascular therapy and prevention 2018 17(2):4-9, http://dx.doi.org./10.15829/1728-8800-2018-2-4-9 (in Russian).

- Seed-money Project: “For better health – Practical implementation of HiAP in the municipalities for better health for all in the Baltic Sea Region” is finished. Financed by EU Interreg Baltic Sea Region. Results.

- Seed-money Project: "А Platform to Strengthen Health Literacy in the Baltic Sea Region” is an application by the Public Health Agency of Sweden (Sweden is the Lead Country, Co-sponsoring countries: Latvia, Lithuania, Poland, and Russia – under the funding approval)

- Seed-money Project: “Healthy Boost – Urban Labs for Better Health for All in the Baltic Sea Region - boosting cross-sectoral cooperation for health and wellbeing in the cities” is proposed for the NDPHS Flagship Project

- Participation in NDPHS PAC-13 side-event (8th of February 2018, Tallinn, Estonia); 13th PAC (9th of February 2018, Tallinn, Estonia); ASA EG meeting (13th of March 2018, Moscow, Russian Federation); 24th meeting of the EG Chairs and ITAs and communication workshop (25-26 April 2018, Riga, Latvia); 29th meeting CSR (26-27th of April 2018, Riga, Latvia); 25th meeting of the EG Chairs and ITAs and communication workshop (16th of April 2018, Riga, Latvia); 30th meeting CSR (17-18th of October 2018, Riga, Latvia).

- Increasing the level of activity in between the meetings by alternative means of document.docx 56

communication, such as telephone and video conferencing, Skype, etc.;


Immediate beneficiaries: Public, politicians, stakeholders at various levels, including national or regional and local community, administrators and health care providers.

Ultimate beneficiaries: general population who avoided NCD development.

Area covered


Finland, Latvia, Lithuania, Norway, Poland, Russia, Sweden


Russian Federation as a Lead Partner, and WHO Regional Office for Europe,

Geographically Distant Office on Prevention and control of Non-communicable diseases as Co-Lead Partner

NCD EG secretariat: Prof. Rafael Oganov (Russia) – Chair

Mr. João Breda – Co-Chair

Ms. Galina Maslennikova (Russia) - Vice-Chair

Ms. Asiia Imaeva (Russia) - ITA


Finland – National Institute for Health and Welfare; University of Eastern Finland,

Latvia – Ministry of Health; Cross-Sectoral Cooperation Unit, Department of Public Health; Centre for Disease Prevention and Control

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Lithuania – Ministry of Health; Centre for Health Education and Disease Prevention; Institute of Hygiene

Norway – Department of Public Health

Norwegian Ministry of Health and Care Services

Poland – Department of Public Health, Ministry of Health; Nofer Institute of Occupational Medicine

Russia – National Medical Research Centre for Preventive Medicine under the Ministry of Health of the Russian Federation

Sweden - Public Health Agency of Sweden

WHO – WHO Regional Office for Europe, Geographically Distant Office on Prevention and control of Non-communicable diseases in the Russian Federation WHO-RUS-GDO


Each partner provides the funding for the activity in the NCD EG, including participation in the NCD EG meetings


Russian Ministry of Health provides funding for NCD EG secretariat activity

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2. Meetings of the NCD Expert Group

15 (5) NCD EG meeting in 2018

Was held in Moscow on 13th April 2018 at National Medical Research Center for Preventive Medicine under MoH of RF (coordinating institute for the NCD activity in the Russian Federation) http://www.ndphs.org/?mtgs,ncd_eg_15__moscow

16 (6) NCD EG meeting in 2018

Was held in Helsinki, Finland on 11-12 October 2018 at the SÄÄTYTALO (House of the Estates)

3. Progress in the implementation of activity in January 2018 – December 2018



Target(as specified in the NDPHS

Action Plan)

Progress toward target(use the indicator as

specified in the NDPHS Action Plan)


Sustainability and expected

long-term impact

“Objectives” as specified in the

NCD EG WP 2018

“Methods” as specified in Elements for the development of the NDPHS

EGs Annual WP

“Planned deliverables” as specified in Elements for the development of the NDPHS EGs Annual WP

1. Better implementation of Health-in-All Policies (HiAP) at

At least 3 more evidence based measures addressing lifestyle related risk factors and health implications developed in the project pilot sites in addition to national actions

No. of evidence- based measures addressing lifestyle-related risk factors and health implications developed in the project pilot sites in addition to

Describe: 1) how the results of the NDPHS activity are/will be used and how the follow-up and

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http://www.ndphs.org/?mtgs,ncd_eg_15__moscow

all levels (local, regional and national) for more effective prevention of non-communicable diseases

Horizontal results laid down in the NDPHS Action plan 2020

1.1 Increased visibility of the NDPHS in the Partner Countries.

1.2 Strengthened national stakeholders, politicians, decision-making people involvement in cost- effective NCD preventing and reducing measures

national action sustainability of the results will be ensured, and 2) expected impact of the NDPHS activity

