On the occasion of the World Health Day 2018, the Association of doctors of Macedonia held a solemn gathering on which the Minister of Health, Dr. Venko Filipce addressed.nnHe emphasizing the commitment of the Government and the Ministry of Health of Republic of Macedonia in the promotion of public health and stressed that one of the main priorities is the modernization of the immunization schedule.nnMinister Filipche pointed out that more serious reforms are underway, with focused on: raising the quality of health services for patients by providing access and opportunities for everyone and everywhere.nn nnLink -> http://zdravstvo.gov.mk/odbelezhan-svetski-den-na-zdravjeto/
WHO at 70 – working for better health for everyone, everywhere
n
On 7 April, World Health Day, the World Health Organization marked its 70th anniversary. On this occasion we should not only reflect on the impressive progress in health that has been achieved in past 7 decades – from routine vaccination against childhood diseases to vastly improved maternal health, a focus on healthy environments, protection from health threats, and a strong legal framework to stop tobacco use, for example – but also recommit to the most fundamental goal of health for all.
n
This year, World Health Day is dedicated to one of WHO’s founding principles: “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”
n
Universal health coverage is a simple idea: it means that all people can use quality health services, where and when they need them, without experiencing financial hardship. It is a fundamental human right, a vision that WHO has pursued in partnership with countries since its foundation 70 years ago.
n
Yet despite impressive progress in the WHO European Region, even the most advanced countries have not been able to protect everyone from financial hardship caused by out-of-pocket payments for health care, and the heaviest burden falls on poor and vulnerable people. Out-of-pocket payments for health make up more than 15% of total spending on health in most countries of the European Region which raises concerns about the strengths of the system in providing protection for patients against the cost of ill health.
n
The 2030 Agenda for Sustainable Development has made “universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all” a global goal. This year, WHO and its Member States have committed to an ambitious 5-year plan to accelerate progress towards achieving universal health coverage.
n
WHO calls on leaders in all Member states, including Serbia to take 3 concerted actions towards universal health coverage. Universal access to a strong and resilient people-centred health system with primary care as its foundation – bringing together community-based services, health promotion and disease prevention – produces social and economic benefits for individuals and societies.
n
Specifically, reducing the out-of-pocket payments that lead to financial hardship requires more public financing and carefully designed coverage policies with a focus on poorer people and other vulnerable groups, and a recent regional analysis suggest that all countries can do more and better to move towards universal health coverage.
n
Health is our most precious asset. It must not be a luxury enjoyed by the privileged. We all benefit socially, economically and environmentally from a world that seeks health for all. It is time that we come together and make this a common goal.
n
Data and context of UHC in Serbia
n
In the past 15 years, the life expectancy of the Serbian population has improved for both men and women from 71.76 years (69.05 years for men and 74.52 years for women) to 75.42 years (72.85 years for men and 78.00 for women) in the period 1998–2014. According to the WHO global health estimates, NCDs accounted for 94% of all deaths in Serbia in 2014. In 2015, the main causes of mortality for all ages included diseases of the circulatory system, malignant neoplasms and diseases of the respiratory system . The standardized death rates (SDRs) for the four major NCDs in Serbia are higher compared to those for countries in the EU and the Region but the SDRs for the main causes of NCD mortality have decreased in recent years, most significantly for diseases of the circulatory system.
n
The highest incidence and mortality from malignant diseases in men came from lung (30.5%), colon (12%) and prostate cancer (8.1%), while most women were affected by breast (17.9%), lung (15.2%) and colorectal cancer (10.5%).
n
Data from the RHIF for 2015 record the number of registered adult patients with arterial hypertension is 28.6% of the adult population registered with a chosen doctor and the number of registered adult patients with diabetes mellitus is 8.1%of the adult population registered with a chosen doctor.
n
Up to 80% of heart diseases, strokes and type 2 diabetes as well as over a third of cancers could be prevented by eliminating common risk factors such as tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol. With its long history of a strong public health infrastructure and established framework and expertise, Serbia has the potential to make remarkable progress in scaling up coverage by core population-based interventions for NCD prevention. NCDs are acknowledged as a major threat to the socioeconomic wellbeing of the population in the 2016 Law on Public Health and concrete actions are formulated in a new draft Public Health Strategy.
n
Total health expenditure increased constantly in past decade but in the same period, the total expenditure on prevention and public health services was increased at a slower rate than total health expenditure, which led to a decrease in the percentage of prevention and public health services as a share of total health expenditure.
n
Out of pocket payment (OOPS) increased according to National Health Account and reached 41% in 2016.
n
Examples of good practice in the health care system in Serbia
n
The development of the Acute Coronary Syndrome network demonstrates that a strategically organized process can be implemented. The full process consists of the planning of human and financial resources, infrastructures, an information technology and communication network, and evaluation and quality processes. Clinical outcomes are comparable with the best international results.
n
A pilot project covering diabetes facilities at PHC centres has started with needs assessments at different levels of care, with the involvement of the multidisciplinary team at all levels of conception and implementation of the programme.
n
Accreditation of health care institutions is improving quality, safety and the patient experience through the established Agency for Accreditation of Health Care Institutions.
