Plenary3 m gabrijelcic

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Plenary3 m gabrijelcic

  1. 1. Food and nutrition action plan – lessons learnt and ways forward<br />Mojca Gabrijelčič Blenkuš<br />National Institute of Public Health of the R of Slovenia<br />PREVACT - ACTION FOR PREVENTION <br />Conference on Member States’ Activities on Nutrition, Physical Activity and Smoking related health issues<br />Budapest, 30th – 31st May 2011<br />
  2. 2. Outline of the presentation<br />1. What do weknow?<br /> - inequalities in health – relevancefornutritionandphysicalactivity<br /> - evaluationofthe FNAP 2005-10<br />2. Whatcanwe do?<br /> - preventionprogrames<br /> - promotionprogrames<br />Nutritionandhealth in allpolicies<br />3. Waysforward<br />
  3. 3. Outline of the presentation<br />1. What do weknow?<br /> - inequalities in health – relevancefornutritionandphysicalactivity<br /> - evaluationofthe FNAP 2005-10<br />2. Whatcanwe do?<br /> - preventionprogrames<br /> - promotionprogrames<br />Nutritionandhealth in allpolicies<br />3. Waysforward<br />
  4. 4. Health inequalities in Slovenia.<br />NIPH, 2011<br />Fig. 2.2 Infant mortality in the EU and Slovenia per 1000 live births, 2006 (WHO, HFA 2010; NIPH Database of deaths 2004-2008).<br />
  5. 5. Health inequalities in Slovenia.<br />NIPH, 2011<br />Fig. 2.5. Percentage of children by the number of hours of physical activity during a week relative to the family’s socioeconomic status, Slovenia, 2006 (HBSC, 2006).<br />
  6. 6. Health inequalities in Slovenia.<br />NIPH, 2011<br />Fig. 2.6. Percentage of overweight and obese individuals relative to socioeconomic status, Slovenia, 1997 and 2008(Koch, 1997; Gabrijelčič et al., 2009).<br />
  7. 7. Health inequalities in Slovenia.<br />NIPH, 2011<br />Fig. 2.8. Percentage of inhabitants with good or very good self-assessed general health status relative to education and age, Slovenia, 2007 (NIPH EHIS, 2007).<br />
  8. 8. Health inequalities in Slovenia.<br />NIPH, 2011<br />Fig. 2.9. Prevalence of cardiovascular disease relative to social class, population group aged 45–64 years, Slovenia, 2008(CINDI Slovenia, 2008).<br />
  9. 9. Health inequalities in Slovenia.<br />NIPH, 2011<br />Fig. 2.18. Premature mortality (0–64 years) from liver cirrhosis in groups of municipalities relative to income tax base per capita by gender, Slovenia, 2004–2008 (NIPH Database of deaths 2004-2008).<br />
  10. 10. Foods and food groups in daily nutrition in adult population in Slovenia, by self-estimated SES<br />Souce: Gabrijelčič Blenkuš et all, 2009<br />
  11. 11. Foods and food groups in daily nutrition in adult population in Slovenia, by age groups<br />Souce: Gabrijelčič Blenkuš et all, 2009<br />
  12. 12. Analytical data<br />“Milk slices”: <br /><ul><li>sugars: 25,8 – 35,7 g/100 g
  13. 13. totalfats: 22,9 – 36,2 g/100g</li></ul>Trans fats in products: <br />- savouryshacks: 38,5%, 24,8%<br /><ul><li>chocolatecake: 15,2 %
  14. 14. rolles: 7,1 %</li></ul>Brekfastcereals<br /><ul><li>sugars: 23% up to 48 % E in differentsamples</li></li></ul><li>Malnutrition in Slovenia<br />Main problem: patients in hospitalsandelderly in elderlycarecentres<br />Slovenia: 17,9 % (2003) up to 40 % (2010) ofmalnourishedpatients or elderly<br />Solutions in policyandrecommendationsdocuments: <br /><ul><li>Resolution on nutritionandnutritioncare in hospitals, MinistryofHealth (2003)
  15. 15. Recommendations on nutritiontreatmentandcareforpatientsandelderly, MinistryofHealth (2008)</li></ul>Implementation:<br /><ul><li>Mainchallangeforthefuture(universalaccess, education, enforcement, evaluation …)</li></li></ul><li>BATON (2008)<br />Comparison of frequencies of reported activities in different target populations, for the past and future period<br />
  16. 16. Evaluationresults – Slovene FNAP 2005-10<br />
  17. 17. Outline of the presentation<br />1. What do weknow?<br /> - inequalities in health – relevancefornutritionandphysicalactivity<br /> - evaluationofthe FNAP 2005-10<br />2. Whatcanwe do?<br /> - preventionprogrames<br /> - promotionprogrames<br />Nutritionandhealth in allpolicies<br />3. Waysforward<br />
  18. 18. CHANGING FOCUS <br />Of PUBLIC HEALTH CHALLENGE<br />Q: What make peopleill?<br />diseaseprevention<br /><ul><li>Patogeneticperspective
  19. 19. Researchandpreventionofmortalityandmorbidity
  20. 20. Researchandpreventionofriskfactors
  21. 21. Indikatorji mortalitete, morbiditete, dej. tveganja</li></ul>Q: What make peoplehealthy?<br />healthpromotion<br /><ul><li>Salutogenicperspective
  22. 22. Researchqualityoflife, increasewellbeing, populationlevel (exist in vocabularyof “ordinary” people)
  23. 23. Researchandencouragingofprotectivefactors (exist in vocabularyofothersectors - HiAP)
  24. 24. Indicatorsofpositivehealth (indicatorofhappines – OECD)</li></ul>Interlinked, harmonizedactivities<br />