Promoting NCD prevention programs, such as Good practices through intersectorial collaboration towards to NCDs prevention;

Develop and integrate in the ND Partner Countries’ National action plans, comprehensive, sustainable and transparently monitored measures, including, if appropriate, cross-sectorial measures, tackling NCDs RF;

Elaboration of the Draft Document on Interagency Strategy on Healthy Style promotion, NCD Prevention and Control among the population up to 2025 (Russian Federation)

Project “For better health – practical implementation of HiAP in the municipalities for better health for all in the Baltic Sea Region” received funding with seed money facility

Project “Health Literacy for general population” Agreed by the ND Partner Countries (RF, Latvia, Sweden) under the funding approval. Sweden agreed to be Lead-Partner of the Project

Project ” “Healthy Boost – Urban

Elaboration of the Project based on The Strategy

Defining interested organizations from partner countries for Project elaboration.

Defining co-sponsoring countries and funding sources

Project adaptation and implementation

Implementation in the NDPHS Region

Project development, justification and implementation.

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Scientific paper, based on the PYLL – project results, published in suitable international public health journals and leading national journals of participating countries.

Scientific paper, based on the discussion NDPHS PAC-13 SIDE-EVENT "Harmful use of alcohol in northern dimension area –perspectives and responses".

Labs for Better Health for All in the Baltic Sea Region - boosting cross-sectoral cooperation for health and wellbeing in the cities” received funding with seed money facility.

Published in Finland in the International Journal “Potential years of life lost (PYLL) caused by preventable premature deaths in Northern Dimension partnership countries 2003 – 2013”. Translated in English.

Published in Cardiovascular therapy and prevention “Control of alcohol consumption in the countries of Northern Dimension Partnership in Public Health and Social Well-being” (in Russian – 2018; 17(2):4-9, http://dx.doi.org./10.15829/1728-8800-2018-2-4-9).

Further agreement with Partner Countries on the leading role for guiding the methodology (instrument) preparation and justification

Report on the methodology (instrument)

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Action Plan)





long-term impact


NCD EG WP 2018

“Methods” as specified in Elements for the development of

the NDPHS EGs Annual WP

“Planned deliverables” as specified in Elements for the

development of the NDPHS EGs Annual WP

2. Work together with all stakeholders, under the leadership of public health authorities, to prepare, strengthen and review initiatives in preventing lifestyle-related risk factors through integrated and multi-sectoral

At least 3 more evidence-based measures addressing lifestyle related risk factors and health implications developed in the project pilot sites in addition to national actions

No. of evidence-based measures addressing lifestyle-related risk factors and health implications developed in the project pilot sites in addition to national action

Describe: 1) how the results of the NDPHS activity are/will be used and how the follow-up and sustainability of the results will be ensured, and 2) expected impact of the NDPHS activity

Identifying structures and agencies to be involved in an integrated and multi-sectoral activity for preventing lifestyle-related RFs (harmful use of alcohol, tobacco use, low

Joint actions for stronger involvement of stakeholders, NGOs and private sector (non-state actors) in preventing lifestyle-related NCD RFs - under discussion;

Future agreement Implementation within ND Partners

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activity

physical activity and unhealthy nutrition) in various target groups of the population;Discussion legislative and other regulative initiatives (advertising, prices, taxes, age and time limits for sales, etc.) on reducing harmful use of alcohol, and promoting adequate health-enhancing physical activity and a nutritionally balanced diet in various target groups of population as well as instruments for monitoring of their effectiveness within the ND region;Discussion the role and contribution of professional organizations and private sector (non-state actors) in the counseling and monitoring preventive measures for NCDs and their RFs through the life course;

Promotion of the Project Idea “UP! Eat better – Move more”, use in suitable application processes for funding.

Common indicators for monitoring of the effectiveness of stronger involvement of stakeholders, NGOs and private sector (non-state actors) in preventing lifestyle-related NCD RFs are under adaptation;

Disseminate of the above mentioned agreement via the NDPHS website, newsletter and media events at regional, national or local level, peer reviewed scientific;

Under discussion

Future agreement

Application for elaboration of the Project Idea

Implementation within ND Partners

Implementation within ND Partners.

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Action Plan)





long-term impact


NCD EG WP 2018


EGs Annual WP

“Planned deliverables” as specified in Elements for the

development of the NDPHS EGs Annual WP

3.Better comprehensive national health care system to response to reduce NCD burden in the ND area


No. of evidence- based measures addressing lifestyle-related risk factors and health implications developed in the project pilot sites in addition to national action


Active discussion of challenges for needed resources (professionals, structures, agencies, funds), their distribution and use for primary and secondary NCD prevention (including the use of evidence-based high-tech and digital applications) in primary health care and social rehabilitation services;

At least 3 partnership countries start project idea (concept) for further developed and all funding application opportunities used;

Defining lead country partner, co-lead partners.

