Saatja: "WEBER, Martin Willi" <
[email protected]>
Saaja: "WEBER, Martin Willi" <
[email protected]>
Teema: "A New Child and Adolescent Health and Wellbeing Strategy in the WHO European Region - a co-creation exercise”_ meeting materials and the way forward
Kuupäev: 2024-09-05 15:44
(текст на русском языке см. ниже)
Dear national focal points,
Thank you for participating in the side event of the 74th Regional Committee
focused on developing a new child and adolescent health and wellbeing
strategy for the WHO European Region.
As discussed during the presentation, we foresee the following process for
the co-creation of the strategy:
* Consultation 1: Online meeting, 90 minutes, on 26 November 2024.
* Consultation 2: Two-day hybrid (in-person and online) meeting on 30-31
January 2025.
* Consultation 3: Online meeting, 90 minutes, on 18 March 2025.
In preparation for the first consultation, we will send you a brief
questionnaire where you can highlight your priorities in the areas of child
and adolescent health, as well as the challenges you face with
implementation that you would like to see addressed in the strategy.
As promised during the meeting, and for the benefit of those who could not
attend the event on Monday, please find attached the materials used during
the presentation. The fact sheets will be shared with you shortly.
Lastly, for the Member States that have not yet nominated a focal point, we
kindly ask that you consider doing so at your earliest convenience.
We look forward to working together on this important initiative.
Thank you once again.
Best wishes,
Dr Martin Weber
Team lead
Quality of Care and Patient Safety
*****
Уважаемые национальные координаторы,
Благодарим Вас за участие в сопутствующем мероприятии в преддверии 74-ой
сессии Регионального комитета, посвященном разработке новой стратегии
обеспечения здоровья и благополучия детей и подростков в Европейском регионе
ВОЗ.
Как обсуждалось во время презентации, для совместного создания стратегии мы
планируем следующий процесс:
∙ Консультация 1: Онлайн-встреча, 90 минут, 26 ноября 2024 г.
∙ Консультация 2: Двухдневная гибридная (очная и онлайн) встреча 30–31
января 2025 г.
∙ Консультация 3: Онлайн-встреча, 90 минут, 18 марта 2025 г.
В рамках подготовки к первой встрече мы вышлем вам краткую анкету, в которой
вы сможете обозначить свои приоритеты в области охраны здоровья детей и
подростков, а также возникшие в ходе реализации трудности, которые вы бы
хотели бы отразить в стратегии.
Как и было обещано во время встречи, и для тех, кто не смог присутствовать
на мероприятии в понедельник, прилагаем презентацию на английском и русском
языках. Информационные бюллетени будут высланы Вам в ближайшее время.
Наконец, мы просим государства-члены, которые еще не назначили координатора,
рассмотреть возможность сделать это в ближайшее время.
Мы с нетерпением ждем совместной работы над этой важной инициативой.
Большое спасибо.
Д-р Martin Weber
Team lead
Quality of Care and Patient Safety
73rd Session of the WHO Regional Committee for Europe
74th Session of the WHO Regional Committee for Europe
Future proofing Europe: Ensuring Health, Equity and
Sustainability – A Renewed Focus on Child and Adolescent
Opening remarks
Dr Hans Henri P Kluge
Regional Director, WHO Regional Office for Europe
Ms Regina De Dominicis
UNICEF Regional Director for Europe and Central Asia
2
74th Session of the WHO Regional Committee for Europe
Child and Adolescents’ health and wellbeing challenges in
the WHO European Region
Dr Susanne Carai, WHO/Europe
Dr Martin Weber, WHO/Europe
Dr Sophie Jullien, WHO/Europe
Ms Ivelina Borisova, UNICEF
Dr Gabriele Fontana, UNICEF
3
Child and Adolescents’
health and wellbeing challenges
in the WHO European Region
74th Session of the WHO Regional Committee for Europe
Which topic are we talking about?