Mr Dragan Bogdanić, Minister of Health and Social Welfare of the Republic of Srpska
n
Mr Victor Olsavsky, Head of the World Health Organization Country Office in BiH
n
Mr Boris Rebec, World Health Organization Country Office in BiH
n
n
n
The World Health Day is celebrated on April 7, on the day when in 1948, the World Health Organization was founded. This year’s World Health Day is dedicated to universal health coverage – Health for all. The marking of the World Health Day is a unique opportunity to point out the need for health care systems in the world to strive to provide the population with quality and accessible healthcare. These goals are also defined in the Global Sustainable Development Goals (SDG).
n
The Government of the Republic of Srpska is continuously working on the improvement of the health system of the Republic of Srpska, with the patient being the focus of interest. This is supported by the fact that within the two phases of the “Health Sector Enhancement Project”, more than 47 million BAM has been invested in the primary healthcare over the past ten years, through construction, rehabilitation, reconstruction and equipping of family medicine outpatient clinics. More than 300 outpatient clinics have been built or reconstructed for the needs of family medicine teams within 120 facilities in 51 municipalities of the Republic of Srpska. Owing to the implementation of this Project, the availability of healthcare throughout the Republic of Srpska has considerably improved, which is particularly reflected in the strengthening of the capacity of branch outpatient clinics that are of great importance to the local population.
n
Furthermore, significant projects at the secondary and tertiary healthcare level have been implemented. The respective projects include the construction and equipping of the Hospital in Bijeljina, Hospital in Nevesinje, reconstruction and equipping of the University Clinical Center of the Republic of Srpska, construction of the Hospital in Istocno Sarajevo (which is in progress). Moreover, the construction of a new hospital in Doboj is being planned.
n
We would like to highlight that much has been done to improve the availability of all health services in the Republic of Srpska in recent years, including the MRI and CT examinations for which the patients needed to wait longer in the past 10 years than today. Waiting for these examinations has been reduced owing the introduction of centralized scheduling of examinations, introduction of the private sector into the health system, investment in equipment and personnel, and the like. In 2004, in the Republic of Srpska there was not a single MRI device and there were only three CT devices; however, today in the Republic of Srpska, there are 10 MRI devices and more than 15 CT devices available to the Fund-insured persons. In addition to the University Clinical Center of the Republic of Srpska, some magnetic resonance imaging in Banja Luka may also be performed in two private healthcare facilities, where patients wait for these examinations for two or three months. Patients wait shorter for MRI examination in hospitals in Doboj and Bijeljina, namely around 30 days. In emergency cases, patients do not wait for these examinations, namely, patients are hospitalized and the examination is performed in the hospital without the scheduling thereof through the Fund.
n
More than 500 new diagnostic and treatment methods have been introduced in our healthcare institutions in the past ten years.
n
Around million inhabitants of the Republic of Srpska have health insurance.
n
Almost 50% of the total insured persons in the Republic of Srpska are on some basis exempt from paying copayment. Children up to 15 years, persons over 65 years, war veterans and families of fallen soldiers, and persons with impaired vision (first and second category) are exempt from copayment for all health services, whereas volunteer blood donors, beneficiaries of permanent financial assistance and persons accommodated in social welfare institutions and retirees with the lowest pension are exempt from copayment for most of health services. All insured persons are exempt from copayment for the measures of the prevention and early detection of disease. Furthermore, copayment is not paid for family planning services, childbirth and other services related to pregnancy and during the maternity period of up to 12 or 18 months after childbirth, under the respective diagnosis. Mothers do not pay copayment 12 months after childbirth, namely, 18 months for the birth of twins, the third child and each subsequent child. Moreover, copayment is not paid for examinations and treatments related to: in vitro fertilization, examination and treatment of oral and dental diseases of persons with inborn or acquired deformity of the face or jaw, examinations and treatment pertaining to communicable diseases for which the law prescribes the introduction of measures for preventing their spread, urgent medical conditions, including emergency medical examinations – life threats, examinations and treatment of occupational diseases and injuries at work, mobile orthodontic apparatus for children, total acrylate denture for insured persons over the age of 65, malignant diseases, diabetes, hemophilia, epilepsy, progressive musculoskeletal disorders, cerebral palsy, multiple sclerosis, improper bone and cartilage development (osteogenesis imperfecta – terminal stage), pleura (para, squared and tetra), chronic renal failure, cystic fibrosis, celiac disease and phenylketonuria, rheumatic fever, hereditary bullous epidermolysis, organ and tissue transplantation (paid neither by a donor nor a recipient), mental illness (psychosis), and intellectual disability.
n
There are about 1,500 medications on the Republic of Srpska Health Insurance Fund List. A quarterly amount of medications may be prescribed to chronic patients. The number of prescription drugs has increased by 85 percent since 2006, while the number of doses and forms with which these drugs appear on the list has been increased by 257 percent. Medications may be taken in any pharmacy with which the Fund has a contract, and the contract is signed with over 200 private pharmacies.
