This document discusses knowledge-based recommendations for health promotion provided to municipalities in Denmark. It notes that Denmark has a population of 5.8 million people divided into 5 regions and 98 municipalities, on average with 59,000 people each. The municipalities are responsible for services like childcare, schools, eldercare, unemployment services, and local health promotion. 235 recommendations across 11 health topics like overweight, drugs, hygiene, and physical activity have been developed. Implementation of the recommendations focuses on areas like programs, information, early identification, and follow up. An example recommendation on programs for school children with moderate overweight is provided. Overall municipalities have positively received the recommendations and made progress in implementing them in areas such as diet, physical activity, mental

1. Knowledge-based recommendations
in municipalities
Tatjana Hejgaard, Senior Adviser (thv@sst.dk)
The Promokids workshop, 3 October 32018, Reykjavik
1

2. Denmark
Population: 5,8 mio.
5 regions
98 municipalities
• Average population size: 59.000
• Local city councils
Danish Health Act §119
Responsibilities within municipalities:
• Children’s day care
• Schools
• Care for the elderly
• Services for the unemployed
• Social services for families, the
physically and mentally disabled, etc.
• Local health services – health
promotion and disease prevention
2

3. 3
Introduction
The municipality´s work
with recommendations
in the Health Promotion
Packages
11 Health
Promotion
Packages
• Overweight
• Drugs
• Hygiene
• Alcohol
• Food & meals
• Tobacco
• Indoor climate in
schools
• Mental health
• Sexual health
• Sun protection
• Physical activity

4. 4
Introduction
Tobacco
All Health Promotion
Packages were
updated in 2018

5. 235 knowledge-based recommendations across the 11
Health Promotion Packages
5
235 recommendations for
health promotion of high quality

6. Health Promotion Package - Overweight
6
Facts
Recommendations
• Frameworks
• Programmes
• Information and education
• Early identification
Implementation and follow-up

7. Recommendations – An example
7
Programmes
Programmes for school children with moderate overweight
The municipality offers programmes for school children with moderate
overweight. The programme involves the entire family and includes elements
regarding food & meals, physical activity, support on how to achieve
behavioural changes as well as an evaluation of the child’s psychosocial
situation. When needed referral to GP. Ongoing mutual changes of
information between GP, health visiting nurses, and other relevant
stakeholders, i.e. NGOs. For some children it may be relevant to involve social
services, but overweight alone is not a reason to do so. The aim is a
coordinated and coherent programme also in transition from one stakeholder
to another.
Inspiration for taking action: …

8. Continued
8
Inspiration for taking action: (examples)
• Early identification of overweight and early intervention among
children and adolescents. Guidelines for school health services
• School Health Services – manual for school nurses
• Health Promotion Package – Food & meals
• Health Promotion Package – Physical activity
• Health Promotion Package – Mental Health
• Mapping of lifestyle interventions in children and adults with
obesity in regions and municipalities
• + Several evaluations of different obesity projects financially
supported by the government

9. IMPLEMENTATION OF KNOWLEDGE-
BASED RECOMMENDATIONS IN
MUNICIPALITIES
Karen Karlsson Eriksen
Center for Health Promotion in Practice
Local Government Denmark

10. Center for Health Promotion in Practice
Supports municipalities in implementing
knowledge-based recommendations concerning
health promotion and disease prevention
​Each year, almost all municipalities attend our
seminars, conferences and training programmes
​Established in 2013 to help implement the
packages in municipalities
​One leader and four fulltime consultants
​http://www.kl.dk/Kommunale-opgaver/Sundhed/Center-for-Forebyggelse-i-praksis/

11. HEALTH PROMOTION AND DISEASE PREVENTION IN DANISH MUNICIPALITIES
Attitude towards the Health Promotion
Packages in municipalities
Monitorering of disease prevention in municipalities. The National Institute of Public Health, 2017.
EMBASSYOFFRANCE,JUNE2018
0
10
20
30
40
50
60
70
80
Very positive Predomantly
positive
Neutral Negetive
Percentage of municipalities

12. Main implementation challenges in municipalities-
related to prevention of childhood overweight
Commitment in all municipal sectors - ‘Health in All Policies’ -
requires political and top-administration priority as well as the
necessary resources
Employees in day-care and schools needs competences and
tools to works with health promotion
Implementation of knowledge–based recommendations requires
translation in to practise and everyday life
Need for more knowledge in how programmes for school
children with moderate overweight is composed efficiently

13. HEALTH PROMOTION AND DISEASE PREVENTION IN DANISH MUNICIPALITIES
Implemented recommendations in the Health
Promotion Packages to a large extent
Monitorering of disease prevention in municipalities. The National Institute of Public Health, 2017.
EMBASSYOFFRANCE,JUNE2018
0
10
20
30
40
50
Diet and
meals
Psycial activity Mental health Overveight
2013/14 2017
Percentage of municipalities

14. HEALTH PROMOTION AND DISEASE PREVENTION IN DANISH MUNICIPALITIES
EMBASSYOFFRANCE,JUNE2018
Conclusions of the approach using Health
Promotion Packages
​All recommendations relevant to municipalities are
collected in one place - Health Promotion Packages
​The municipalities have welcomed the
recommendations and are in the process of
implementing them
​For 6 years the focus has been centered around the
Health Promotion Packages
​Activities in the ‘Center for Health Promotion in
Practice’ give municipalities opportunities to share
experiences and translate recommendations into
practice

15. ​THANK YOU
Tine Curtis – tcu@kl.dk
Karen Karlsson Eriksen – kae@kl.dk