5
74th Session of the WHO Regional Committee for Europe
Overweight
and obesity
One in three
children age 5-9
and one in four
adolescents are
living with
overweight or
obesity
74th Session of the WHO Regional Committee for Europe
Why is this important?
Physical health
Overweight
and obesity Mental health
Social health
Society
Financial burden
74th Session of the WHO Regional Committee for Europe
Successful governance:
Overweight
and obesity 1. Invests in primary health care and healthy schools
2. Engages with children and adolescents
3. Promotes and supports breastfeeding
4. Implements marketing restrictions on unhealthy foods and
drinks to children
5. Imposes taxes on sugar-sweetened drinks
Sugar-sweetened Beverages
Taxation
The case of Portugal
Francisco Goiana-da-Silva MD MSc MiM PhD
THE CHILDHOOD OVERWEGHT EPIDEMIC
Benchmark & Surveillance
% children
Chile
United States
New Zealand
Mexico
Spain
Greece
Brazil
Portugal
Hungary
Finland
Denmark
Slovenia
Canada
Australia
OECD24
UK (England)
Korea
Austria
South Africa
Lithuania
China
Ireland
Switzerland
Sweden
Turkey
Netherlands
Belgium
Poland
Norway
Indonesia
8 18 28 38 48
OECD’s statistical databases, 2017 Childhood Obesity Surveillance Initiative – Portugal, 2016
POLICY APPROACH
Where to start?
POLICY APPROACH
WHO Best Buys
POLICY APPROACH
Global Integrated Strategy Tiered Taxation Architecture (2016)
AXIS 1
Modify the environment where people choose and buy food by
modifying the availability of food in certain physical spaces and
promoting the reformulation of certain categories of food.
> 80g Added Sugar p/Liter
AXIS 2
Improve the quality and accessibility of information available to
consumers in order to inform and empower citizens for healthy food
choices.
AXIS 3
Promote and develop literacy and autonomy for the exercise of
healthy consumer choices
< 80g Added Sugar p/Liter
AXIS 4
Promote innovation and entrepreneurship directed to the area
of promoting healthy eating.
Key Achievements
Evidence and Projections for the Future
2018 2020
Key Achievements
NCDs Funding | Sweetened Beverages
Evidence and Projections for the Future
PRODUCT REFORMULATION | TIER DISTRIBUTION
11.1% 11.6% 12.4% 15.5%
Up to 2,5 g
LOWER 40% REDUCTION OF
THE SHARE OF
From 2,5 to 5 g 17.5%
From 5 to 8 g TAX TIER 20.4% 19.4%
19.1% UPPER TIER
PRODUCTS
8.7%
7.3% 7.4%
28.6% 6200 REDUCTION OF
TONS OF SUGAR
INGESTED
- 40%
More than 8 g
UPPER
62.6% 60.8% 60.8%
TAX TIER
36.8%
5% REDUCTION OF
CONSUMPTION
2014 2015 2016 2017
PROBEB 2017
One in three
children age 5-9
and one in four
adolescents live
with overweight
or obesity
Digital
environment
Digital dilemma
spanning Europe:
11% of teens
struggle with
problematic social
media use
Why is this important?
Digital Problematic social media use and gaming
environment • is linked to mental health issues, sleep disturbances,
and increased substance abuse
• is associated with lower life satisfaction
• can impact physical health and academic performance
One in three 11% of teens
children age 5-9 struggle with
and one in four problematic
adolescents live social media use
with overweight
or obesity
Adolescent
mental health
Adolescents today
have poorer mental
health than
previous
generations
74th Session of the WHO Regional Committee for Europe
Factsheets - Child and adolescent health in the WHO
European Region
25
Healthy schools
CASE STUDY CROATIA
2 September 2024
WHAT WAS THE CHALLENGE?
o Students' health is vital for societal progress and
successful education.
o The COVID-19 pandemic highlighted the indivisible
link between health and education.
o Croatia largely succeeded in keeping schools open
during the pandemic, which helped preserve
students' mental health and well-being.
