THE FRAMEWORK FOR A NEW PUBLIC HEALTH STRATEGY

FOR THE REPUBLIC OF SERBIA

Prof. Dr Snežana SimićSchool of MedicineBelgrade UniversitySerbia and Montenegro

snezanas@EUnet.yuThe Role of Graduate Public Health Education in Addressing Health Challenges in CEE –NIS CountriesKyiv – Ukraine,July 1-3 2004.

PUBLIC HEALTH IN SERBIA TODAY

Institutes of Public health (23)

monitoring, investigation, assessment of the health status of population;

environmental aspects of health; availability, organization and utilization of health

services; surveillance of diseases; health promotion and health education; planning and development of health programs,

monitoring and evaluation

According to Health Care Law, the IPH should provide services at least in social medicine, epidemiology, microbiology, parazitology and virology, hygiene, environmental protection

Health centers (160) providing Primary Health CareInspectorate services (Ministry of Health) – health,

sanitary and drug inspection

Public Health Professionals in Republic of Serbia (without Kosovo)

Occupational medicine 650 Epidemiology 190 Social Medicine 150 Hygiene and Medical Ecology 130 Others (health economy,

health law, psychology, sociology, organizational sciences 30

Community nurses – about 5000

1/5800

1/3000

Assessment of public health network in Serbia

(Belgrade, September 2002)

Absence of integrated Public Health Policy;

Rigid and out of date structure of IPHs;

Overstaffing with administrative and technical personnel;

Lack of multi-professional personnel;

Unclear mechanism for financing Public Health

Undeveloped information and communication systems

Lack of knowledge and skills for new public health

Belgrade – Federal Assembly

Ministry of Health Republic of Serbia

BETTER HEALTH FOR EVERYONE IN THE THIRD MILENIUM

•Health policy•Vision of the health care system in

Serbia•Strategy and action plan of the

reform of health care system in Republic of Serbia by 2015 - draft

INTERNATIONAL PARTNERS FOR STRENGTHENING PUBLIC HEALTH IN

REPUBLIC OF SERBIA

Support to the Public Health Development in Serbia - EAR

Strengthening Preventive Health Care – EAR

Programmes for Training and Research in Public Health - Stability Pact for South Eastern Europe

Reform of Public Health Financing – WB

Strengthening Essential Public Health Functions in the Balkans - CPHA

Primary Health Care Basic Health Benefits in Kraljevo Municipality

Health promotion on community level - OSI

European Agency forReconstruction - EAR

ICRC – International Committeeof Red Cross

The WORLD Bank Group

Canadian International Development Agency – CIDA;Canadian Public Health Association

1

2

3

4

Open Society Institute - Belgrade5

MILLENIUM DEVELOPMENT GOALSOUN

Poverty Reduction Strategy PaperAction Plan for ChildrenEmpowerment of the Roma population

MULTISECTORIAL STRATEGIES

CDC/ATSDR`s - A Global Health Strategy

Working with Partners to improve Global Health

The CDC Global Health Strategy defines goals in the following five critical areas for public health:

Public Health Surveillance and Response, Public Health Infrastructure and Capacity

Building, Disease and Injury Prevention and Control Applied Research for Effective Health Policies Exchange of Information and Lessons Learned

WB – PUBLIC HEALTH AT A GLANCEThe Public Health at a glance fact sheets aim to

provide easy access to the state of the art in basic public health, nutrition and population (HNP) preventive and curative services.

The basic public health services include:• Nutrition, • Malaria, TB and HIV/AIDS prevention and control

interventions,• Reproductive health,• IMCI and immunization,• School health,• Mental health,• Tobacco control, indor air polution, road safety

and water and sanitation

The European Commission – Public Health

Politically important was the Commission's decision to place “health” as one of its key priorities;

On 16 May 2000 the Commission adopted a Communication on the Health Strategy of the European Community and a proposal for a Decision of the EP and Council adopting a program of Community Action in the field of public health,

The Commission takes account of the review of the existing situation and recent legal and political developments

EU action in Public Health:• Health promotion• Health monitoring• AIDS and communicable

diseases• Cancer• Rare diseases• Injury prevention• Pollution related diseases• Drug abuse

FUTURE ACTIVITIES IN REPUBLIC OF SERBIA

Public Health Policy Framework and Strategy Paper - draft

The School of Public Health Initiative – Postgraduate Public Health Training for Practice and Research

Strategy on Tobacco Control – draft of the National Tobacco Control Commission

New Model of Public Health Financing

PUBLIC HEALTH ASSOCIATION OF SERBIA Established in October 2003.

500 public health professionalswere present at October 2003. meeting in Belgrade

NATIONAL PUBLIC HEALTH STRTAEGY OF THE REPUBLIC OF

SERBIA - draft

Essential public health functions in Serbia:

Health promotion – actions to affect overall health and wellbeing

Prevention – of specific diseases, injuries and social problems

Protection – preventive and emergency services

Surveillance – keeping track of patterns of disease to enable timely action

Population health assessment – measuring, monitoring and reporting on the status of the health in community

Intersectorial collaboration in health

NATIONAL PUBLIC HEALTH STRATEGY – general aims

1. Establishment national priorities in area of public health and creation of effective interventions within community directed to health promotion;

2. Moving of intervention focus from disease to health determinants and risk factors;

3. Promotion of evidence based healthy public policy developments;

4. Providing valuable information on health and establishing minimal set of indicators for health status assessment;

5. Fast reaction in crisis including surveillance of communicable diseases and prevalence of risk factors in population

National public Health Strategy

- next steps - To reach consensus on a

new framework for public health in Serbia,

To encourage a broad-based approach to public health,

To develop public health oriented workforce,

To define the roles and responsibilities of stakeholders – Ministry of Health, IPH, PHC and NGOs

Central Serbia - country side