Implementation within ND Partners

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Elaboration of a common instrument for monitoring of national health care system’s effectiveness in addressing NCD prevention and control in collaboration with PHC EG

Further promotion of the Project Idea “DOWN with NCDs”, use in suitable application processes for funding.

Draft report on “Instrument for the assessment of CVD prevention in primary health care with focus on biological risk factors” in the process;

Seeking interested countries for project implementation.

Agreement on report

Defining lead country partner, co-lead partners.

Report

Report

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Action Plan)





long-term impact


NCD EG WP 2018


EGs Annual WP

“Planned deliverables” as specified in Elements for the development of the NDPHS EGs Annual WP

4. Obtaining and promoting mutual interests for collaboration with other NDPHS Expert Groups


No. of evidence- based measures addressing lifestyle-related risk factors and health implications developed in the project pilot sites in addition to national action


Obtaining mutual interested areas for effective preventive measures to reduce NCDs and NCD with at least 3 other NDPHS EGs.

Identifying the best structures, agencies, funds within and outside of the health care systems for interagency, cross-sectoral cooperation;

Searching for financial and personnel resources for operational

Agreeing on mutual interested areas for effective preventive measures to reduce NCD and NCD RFs with PHC EG and ASA EG representatives at the NCD EG meetings in April, 2017 and September, 2017

Discussions on Practical aspects of collaboration are ongoing.

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activities;

5. Streamlining the adjustment of NCD EG Action Plan for 2017-2020 according to suggestions and additions issued by Partner Countries

Continue discussion of project ideas for 2017-2021; adoption of the Progress Report for 2018, Action Plan for 2018

Discussion of a structure of the NCD EG Action Plan for 2017-2021;

Define NCD EG Action Plan priority objectives for 2017-2020 that are agreed between the NDPHS Country Partners.

Agreed draft on the NCD EG Action Plan for 2017 – 2020 is adopted

Discussion of the future activity: projects, agreed strategic documents (guidelines, recommendations, policy declarations, other education materials);

Identify target groups, populations for interventions; or interventions.

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Annex 5

OSH EG


Policy document/project name: Better prevention, identification and reporting of work-related and occupational diseases and emerging risks - Prevention Reporting Identification Work-Related and Occupational Diseases



The main NDPHS Strategy objective to which the project “Better prevention, identification and reporting of work-related and occupational diseases and emerging risks” contribute is objective 6: Strengthened occupational safety and health and well-being at work - through information and reporting systems, workplace activities and occupational health services. It partly contributes also to objective 3: Reduced impact of non-communicable diseases - through strengthening prevention and addressing lifestyle-related risk factors.


The project “Better prevention, identification and reporting of work-related and occupational diseases and emerging risks” contributes to the NDPHS Strategy 2020 overall objective “Health equity and social cohesion in all action”. The project aim is also to support the cross-cutting theme “the health in all policies” and “inclusion of people in vulnerable situations”


It can be seen that if the project is successful the results will contribute to all horizontal results. Already in the project planning phase WHO, ILO and EU OSHA were interested in the project which contributes to the horizontal result 3 “Increased and strengthened policies to improve health and social well-being through regional cooperation.”

Immediate objectives (list immediate objectives, such as:

The project “Better prevention, identification and reporting of work-related and occupational diseases and emerging risks” has five specific objectives to fulfil the desired

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development and dissemination of policy recommendations, a report, a review, a strategy, a thematic paper, etc.)

outcomes.

Promote the understanding of the significance of the prevention and reliable statistics of occupational and work-related diseases and emerging risks

Collect national lists and criteria for reporting of occupational and work-related diseases as well as emerging risks and describe the identification and reporting systems in the NDPHS countries.

Detect barriers to identification and reporting of work-related and occupational diseases.

Develop recommendations for improved reporting systems Disseminate and promote the results and recommendations in the NDPHS member

countries.

These project objectives answer especially to the NDPHS action plan objective 6: Strengthened occupational safety and health and well-being at work - through information and reporting systems, workplace activities and occupational health services and it’s expected result 3: Coordinated special national programmes for the development of occupational health services for all working people and sub-objective 6: Better practical implementation of policies by improved information dissemination.

However, it also contributes to the expected result 5: Strengthened training framework for OSH staff in the Northern Dimension area.


are those who will benefit from the action in the long term at the level of the society or

Policy decision makers

OSH experts, specialists and statisticians

Workplaces (entrepreneurs, employers and workers)

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sector at large)

Area covered


OSH EG member countries ( not Island) and Belarus


OSH EG, including member countries, WHO, ILO, EU OSHA, Eurostat


NDPHS member countries


Project idea and preparation of the terms of reference was funded by Ministry of Social Affairs and Health, Finland and supported by OSH EG members and BSN members.

The project got the financing from EU, approximately 200 000 €.


