Health Programme

Portugal
1
Health Programme
Portugal:
•
•
•
•
Capital:
Area:
Population:
Currency:
Lisbon
92 072 Km2
10,6 million
Euro
Population (1970-2060)
12000000
10617575
9730000
10000000
10364157
8000000
6000000
4000000
5042890
4670680
5478768
5335109
5138807
5029048
Male
Female
2000000
H/M
H
M
2010
2020
2030
2040
2050
2060
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
0
2
Health Programme
Portugal:
GDP (billion €)
174
172
170
168
166
164
162
160
Public Deficit / GDP
Public Debt / GDP
0%
140%
173
120%
171
107%
100%
2010
2011
2010
-1%
40%
-5%
20%
-6%
0%
-7%
2010
2012
-2%
-4%
60%
2012
2011
-3%
86%
80%
165
120%
2011
2012
-4%
-5%
-8%
-8%
-9%
Nat.Health System Public Budget (million €)
9.000
8.500
8.849
8.000
7.614
7.500
-14% / 3y
7.000
6.500
2010
2013
3
Health Programme
PORTUGUESE HEALTH SYSTEM
•
Integrates 2 co-existing systems:
 The National Health Service (NHS) (public)
funded with taxation
available to all citizens
( based on hospitals and health centers, where patients pay a symbolic fee);
 The health subsystems (with co-payment by users and state as the
employer)(army, police, general public employees);
 private health insurance schemes (mainly paid by companies to employees as a
fringe benefit;
4
Health Programme
NATIONAL HEALTH SERVICE
Main caracteristics
• High quality care
• World lowest childhood death rate
• World 12th in quality (WHO – World National Organization (UN))
• Excess hospital capacity
• Inappropriate use of hospital services
• Inequalities on access
5
Health Programme
BASIC INFORMATION
•
Programme 
Public Health Initiatives
•
Programme Operator 
Ministry of Health (through ACSS),
•
Programme Partner 
Norwegian Institute Of Public Health
•
National Focal Point 
Ministry of Agriculture, Sea, Environment and
Territorial Planning
•
Amount 
•
Approved
April 15th, 2013
•
Duration 
up to April 30th, 2017
€ 11,7 Million (€ 10,0 Million from EEA Grants)
6
Health Programme
The PORTUGUESE EEA
PROGRAMME for HEALTH
Focus on reducing inequalities and improve bilateral relations, acting on:
• Prevention and
• Sustainability:
Areas which represent the most significant costs in health:
- Diabetes
- Heart diseases
- Infection diseases (HIV…)
The programme will cover:
- Nutrition;
- Communicable Diseases;
- Mental Health.
With a pre-definid project on health information siystems (Epidemological Health
Information )
7
Health Programme
NUTRITION
•
High income distribution inequalities
•
Low income social groups with umbalanced diets
•
High childhood obesity prevalence
•
Obesity related chronic diseases
•
Potential increase of social exclusion due to current economic situation
8
Health Programme
MENTAL HEALTH
•
33% of people with severe mental illness had no access to treatment
•
Lack of accessibility:
 median delay for depression treatment is 4 years
9
Health Programme
COMMUNICABLE DISEASES
•
High prevalence
•
High level of expenses
•
Antimicrobial resistance related with:
 HIV/AIDS
 STI´s
10
Health Programme
PROGRAMME EXPECTED RESULTS
•
Reduced inequalities between user groups
•
Improved mental health services
•
National health registries and
management and use improved
•
Improved prevention and treatment of communicable diseases (including
HIV/AIDS and TB)
health
information
systems,
data
11
Health Programme
REDUCED INEQUALITIES
BETWEEN USER GROUPS
•
Educational and informative tools to promote healthy diets
•
Training programmes at regional school level to prepare staff to deal with
nutritional inequalities
•
Regional programmes to qualify social institutions and ONG´s to provide
food services adapted to vulnerable groups
•
Regional training programmes aimed at prepare health care professionals
who deal with vulnerable groups
12
Health Programme
IMPROVED MENTAL HEALTH
SERVICES
•
Mental health evaluation and management systems
•
Regional intervention programmes to promote mental health at workplaces
•
Intervention programmes to support unemployed people
•
Regional collaborative stepped care interventions for secondary prevention
of depression at primary health care level
•
Regional coordinated programmes to prevent children and adolescents
mental health disorders
• Data collection to access impact of the crisis in mental health inequalities
13
Health Programme
HEALTH INFORMATION SYSTEMS
•
Collect and disseminate information on activities and projects related to
nutrition
•
Implementation, collection, analysis and dissemination of epidemiological
data (Pre-defined project)
•
Improve National registry information systems on healthcare associated
infections and antimicrobial resistance
14
Health Programme
PRE-DEFINED PROJECT
Title: “Improvement of epidemiological health information to support public
health decision and management in Portugal – towards reduced inequalities,
improved health and bilateral cooperation”
Project Promoter: The Portuguese National Institute of Public Health (INSA)
Donor project partner: The Norwegian Institute of Public Health, Department of
Epidemiology
Maximum grant amount: €1,352,404
Project grant rate: 85%
Estimated total project cost: €1,591,064
15
Health Programme
PRE-DEFINED PROJECT
•
•
Objectives: deliver high quality epidemiological information on inequalities
in health determinants and risk factors, health status (morbidity and
functionality) and use of health care (preventive and curative). This
improved and updated information will be delivered to specific audiences
namely the general population, Public Health decision makers and
professionals, other health professionals and the media, using existing and
improved communication channels.
Delivers high quality epidemiological information on:
 Inequalities in health determinants and risk factors;
 Health status (morbidity and functionality):
 Use of health care (preventive and curative)
16
Health Programme
PRE-DEFINED PROJECT
•
Delivers high quality epidemiological information on:
 Inequalities in health determinants and risk factors;
 Health status (morbidity and functionality):
 Use of health care (preventive and curative)
•
This improved and updated information will be delivered to:
 Population, in general;
 Public health decision makers and proffessioals
 Media
17
Health Programme
BILATERAL RELATIONS
• Aim to exchange and share knowledge and best practices with:
 The Norwegian Institute of Public Health (Programme Partner);
 Other entities from Donor States.
• Trough:
 Conferences;
 Seminars;
 Study visits;
 Training
18
Health Programme
ACKNOWLEGEMENTS
 Royal Norwegian Embassy to Lisbon
 Norwegian Institute of Public Health (NIPH)
 Andrej Gribovsky; Arne Holte;Elizabeth Peacocke ;Hans Blystad;Heidi Lyshol ;Karin Ronning;Liv
Paltiel;Patricia Schreuder;Solfrid Johansen
 Norwegian Knowledge Center for the Health Services (NKCHC)
 Ingrid Margaretha Høie
 Norwegian Diretorate of Health (NDH)
 Ellen Ronning-Arnesen
 University of Oslo (UO)
 Nanna Lien
 European Free Trade Association (EFTA)
 Anne Camilla Hilton
 Financial Mechanism Office (FMO)
 Pawel Krzeczunowicz
19
Health Programme
THE PROGRAMME OPERATOR
•
ACSS – Administração Central do Sistema de Saúde
•
Contact: email : eeagrants@acss.min-saude.pt
20