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Saatja: "PETTERSSON, Olga Tchachtchina" <[email protected]> Saaja: "Leena Kalle - SOM" <[email protected]> Teema: Estonia_Country Profile_Child and Adolescent Health & Well-being Kuupäev: 2025-09-03 13:26 Tähelepanu! Tegemist on välisvõrgust saabunud kirjaga. Tundmatu saatja korral palume linke ja faile mitte avada. /Sent on behalf of Dr Sophie Jullien/ Dear National Focal Points on Child and Adolescent Health, We are pleased to provide you with an update on "A healthy start for a healthy life", the regional strategy for child and adolescent health and well-being, which is on track for submission to the Regional Committee in October. We have carefully integrated the written feedback received from Member States during the consultation following the SCRC, and are grateful for the thoughtful comments and valuable contributions. In preparation for implementation, we have been developing country profiles that will serve as a baseline for monitoring progress under the Strategy. These profiles are based on already collected data and have been complemented by responses to the shorter survey circulated via the Health for All platform in June 2025. Please note that survey responses submitted after 26 August could not be incorporated into the present version of the profiles. Our aim is to have the finalized country profiles available for the RC75. In this regard, we are pleased to circulate a draft of your country’s profile for review, and we kindly request your feedback by 19 September 2025. As planned, we will also work in close collaboration with Member States to define a limited set of indicators for monitoring the implementation of the strategy once it has been adopted. Please do not hesitate to get in touch should you have any questions or require further information. Thank you for your continuous support and collaboration. Kind regards, Sophie Dr Sophie Jullien Technical Officer Child and Adolescent Health World Health Organization Regional Office for Europe | Division of Country Health Policies and Systems WHO Athens Quality of Care and Patient Safety Office | Ploutarchou 3 | 10675 Athens, Greece Web: Child health EURO <https://www.who.int/europe/health-topics/child-health#tab=tab_1> Estonia A healthy start for a healthy life: a strategy for child and adolescent health and well-being in the WHO European Region, 2026–2030 ⬤ Estonia ⬤ WHO European Region average ⬤ Worst-performing country ⬤ Best-performing country Child and adolescent development and health status Child mortality (0–4) Adolescent mortality (10–19) 2.1 deaths per 1,000 births 2.6 deaths per 1,000 adolescents Country at a glance Total population 1 374 687 Under 18 population 267 879 Children developmentally on track Measles vaccine coverage No data Source information 74% Under 5 population 66 025 Adolescent population 155 026 GDP per capita 49 334 USD Breastfeeding initiation within 1 hour Multiple health complaints (well-being and mental health) (11–15) No data 60% of girls 37% of boys Being cyberbullied (11–15) Violence against children (1–14) 19% No data Page 1 / A healthy start for a healthy life: a strategy for child and adolescent health and well-being in the WHO European Region, 2026–2030 / Country profile: Estonia Health behaviours and outcomes ⬤ Estonia ⬤ WHO European Region average ⬤ Worst-performing country ⬤ Best-performing country Nutrition, physical activity and obesity No fruits/vegetables daily (11–15) Soft drinks daily (11–15) Insufficient physical activity (11–15) Overweight and obesity (6–9) 0% 20% 40% 60% 80% 100% Tobacco and alcohol Current e-cigarette use (13–15) Current cigarette use (13–15) Current alcohol use (13–15) Drunk in last 30 days (13–15) Ever been drunk (13–15) 0% 20% 40% 60% 80% 100% Policies for child and adolescent health ⬤ Estonia █ Yes/implemented █ Partial implementation/planned █ No/not implemented █ Data missing Dental care coverage Adoption of the ECD Framework Restrict HFSS food/drink marketing Tax on sugar-sweetened beverages Limit marketing on mobile/gaming platforms Advertising ban on all forms of tobacco Tax on alcohol Ban on corporal punishment 0 5 10 15 20 25 30 35 40 45 50 Member States ECD = Early childhood development HFSS = High in fat, salt or sugar Page 2 / A healthy start for a healthy life: a strategy for child and