Terms of Reference: Finland, Ministry of Social Affairs and Health

The project: EU

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NDPHS Action Plan)






3. Coordinated special national programmes for the development of occupational health services for all working people

Improve further the quality of occupational health services systems in countries with an

At least 4 countries

No. of countries with programmes with action plan

Will be assessed in the end of year 2017

NOTE! To achieve the final target smaller steps are needed.

The project started in the beginning of year 2017 and ended in the end of 2018.

The country-based answers to survey was analyzed. The final report was evaluated together with the OSH

The results are meaningful to all NDPHS countries as well as in EU and globally. Several interested utilizers are Eurostat, EU OSHA, ILO and WHO.

The NDPHS member countries will in due course re-evaluate their data collection and recording systems related to occupational and work-related diseases.

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operational system.Develop basic occupational health systems concepts in countries in need of improved services. Concept to be approved at the highest political level.

expert group. In the autumn meeting group also discussed recommendations on training and education, and done suggestions.

Group discussed the dissemination of the results of the project. At least following are done:

Scientific article Modernet/Esprit

meeting in Ankara

Other meetings/congresses for dissemination

Rapporteurs' contribution to reporting/publications

Policy document/project name: Developing a methodology to assess country needs for competencies and skills in occupational health and safety (Former A draft questionnaire and survey of quality standards of OH-specialists’ training)

1. Summary of activitydocument.docx 72


Objective 6: Strengthened occupational safety and health and well-being at work - through information and reporting systems, workplace activities and occupational health services

Partly contribute to all other objectives.


Contribute to all four cross-cutting themes


Especially horizontal results 1, 3, 5


To develop a methodology for undertaking national needs assessments for competencies and skills in occupational health and safety

Immediate outcomes:

1. Country experiences in undertaking national needs assessments for competencies and skills in OH&S are identified and analysed (Research)

2. A methodology for undertaking national needs assessments for competencies and skills in OH&S is developed as a collaborative effort between OH&S knowledge agencies, institutions, organizations and experts (Development)

3. Results of country needs assessments are integrated into the strategic planning of OH&S capacity development by the governments in consultation with other relevant stakeholders (Advocacy)


OH specialists

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policy makers

workplaces

Area covered






OSH EG members


Financing agency (specify financing agency/agencies and the amount of funding (in EUR)

Not applied for funding, support from OSH EG member countries and the ILO. Representative from ILO and Estonia have invested in to present and promote the project in OSH EG and ministries of Finland, Estonia and Lithuania cover by their organisations.

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granted by each financing agency)

ILO engaged into resource mobilization.

That mentioned, the ILO is pursuing the development of the project in light of the strategic importance of the issue at stake. We’re exploring possible connection with the larger ILO-OECD-WHO collaboration framework “Working for Health” for the implementation of the recommendations of the High-Level Ministerial Meeting on Health Employment and Economic Growth which I assume you may be familiar with. While there is no direct possibility of integrating the project into some kind of a “Working for (Occupational) Health” component, there appear to be real opportunities for synergy through country level interventions and this is where we intend to invest our follow-up efforts.

We do not see a need to discuss the project again with the OSH EG. Thus, early information on the objective and tentative agenda of the proposed meeting in Stockholm would be useful to assess the relevancy of our participation. We would welcome a thorough review of the implementation of the OSH EG work plan as the main subject for discussion.








NDPHS Action Plan)



(Describe: 1) how the results of the NDPHS activity are/will be used and how the follow-up and sustainability of the results will be

ensured, and 2) expected impact of the NDPHS activity)

3. Coordinated special national programmes

At least 4 countries

No. of countries with programmes

ILO and Estonia completed the

The ILO has joined the activity to assess and develop the quality of occupational health staff.

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for the development of occupational health services for all working people

Improve further the quality of occupational health services systems in countries with an operational system.

Develop basic occupational health systems concepts in countries in need of improved services. Concept to be approved at the highest political level.

NOTE! To achieve the final target smaller steps are needed.

with action plan

Will be assessed in the end of year 2017

concept note presented and accepted in OSH EG.

The concept note has been reviewed and no member state has so far reported within the given time that they plan to participate. We assume it is among other things a matter on shortage of national resources. The OSH EG stands still for the project.

The ILO is pursuing the development of the project in light of the strategic importance of the issue at stake. ILO is exploring possible connection with the larger ILO-OECD-WHO collaboration

.

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framework.

Other activities done in 2018

Meetings

The first meeting of the OSH EG was 5th April 2018 in Tartu, Estonia The second was joint meeting with BSN on OSH and was taking place 16th October 2018, in Riga, Latvia

Cooperation with CBSS/BSLF (EGLE)

Swedish member took part to CBSS/BSLF meetings held in Stockholm Expert group wrote a paper how the OSH EG sees the cooperation with the new establishing group EGLE.

Horizon 2020 Mental health in the workplace –program

Russian representative invited OSH EG to take part to Horizon 2020 Mental health in the workplace -program. No one in our group were interested in to be a coordinator. Coordinator was found from Belgium, but after conversation about the idea and partners, it was accepted that group do not have enough time for project planning and preparation in the given schedule.