RECENT POLICY REFORMS IN
CROATIAN SCHOOLS
o Quality time spent in a healthy school environment
forms the foundation of two major reforms
currently underway in Croatian schools:
- the Whole-day school project and
- free school meals
The Whole-day school
o Goal is a balanced, equitable,
efficient, and sustainable education
system.
o Extended school hours enable a
wider range of skill-based activities.
o Currently implemented in 62 schools,
the goal is nationwide
implementation in the coming years.
o Practical Skills Curriculum
Photo source: https://www.skolskiportal.hr/kolumne/nasa-cjelodnevna-skola/
Free school meals
o one meal daily for all students
o A little under 6 million free
meals are consumed each
month
o Fight against disadvantage
and inequality
o Fight against the obesity
epidemic
WHAT DID WE ACHIEVE?
o In the previous school year, we addressed the
physical state of our schools.
What was difficult/ remains to be done?
o Now, our focus is on improving educational quality
for all students, irrespective of their
circumstances.
OPPORTUNITIES
School health Schools for Health
services in Europe (SHE)
network
In Croatia, school can
Croatia is a member of
contact school doctor for
the SHE network that
specific health issues.
provides schools with
effective tools and skills
for health promotion.
o I welcome a New Child and Adolescent Health
and Wellbeing Strategy.
o New Strategy will enable a better future for
our children through the strong bond between
health and education.
One in three 11% of teens Health and
children age 5-9 struggle with education
and one in four problematic inequalities widen
adolescents live social media use for school-aged
with overweight children due
or obesity to pandemic
Adolescents
today have poorer
mental health
than previous
generations
One in three 11% of teens Health and
children age 5-9 struggle with education
and one in four problematic inequalities widen
adolescents live social media use for school-aged
with overweight children due
or obesity to pandemic
Adolescents
today have poorer
mental health
than previous
generations
Breastfeeding initiation within the first
hour of life
Breastfeeding
Too many
newborns are not
breastfed within
their first hour
of life
Prevalence of breastfeeding initiation within the first hour of life
Why is this important?
Delayed initiation can have life-threatening consequences
Breastfeeding
Diarrhoea, pneumonia, asthma
Obesity and noncommunicable diseases
Contributes to the health and well being of mothers
Successful governance
Breastfeeding 1. Implements the standards set up by the Baby Friendly
Hospital Initiative
2. Complies with the International Code of Marketing of Breast
Milk Substitutes
3. Supports breastfeeding practices through paid family leave
and workplace regulations
4. Invests in training doctors, midwives and nurses in
breastfeeding protection, promotion and support
Early initiation of breastfeeding
The case of Norway
Gry Hay, Special Adviser, Norwegian Directorate of Health
Anne Bærug, Senior Adviser, Norwegian Directorate of Health
What was the challenge before the BFHI was introduced
in 1993?
• Only a few hospitals had a
breastfeeding policy
• Systematic training of staff was lacking
• Most babies were put early to the
breast, however, mothers and babies
were not given enough time with
undisturbed skin-to-skin contact Up until the 90's mothers and babies were
• Scheduled feeding was still the separated for many hours
practice in some hospitals.
• Mothers and babies were separated at
night
41
What policy change was implemented?
The WHO/Unicef Baby-Friendly
Initiative was recommended by the
Norwegian health authorities for the:
• antenatal care (1993)
• delivery and maternity wards (1993)
• neonatal intensive care units (1995)
• community health services (2005)
42
What was the impact ?
Breastfeeding in Norway before and after BFHI
43
Changes (challenges) that still have to be
addressed
• Frequent use of formula in the
hospital
• Early discharge from the hospital,
and not good enough follow up
after hospital discharge
• Digital marketing of infant formula
targeting mothers from pregnancy
on
44
Europe has
the lowest
breastfeeding
rates in the world
One in three 11% of teens Health and
children age 5-9 struggle with education
and one in four problematic inequalities widen
adolescents live social media use for school-aged
with overweight children due
or obesity to pandemic
Adolescents
today have poorer
mental health
than previous
generations
Early Childhood
Development
More than 5 million
children are at risk
of developmental
difficulties
Why is this important?