  25. 25. Diseasepreventionprogrames, with HP components<br />Nationaldiseasepreventionprogrames in Slovenia<br />Diabetes<br />Cancer, includingcancerscreening<br />Cardiovasculardiseases<br />Holisticapproach to thepatient at theprimaryhealthlevel<br />ChronicdiseasesstrategyforSlovenia<br />Jointactionforcancer at EU level – outcomeofSlovenepresidency 2008<br />Healthcaresystem<br />
  26. 26. Schoolenvironment<br />National<br /><ul><li>Nutritionandphysicalactivity are part of a regularcuriculla in schools
  27. 27. Nationalschoolnutrition programe</li></ul>EU level<br /><ul><li>ESF used by Mo Education, developmentof a model “Healthylifestyle in schoolenvironment”
  28. 28. CAP Schoolfruitscheme</li></ul>WHO<br />- 2nd FNAP andactionnetworks (marketing: ban on vendingmachines, May 2010)<br />- Slovenehealthyschoolsnetwork<br /><ul><li>Nutritionfriendlyschoolinitiative (as a pilot) </li></li></ul><li>ALCOHOL <br />And<br />TOBACO<br />MENTAL HEALTH<br />PHYSICAL ACTIVITY<br />NUTRITION<br />(Suporting<br />CAP SFS)<br />
  29. 29. Mainchallengesforhealthpromotion in nutritionandphysicalactivity<br />STRUCTURAL LEVEL<br />Createsupportiveenvironmentsforphysicalactivity – schools (PA as a vital part ofschoolcurricula at alllevels), urban planning, transport …<br />Createsupportiveenvironmentsforhealthynutrition – reformulationoffoodproducts, regulationofspecificnutrients (TFA), fiscalemeasures, reducingpressure in marketing foodandbeverages to children, …<br />INDIVIDUAL LEVEL<br />Segmentation, subpopulationgroupspecificapproaches<br />
  30. 30. Outline of the presentation<br />1. What do weknow?<br /> - inequalities in health – relevancefornutritionandphysicalactivity<br /> - evaluationofthe FNAP 2005-10<br />2. Whatcanwe do?<br /> - preventionprogrames<br /> - promotionprogrames<br />Nutritionandhealth in allpolicies<br />3. Waysforward<br />
  31. 31. Relevant partners<br />Concept developed by MAFF, in cooperation with MoE and MoH<br />Working group for the SFS:<br />drafting the Strategy,<br />national implementation,<br />official statements;<br />Responsible for the SFS:<br />MAFF -<br />Ministry <br />of Agriculture, Forestry and Food<br />Chamber<br /> of Agri. <br />Agriculture:<br /><ul><li>MAFF
  32. 32. AAMRD</li></ul>The SFS is implemented by:<br />AAMRD –<br /> Agency for Agricultural Markets<br /> and Rural Development<br />Health:<br />- M.of Health,<br />- IPH<br />Education:<br />- M.of Educ.<br />Source: Report of Slovene MAFF to DG AGRI, Feb 2010<br />
  33. 33. SchoolFruitScheme<br />73 %ofallSlovene<br />primaryschoolsinvolved<br />Allkidsfrom 6 – 15 <br />yearsof age, additional<br />fundingfromSlovenegovernment<br />517 tonsoffruitandvegetables used in schools (2009/10)<br />
  34. 34. HiAP in SEE<br />Third Health Ministers Forum: Health in All Policies in South-eastern Europe: “A Shared Goal and Responsibility”, Banja Luka (BIH), 13 - 14 October 2011– Political Declaration to be adopted<br />(South-eastern Europe Health Network (SEEHN) members: Albania,Bulgaria, Bosnia and Herzegovina, Croatia, FYR Macedonia, Moldova, Montenegro, Rumania, Serbia)<br />For more info on SEEHN and Ministerial Forum please visit: http://seehnsec.blogspot.com/p/third-see-ministers-of-health-forum.html<br />Preparatory process-all SEEHN countries prepared the overview of the HiAP approach within respective countries<br />
  35. 35. Outline of the presentation<br />1. What do weknow?<br /> - inequalities in health – relevancefornutritionandphysicalactivity<br /> - evaluationofthe FNAP 2005-10<br />2. Whatcanwe do?<br /> - preventionprogrames<br /> - promotionprogrames<br />Nutritionandhealth in allpolicies<br />3. Waysforward<br />
  36. 36. CAPACITY BUILDING<br />COMUNICATION<br />Food safety<br />Localsustainable<br />foodsupply<br />Healthyand<br />balancednutrition<br />&<br />physicalactivity<br />in lifecycle<br />HEALTH AND SOCIAL CARE SYSTEM<br />SOCIAL DETERMINANTS OF HEALTH AND HEALTH EQUITY<br />RESEARCH, MONITORING AND EVALUATION<br />
  37. 37. FNAP 2012-20 - challenges<br />Continuity, based in presentknowledge, achievements, lessonslearnt.<br />Harmonized/integratedwithotherhealthpromotionanddiseasepreventionprogrames; focus: health, wellbeingforallandsustainability.<br />Institutionalizedmeasures, health in allpoliciesapproach.<br />Participativenes, specialfocus to subpopulationgroups.<br />Transparent andindependatmonitoringandevaluation.<br />Provide evidence.<br />Workingtogether:<br />EC – HLG, definingcommonframeworks at the EU level<br />WHO – 1st and 2nd FNAP, actionnetworks, monitoringandevaluation; <br />Networks as – EHN (EU policies, SDH/HI)<br /> SEE HN (regionalrelevance) <br />Specialimportanceofharmonizedcommonactivities at thenationallevels in theglobalenvironment.<br />

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