Three surveys were conducted in the group

The questionnaire concerning harmful use of alcohol on workplace was part of the ASA EG’s development of a thematic report on Alcohol. One of the chapters related to the prevention at work places. OSH EG agreed that our EG will collaborate on developing of this chapter.

The second questionnaire was based on project proposal presented by ILO.

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The third survey was mapping the situation of member countries in relation to the expected results in the end of 2017.

In Tartu meeting our group continued to building the roadmap.

In PAC conference Tallinn Riitta Sauni the chair of OSH EG gave the presentation concerning work and alcohol.

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Annex 6

PH EG


1. Policy document/project name: Questionnaire on control of infectious diseases in prison, especially regarding HIV, TB and Hepatitis (Lead countries for this work package: Latvia and Russia)



Objective 1: Reduced impact of HIV, hepatitis and TB and non-communicable diseases among key populations at risk, including prisoners, through strengthened prevention, screening and access to treatment


Health equity and social cohesion in all actions Inclusion of people in vulnerable situations in all actions of relevance


Horizontal result 1: Strengthened and more visible role of health and social well-being on the regional agenda in the Northern Dimension area

Horizontal result 4: Increased visibility of the NDPHS in the Partner Countries

Immediate objectives (list immediate objectives, such as: development and dissemination of policy recommendations, a report, a review, a strategy, a

1.5. Better knowledge on how to improve control of infectious diseases in prisons, especially regarding HIV, TB, hepatitis and HIV-TB co-infection

Our objective is to provide policy recommendations and make data of different

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thematic paper, etc.) countries comparable.



Immediate and ultimate beneficiaries are policy makers, national institutes of public health, experts from different countries of the NDPHS and last but not least people being in prison settings. Focusing on the vulnerable group of prison populations has a key role in the prevention of the emergence and spread of HIV, hepatitis and TB.

Area covered


Russia, Latvia, Germany, Norway, Finland participated at the survey (Estonia, Lithuania, Sweden and Poland are kindly invited to join the activities of the PH EG).


PH EG

Lead countries for this work package: Latvia and Russia. The questionnaire has been drafted by Latvia. Russia translated the questionnaire in Russian and made an interview with experts of PH.

We are welcoming WHO to participate in the process.


-

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Budget

Financing agency -

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NDPHS Action Plan)




activity)

1. Better knowledge on how to improve control of infectious diseases in prison, especially regarding HIV, TB, hepatitis and HIV-TB co-infections

At least one more country monitoring the number of TB (with detected resistances MDR or XDR) plus HIV cases, according to international standards

In accordance with the PH Work Plans 2016 /2017 several steps have been taken towards achieving the target (ex. formulating questions, creating a questionnaire, approval by the PH EG experts, distributed to participating countries for data collection etc.)

We have worked

The baseline needs to be estimated as part of the activities.

Influence National Institutes of Public Health to consider the Iceland’s goal of eliminating hepatitis C, which would be a huge step in creating equal health.

The PH EG took the lead in the last NDPHS e- Newsletter. With 4 articles, the subject of Health in Prison was put

1) Re-using the questionnaire in the future can measure the progress made.

2) Improvement of the monitoring and availability of epidemiological information of key populations at risk in the Northern Dimension area. It will help to compare situations in the countries of Northern Dimension area and facilitate awareness and knowledge of decision makers about current situation and best practices. This activity ensures policy sustainability by evidence based decisions and

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very closely with the EG on HIV, TB and AI in order to avoid duplications in the questions of the questionnaire. Moreover the questions in the questionnaire have also been compared to WHO questionnaire on Prison Health in order to illustrate different aspects.

A draft report on prison health based on a survey of several countries (Latvia, Russia, Germany, Norway and Finland) has been drafted and approved by the expert group.

in the focus of this edition. Activities to increase the visibility of the activities of the PH EG have been discussed.

Next steps will be the drafting of recommendations as well as the distribution to policy makers as well as national institutes of Public Health.

The report covers countries with different social economic situation thus providing objective information about the real situation in the region. Nevertheless, a wider involvement of countries in the survey would facilitate comprehensiveness of the report and give more precise recommendations.

The report should be supplemented by an analysis of cost effectiveness of measures

monitoring of the results.

3) Policy makers’ capacity to make proper decisions on Prison Health is strengthened. This contributes to improved cost-effectiveness of measures in prison health.

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to assist decision-making.

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2. Policy document/project name: Harm on health from imprisonment: risk factors(Lead countries for this work package: Germany and Estonia)





- Health equity and social cohesion in all actions- Inclusion of people in vulnerable situations in all actions of relevance


Horizontal Result 1: Strengthened and more visible role of health and social well-being on the regional agenda in the Northern Dimension area

Leading and coordinating the Health Policy Area in the EU Strategy for the Baltic Sea Region Action Plan

The responsibility for prison health in some of the partner countries is still in the hands of Ministries of Justice. Following the international recommendations of independent medical services and the Standard of equivalence of care should guide to further activities.