Early Childhood
Development
Successful governance
1. Guarantees support for ECD through all contacts with the
Early Childhood health system
Development 2. Empowers parents as key agents of child development &
wellbeing
3. Ensures the monitoring of child development and the
provision of timely interventions for children with
developmental difficulties
4. Promotes health, breastfeeding, immunization, responsive
caregiving and early learning opportunities
5. Invests in well trained health workforce to deliver ECD
services in collaboration with other sectors
Children with Europe has
developmental the lowest
difficulties are breastfeeding
identified too late rates in the world
One in three 11% of teens Health and
children age 5-9 struggle with education
and one in four problematic inequalities widen
adolescents live social media use for school-aged
with overweight children due
or obesity to pandemic
Adolescents
today have poorer
mental health
than previous
generations
Neonatal mortality rates
European Region
Mortality
The neonatal
mortality in the
highest mortality
country is 10 times
higher than the
WHO European
Region and 28 times
higher than the
lowest mortality
countries
Inequalities in Children with Europe has
newborn and child developmental the lowest
mortality persist difficulties are breastfeeding
across the Region identified too late rates in the world
One in three 11% of teens Health and
children age 5-9 struggle with education
and one in four problematic inequalities widen
adolescents live social media use for school-aged
with overweight children due
or obesity to pandemic
Adolescents
today have poorer
mental health
than previous
generations
There are 9 million forcibly displaced children
in Europe
Refugee
and
migrant
health
To honour commitments made in the united nations
convention on the rights of the child:
Refugee and 1. Protect children during armed conflict
migrant health
2. Provide quality healthcare, social protection, and education to
all children
3. Collaborate with other countries to address the issues that cause
forced migration, increase the availability of safe and legal
routes, and ensure the responsiveness of all host countries
4. Develop and implement cross sector emergency preparedness
and response plans that account for refugee and migrant
children’s needs
Inequalities in Children with Europe has
newborn and child developmental the lowest
mortality persist difficulties are breastfeeding
across the Region identified too late rates in the world
One in three 11% of teens Health and
children age 5-9 struggle with education
and one in four problematic inequalities widen
adolescents live social media use for school-aged
with overweight children due
or obesity to pandemic
There are Adolescents
9 million forcibly today have poorer
displaced children mental health
in Europe than previous
generations
Inequalities in Children with Europe has
newborn and child developmental the lowest
mortality persist difficulties are breastfeeding
across the Region identified too late rates in the world
One in three 11% of teens Health and
children age 5-9 struggle with education
and one in four problematic inequalities widen
adolescents live social media use for school-aged
with overweight children due
or obesity to pandemic
There are Adolescents Adolescents
9 million forcibly face barriers in today have poorer
displaced children accessing sexual mental health
in Europe reproductive than previous
health services generations
Inequalities in Children with Europe has
newborn and child developmental the lowest
mortality persist difficulties are breastfeeding
across the Region identified too late rates in the world
One in three 11% of teens Health and
children age 5-9 struggle with education
and one in four problematic inequalities widen
adolescents live social media use for school-aged
with overweight children due
or obesity to pandemic
There are Adolescents Adolescents Adolescents
9 million forcibly face barriers in today have poorer cannot access
displaced children accessing sexual mental health health services
in Europe reproductive than previous by themselves
health services generations
74th Session of the WHO Regional Committee for Europe
Factsheets - Child and adolescent health in the WHO
European Region
62
Inequalities in Children with Europe has ... Alcohol use Immunization
newborn and child developmental the lowest during pregnancy
mortality persist difficulties are breastfeeding
across the Region identified too late rates in the world
... ...