To mark World Health Day in the Republic of Moldova, health professionals were recognized for their dedication and leadership during a national awards ceremony on 11 April. Awards were given in categories such as best family doctor, best nursing team, best emergency team, best health NGO, best health journalist and more.
n
In partnership with the Ministry of Health, Labour and Social Protection, the National Health Insurance Company and the Centre for Health Information and Communication, WHO organized the fifth anniversary of the Health Gala – a national awards ceremony acknowledging the performance and best achievements of health professionals in the country, as well as innovation and best practices.
n
The Minister of Health, Labour and Social Protection, Svetlana Cebotari, the Prime Minister of the Republic of Moldova, Pavel Filip, the director of Programme Management in WHO/Europe, Dr Nedret Emiroglu, and the WHO Representative to the Republic of Moldova, Haris Hajrulahovic, addressed about 250 health professionals, health sector managers, development partners and representatives of diplomatic missions, as part of the World Health Day 2018 celebration.
The 2018 World Health Day was celebrated or observed in Romania through activities organized by the county Public Health Directorates throughout the country. Information related to the theme of World Health Day, “Universal health coverage: everyone, everywhere.”, was promoted through information materials, meetings and press releases. Under the slogan “Health for All”, the information highlighted the importance of access to essential health services for all, regardless of the economic or social status, age or residence. Coordination of the campaign was ensured by the National Institute for Public Health.
n
To mark the 2018 World Health Day and to promote its message, Sorina Pintea, Minister of Health and Miljana Grbic, Head of the WHO Office in Romania, visited the Community Medical Assistance Center in Gostinari, Giurgiu County.
n
“The community medical center we have seen is a successful recipe that we intend to promote and expand. The way things work here shows that it can be done, if there is a collaboration with local authorities. We need to provide medical services to isolated communities with poor populations, especially in localities where there are no family doctors. A mapping is in progress to identify the needs for community-based health services across the country. “Sorina Pintea, Minister of Health, said.
n
“Universal coverage of health services is a simple idea: it means that all people can use quality health services where and when they need it, without getting impoverished because they paid for the treatment they needed. This is one of the fundamental human rights.”, said Miljana Grbic, Head of the WHO Office in Romania.
On the occasion of the World Health Day 2018, SEEHN Secretariat and Regional Health Development Center on Public Health Services hosted by the Institute of Public Health in Skopje, marked the event on Thursday, April 5th at the Best Western Hotel Turist in Skopje.
n
World Health Organization established April 7th as World Health Day 70 years ago and this year the theme and slogan was “Universal Health Coverage: everyone, everywhere. Health for All”
n
Addressing the audience Dr. Mira Jovanovski-Dasic, Director of SEEHN Secretariat, underlined that all countries of the SEE region share common economic, environmental, demographic, political, challenges which all combined make a huge impact and diminish universal access to healthcare services, essential quality care and financial protection thus ultimately determining a huge gap of 10 years less in life expectancy comparing to the ones in the EU region.
nn
n
SEEHN will work intensively with its Member States in the forthcoming period for further upgrading public health services moving towards achieving its commitments from the Chisinau Pledge, which focus on:
n
Striving universal health coverage for our populations
n
Increasing public financing for health
n
Sustaining and strengthening the regional cooperation in public health
n
Working more closely and efficiently with our partners.
n
nn
This is what we all can do to achieve UHC at the regional, governmental, individual level by spotting policy-makers’ power to transform the health of their nation and to invite them to be part of the change; by sharing examples on the progress achieved towards UHC and encourage others to find their own path; by providing tools for structured policy dialogue on how to advance UHC nationally and by supporting such efforts at the regional level ( through expanding service coverage, improving quality of services, reducing out-of-pocket payments) pointed out Dr. Mira Jovanovski-Dasic.
n
She reiterated that SEEHN is committed to further supporting and working in this area and to spreading best practices in every possible occasion.
n
Our efforts aim to enhance people’s health, and the 2018 slogan “Health for All” shall be the headline of our daily activities that ultimately will drive changes for the other half of population to enjoy high qualitative healthcare services, concluded Dr. Mira Jovanovski-Dasic.