Horizontal Result 4: Increased visibility of the NDPHS in the Partner Countries

The EG was in close collaboration with WHO HIPP Project and took again part in 2 steering

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group meetings.

A first contact to CPT was established in 2016. The planned contact to CPT must be reactivated.

The PH EG Experts participated actively in following meeting and conferences and thereby increased the visibility of the NDPHs activities in the field of prison health:

- WHO international meeting on prisons and health: recognizing the role of prisons in addressing health inequalities, Lisbon

Exploring and implementing new approaches for collaboration within the NDPHS

There has been a joint meeting with the Expert Group on Primary Health Care in October 2017 in Moscow. This exchange reinforced the fact that the issues that exist in Primary Health Care are quite similar to those existing in Prison Health settings. One of the main discussions was based on aspects of “Through-Care”. More exchange in the future would be helpful.

Currently the cooperation between the EGs on HIV and ASA is also increasing due to the many crosscutting subjects and a combined EG meeting took place on the 12th and 13th of April 2018 in Warsaw.


Inform about good practice, distribute (translate) available materials widely.

Inform about upcoming international, regional and national conferences and ensure attendance.

Explain monitoring process to participating countries.

Combined with HIV EG and under Objective 1.5 of the Working Plan 2016.

- Point out benefits

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- Request commitment and collect monitoring data from central and local authorities

- Evaluate data

- Count countries fulfilling process

- Report data



Policy Makers and Prisoners.

To support the future plans of the EG the results need to be taken up to the political level. It is crucial to implement the understanding that the only form of punishment is the deprivation of liberty and not a lack of healthcare or social wellbeing. A sufficient process of re-socialization will reduce criminal behavior and reintegrate inmates back into society after the release from sentence. Increasing prisoners’ health will dry out the melting pot of spreading of infectious disease inside prisons. By this cost for infectious diseases will go down.

Area covered


Russia, Estonia, Latvia, Lithuania, Germany, Norway, Finland, Sweden

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PH EG

The first drafting has started by the members of Estonia and Germany. The Estonian Expert retired in February 2017 from her position and hasn’t been replaced so far.


WHO HIPP Project

CPT

It will be important that the CSR would help convey the policy recommendations to the national level.

Budget -

Financing agency -

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Target(as specified in the

NDPHS Action Plan)



Action Plan)



(Describe: 1) how the results of the NDPHS activity are/will be

used and how the follow-up and sustainability of the results will be

ensured, and 2) expected impact of the NDPHS

activity)

1.6. Raised awareness of harm on health from imprisonment, in accordance with WHO Europe/HIPP and CPT standards, especially regarding HIV and TB

At least one more country that has developed measures to achieve WHO/ HIPP Standards

In accordance with the PH Work Plan several steps have been taken towards achieving the target (ex. preparation of a set of slides, newsletter contribution etc.)

The baseline needs to be estimated as part of the activities.

Policy makers’ capacity to make proper decisions on Prison Health is strengthened. This contributes to improved cost-effectiveness of measures in prison health.

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3. Policy document/project name: Through Care(Lead countries for this work package: Norway and Sweden)





Health equity and social cohesion in all actions Inclusion of people in vulnerable situations in all actions of relevance Innovative approaches and technologies


Horizontal Result 1: Strengthened and more visible role of health and social well-being on the regional agenda in the Northern Dimension area

Horizontal Result 3: Increased and strengthened policies to improve health and social wellbeing through regional cooperation.

The WHO guide to essential health in prison is crucial; it is recommended to close links between the ministry of health and the ministry responsible for the penitentiary, to ensure that necessary health care is provided of their liberty and free of charge by independent medical staff under confidentiality. The continuity in treatment before, in prison and after release under the through care aspect is recommended. Professional independence and patient autonomy must be emphasizes to provide equitable Health care services inside prison. To safeguard this and the continuity, it is recommended that healthcare in prison is provided by the public health system subjected to the health authorities.

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Collection of examples of through care.

Identifying best practice examples.

Distribution of information.

Describe goal of good care situation -

- e-health services- Health insurance- Patient data- Medical recording- Privacy laws- Privacy of data

Through care in the area of mental health, occupational health and addiction medicine.

The subject of through-care and the most important aspects of it have been discussed in the group and will be presented by the PH EG Chair at the WHO HIPP meeting in 2019.


To policy makers, prison authorities and health authorities:

To safeguard this and the continuity, it may be recommended that healthcare in prison is provided by the public health system subjected to the health authorities. This may secure the continuity of treatment and prevent the spreading of infectious diseases.

The inmates

Ensure the right to necessary health care services including mental health care, oral health, occupational and addiction medicine services. Inmates must have medical care in accordance with international standards.