Complementary Asthma Quality of care: Violence against
feeding unnecessary children
hospitalizations
Unintentional Tuberculosis OneOverweig
in three Oral 11% ofDigital
teens Health
Impactand
of
injuries children
ht andage 5-9 health struggle with
environme education
COVID on
andobesity
one in four problematic
nt inequalities
educationwiden
adolescents live social media use for school-aged
with overweight children due
or obesity to pandemic
There are Adolescents ... Adolescents Adolescents
Refugee Access to sexual Adolescent Providing Tobacco
9 million forcibly
and migrant face barriers in
and reproductive today have poorer
mental cannot access
services to
displaced
health children accessing sexual
health mental health
health health services
adolescents
in Europe reproductive than previous by themselves
health services generations
The Finnish Child Strategy
Pia Suvivuo
Senior Specialist, Ph.D
Ministry of Social Affairs and Health
FINLAND
Why was the National Child Strategy
needed in Finland?
• Finland’s child and family policy has long been short-
term and fragmented.
• The rights of the child are not fully realized in
Finland.
• The rights of the child are not realized equally in all
regions or with regard to all children.
65 | 5.9.2024
National Child Strategy
• Helps to make our child and family policies more coherent with the
rights of the child and their full implementation in Finland.
• Shares its goals with the EU Strategy on the Rights of the Child and
the European Child Guarantee.
• E.g. it focus on child participation, child impact assessment, child
budgeting and equality of children.
• First national child strategy adopted in 2021.
• The strategy was prepared with parliamentary committee in 2020
• The committee represented all parliamentary parties.
66 | 5.9.2024
The National Child Strategy : 2 phases
1) Long-term objectives and measures: recorded in the actual Child
Strategy.
Parliamentary preparation
2) The objectives, measures and resources for the government term
(or a corresponding shorter term): recorded in the implementation
plan for the strategy.
Preparation by public officials
Follow-up report: tool for assessing the Strategy and its
implementation plan and as a bridge for the policy guidelines of the
Strategy between government terms.
67 | 5.9.2024
Implementation
• Each government will implement its own
implementation plan based on the Child Strategy.
• The second implementation plan for the Child
Strategy is currently being implemented.
• Coordinated by the National Child Strategy unit
which was established in 2022.
• The unit promotes the implementation of the Child
Strategy on a cross-sectoral basis through the action
plans of the current and future governments.
68 | 5.9.2024
Thank you!
More information:
Website: https://childstrategy.fi/
E-mail:
[email protected]
Child and Adolescents’
health and wellbeing challenges
in the WHO European Region
74th Session of the WHO Regional Committee for Europe
Call to action
Ms Valeria Babenco, Youth volunteer network, Moldova
Dr Berthold Koletzko, European Academy of Paediatrics (EAP)
Dr Massimo Pettoello-Mantovani, European Paediatric Association (EPA-UNEPSA)
Ms Caroline Costongs, EuroHealthNet
Dr Oddrun Samdal, Health Behaviour in School-aged Children (HBSC) network
Dr Eileen Scott, WHO Collaborating Centre Representative, Public Health Scotland
71
74th Session of the WHO Regional Committee for Europe
Q&A and closure
Dr Natasha Azzopardi-Muscat
Director, Country Health Policies and Systems, WHO Regional Office for Europe
72
74th Session of the WHO Regional Committee for Europe
A new child and adolescent health and wellbeing strategy,
a co-creation exercise
Member States consultations
Side event RC74 Consultation 1 Consultation 2 Consultation 3 RC75
2 September 2024 26 November 2024 30-31 January 2025 18 March 2025 October 2025
73
74th Session of the WHO Regional Committee for Europe
Thank you
For more information, contact:
Sophie Jullien - Technical Officer, Child and Adolescent Health;
[email protected]
Martin Weber - Team lead, Quality of Care and Patient Safety;
[email protected]
Susanne Carai - Consultant for Child and Adolescent Health and Quality of care;
[email protected]