Area covered Russia, Estonia, Latvia, Lithuania, Germany, Norway, Finland, Sweden (Poland is kindly

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invited to join the activities of the PH EG)


WHO HIPP Project

CPT

It will be important that the CSR would help convey the policy recommendations to the national level.


-


-


-

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NDPHS Action Plan)






Improved linkages between medical care in prisons and community public health services

At least one more country has established a through care situation for HIV &TB patients

In accordance with the PH Work Plan several steps have been taking towards achieving the target (ex. collection of good practices).

Continue the collection of best practices and distribute the results to partner countries.

Policy makers’ capacity to make proper decisions on Prison Health is strengthened. This contributes to improved cost-effectiveness of measures in prison health.

4. Policy document/project name: International Standards in Prison Health and more healthy conditions in prison

(Lead countries for this work package: Lithuania and Finland)

The work relates to the Objective 5.5 of the PH Work Plan 2016 and 2017.

Due to missing contributions from the lead countries for this project Lithuania and Finland, no progress can be reported for this project. Finland announced that participation will be reactivated once the national restructuration process has been completed.

5. Update on the Prison Health Declaration

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In 2018 the PH EG has started to work on an update of the Declaration on principles of cooperation between Prison Health and Public Health Services and the development of a safer and healthier society. The aim of the work on the declaration is to include new trends and look at the most pressing issues in prison health settings in the NDPHS region.

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Annex 7

PHC EG


Policy document/project name: Development of the NDPHS strategy and action plan in the field of Primary Health Care



Objective 5: Adequately addressed health and social needs related to chronic conditions and demographic changes – through strengthened integration and coordination of care and prevention throughout the life course at the primary care level


2.1. Health equity and social cohesion in all actions

2.3. The ‘Health in All Policies’ approach


Horizontal result 1. Strengthened and more visible role of health and social well-being on the regional agenda in the Northern Dimension area.

Horizontal result 2. Strengthened support and involvement of other stakeholders in the NDPHS-facilitated activities

Horizontal result 3. Increased and strengthened policies to improve health and social wellbeing

through regional cooperation

Horizontal result 4. Increased visibility of the NDPHS in the Partner Countries

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Horizontal result 5. Ensured coherence and mutual support in addressing regional challenges and opportunities in the area of health and social well-being through a successful leadership of the EU Strategy for the Baltic Sea Region’s Health Policy Area


- Continue effective dialogue between knowledge providers and policy makers in the field of people-centered, integrated care for patients with multi-morbidity, with strengthened coordination and networking between WHO and national stakeholders in the Northern Dimension area through organization of Partnership’s side-events or presentations at NDPHS’ and NDPHS-related events.

- Prepare materials for our policy-makers who will participate in Almaty Conference, October 2018

- Collect and analyze guidelines on strengthening role of patients and their families in the implementation of integrated care plans using experience collected from the NDPHS Partner Countries on how the peer group’s education is used to cope with diseases for different groups of patients and how to include the role of the patients and their family members in the care plans

- Workshop with local authorities in Kaliningrad, Russia – discussion of mid-term results of the project “Assessment and development of recommendations to improve medical and social outpatient care for patients with chronic noncommunicable comorbidity in Northwest Federal District of the Russian Federation in cooperation with other countries operating within Northern Dimension Partnership in public health and social well-being” being implemented in Kaliningrad.

- Experience exchange with NDPHS Partner Countries, discussion of good practices in resource allocation and possible incentives supporting an integrated and better-coordinated care for patients.

- Cooperate with relevant regional and international actors to include NDPHS-facilitated health and social well-being items on the regional cooperation agenda in the Northern Dimension area.

- Include provisions regarding health and social well-being and the importance of the a Health in All Policies (HiAP) approach, a focus on health inequalities, as well as the Partnership’s role, in relevant high level and other documents. Work with other relevant stakeholders towards the achievement of the health-related actions and targets as spelled out in the NDPHS Action Plan.

- Develop a concept of PHC EG work package for Joint NDPHS flagship project- Cooperate with relevant stakeholders to communicate the results of NDPHS projects

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and/or NDPHS-facilitated projects to the policy level in the Northern Dimension area, including appropriate events as national and international conferences, forums, and seminars.

- Approach and encourage stakeholders to communicate, when relevant, the results of interregional projects to the policy level by using the NDPHS’ structures.

Continue the dialogue with the NDPHS Partner Countries and Organizations by highlighting current information about the NDPHS work on home websites.

- Facilitate the development and implementation of actions and flagship projects defined in the Health Policy Area.

- Monitor and report the implementation progress within the Health Policy Area.- Regularly review the relevance of the Health Policy Area as described in the EUSBSR

Action Plan.


Policy makers, Local authorities, Primary health care authorities, Public health specialists, NGOs dealing with health and social development issues, General population

Area covered


Estonia, Finland, Latvia, Lithuania, Norway, Poland, Russia, Sweden

Implementing organization PHC EG, Partner Countries and Organizations, NDPHS Secretariat, CSRdocument.docx 97

(list the NDPHS structures/other organizations, institutions and experts leading the implementation of the activity)


WHO, IOM, relevant organizations in the partner countries


Work of the Chair, Co-Chair, ITA and two Expert Group meetings (23-24 May 2018, Krakow, Poland and 26-27 September 2018, Moscow, Russian Federation) were financed.


Ministry of Health of the Russian Federation

The National Board of Health and Welfare in Sweden

Ministry of Health of the Republic of Poland

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Progress toward target(use the indicator as specified in

the NDPHS Action Plan)Further action required,

obstacles, comments

Sustainability and expected long-term

impact

(Describe: 1) how the results of the NDPHS

activity are/will be used and how the follow-up

and sustainability of the results will be ensured,

and 2) expected impact of the NDPHS activity)

1. Higher awareness among national health policy-makers of the increasing prevalence of multimorbidity in the elderly population and of an effective policy response.

At least 3 of countries with approved policy documents addressing multimorbidity

Steps taken to achieve this target:

- Participation in NDPHS Workshop on aging populations organized in Stockholm, Sweden in spring 2018.

- Seminar on legal basis and organizational technologies for protecting the health of elderly patients with multimorbidity was organized on 6th PHC EF meeting. Results of pilot project in Kaliningrad were presented.

Strengthen coordination and networking between WHO and national stakeholders in the Northern Dimension area through organization of Partnership’s side-events or presentations

National strategies and actions are influenced by results of EG PHC work

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- Site visit of pilot polyclinic in Moscow, Russia to see examples of good new practices for managing care for patents of older age groups with multiple chronic diseases

- Analytical report “Brief results of the Russian Federation activities in NDPHS in 2003-2018.” was prepared and published in Russian newspaper “Medical newspaper”

2. Better understanding and commitment of national policy-makers to strengthening the role of patients and their families in the implementation of integrated care plans

At least 3 countries where active role of patients and their families is recommended for inclusion in the integrated care plans

Steps taken to achieve this target:

- Questionnaire developed for additional collection evidence from good practices on integrated care for patients with multi-morbidity

- A Working Group established to systematize the information obtained from PHC EG Partner countries using the model proposed in Chrodis report.

Systematize the information obtained from PHC EG Partner countries using the model proposed in Chrodis report.

Prepare a comprehensive overview on guidelines on strengthening the role of patients and their families in the implementation of integrated care plans for national policy-makers.

Publish a monograph based on PHC EG report on multimorbidity created

Models of integrated care plans, developed by EG PHC, which will be used by national policy-makers.

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using the information collected by PHC EG Partner countries.

Organize a conference for discussion and further promotion of information.

3. More in-depth knowledge among health and social care administrators on the resource allocation and incentives to support integrated and coordinated care for patients with multi-morbidity

3 countries with revised resource allocation and introduced incentives

Steps taken to achieve the target:

- Innohealth project proposal (Prevention of hospitalization in the Baltic Sea Region: structural and organizational innovation supported by ICT in primary healthcare for more cost-effective health systems performance) was developed and presented for financing in INTERREG program for BSR.

- Collaboration and meetings between Kaliningrad authorities, FRIHOI, Klaipeda University and Public Health Bureau, in framework of joint project «Assessment and development of

As Innohealth project did not receive funding, three possible ways for further action were discussed:

- Start to develop smaller projects on integrated and coordinated care for patients with multimorbidity based on information ideas from Innohealth project proposal

- Consider possibilities to join other NDPHS projects

- Strengthen and elaborate further the Innohealth project idea

National strategies and actions are influenced by results of EG PHC work

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recommendations to improve medical and social outpatient care for patients with chronic noncommunicable comorbidity in Northwest Federal District of the Russian Federation in cooperation with other countries operating within Northern Dimension Partnership in public health and social well-being”, supported by Russia

- Seminar on legal basis and organizational technologies for protecting the health of elderly patients with multimorbidity was organized on 6th PHC EF meeting. Results of the pilot project in Kaliningrad mentioned above were presented.

4. Better identified psychosocial causes of NCD-related risky behavior among children and adolescents for the purpose of developing adequate preventive

3 countries introducing new methodologies and/or models for identification of psychosocial causes

No progress in 2018

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measures

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Annex 8

Leadership and coordination in the Partnership EGs

(Up to 31 December 2018)

NDPHS Partners

AMR EG

ASA EG

HIV, TB& AI EG

NCD EG

PHEG

PHCEG

OSH EG

Estonia

FinlandChair and ITA

Chair and ITA

Germany Vice-Chair

Chair and ITA

IcelandLatvia Vice-ChairLithuania Vice-

Chair

NorwayChair and ITA

Poland Vice-Chair

Russia Vice-Chair

Chair, Vice-Chair and ITA

Chair, Vice-Chair and ITA

SwedenChair and ITA

Co-Chair

BEACCBSSECILOIOMNCMUNAIDSWHO Co-

Chair

- denotes Lead Partner - denotes Co-lead Partner

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