adolescent health and well-being in the WHO European Region, 2026–2030 / Country profile: Estonia System performance for child and adolescent health Child and adolescent rights Adolescent participation Age to access health care without parental consent Involved adolescents in a national child and adolescent Maturity health strategy No data ●● Estonia ●● Based on maturity Waiting for new data ●● Yes Estonia ●● No 14–15 years ● 16–17 years 18 years Not reported Service delivery Workforce School health services onsite or through linkages Monthly salary (PPP) for general paediatricians No data No data ●● Estonia ● WHO European Region average Highest salary country ● Lowest salary country ●● Estonia ●● Yes No Not reported Financing Out-of-pocket payments (% of Public spending on health (% of Public spending on health: current spending on health) total public spending) availability of data disaggregated 23.4% 13.2% by age (0–18) No data Children and adolescents in vulnerable situations Asylum applicants 93% 7% Children seeking asylum per 100 000 resident children (0–18) 35 ●● Adults ● <18 years unaccompanied <18 years accompanied Children seeking asylum (0–18) 95 Page 3 / A healthy start for a healthy life: a strategy for child and adolescent health and well-being in the WHO European Region, 2026–2030 / Country profile: Estonia Indicator definitions and sources Last accessed 30 July 2025 Total population: Total population. Source: UNICEF TransMonEE: Eurostat; Ever been drunk (13–15): Percentage of 13–15-year-olds who report having United Nations, Department of Economic and Social Affairs, Population been drunk on two or more occasions in their lifetime. Source: HBSC study Division (2024); and revised/validated by countries. 2021/2022. Under 18 population: Children aged 0–17 years. Source: UNICEF TransMonEE. Dental care coverage: Dental care for children and adolescents (0–18) covered under national health insurances schemes or government benefit packages. Under 5 population: Children aged 0–4 years old. Source: UNICEF Sources: WHO/Europe Member States (MS) Survey 2025 and WHO Child and TransMonEE. adolescent health in Europe: report on progress to 2021. Copenhagen: WHO Regional Office for Europe; 2024. Licence: CC BY-NC-SA 3.0 IGO. Adolescent population: Adolescents aged 10–19 years. Source: UNICEF TransMonEE. Adoption of the ECD Framework: Adoption of the WHO Framework on Early Childhood Development (ECD) in the European Region. Source: WHO/Europe GDP per capita: Gross domestic product per capita is the total value of goods MS Survey 2025. and services produced in a country divided by its population, expressed in current US dollars and not adjusted for inflation. Source: International Restrict HFSS food/drink marketing: Existence and implementation status of Comparison Program, World Bank. policy restricting marketing of foods and drinks high in fat, sugar and salt (HFSS) to children and adolescents. Source: Noncommunicable diseases Child mortality (0–4): Number of deaths among children under age 5 per 1000 (NCD) Country Capacity Survey (CCS) 2023. live births in a given year. Source: United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Tax on sugar-sweetened beverages: Existence of a national tax on sugar- sweetened beverages. Source: World Bank, Global SSB Tax Database. Adolescent mortality (10–19): Number of deaths among adolescents (10–19 years) per 1000 adolescent population in a given year. Source: UN IGME. Limit marketing on mobile/gaming platforms: Existence and implementation of restrictions on food and beverage marketing on mobile and gaming Children developmentally on track: Percentage of children aged 24–59 months platforms. Source: WHO/Europe MS Survey 2025. who are developmentally on track in at least three of the following domains: literacy–numeracy, physical development, social emotional development and Advertising ban on all forms of tobacco: Bans on tobacco advertising, learning. The data covers 36–59 months, except for Uzbekistan, which used promotion and sponsorship. Red: Complete absence of ban, or ban that does the new Early Childhood Development Index calculation method for 24–59 not cover national television, radio and print media. Yellow: Ban on national months. Source: UNICEF TransMonEE: Multiple Indicator Cluster Surveys television, radio and print media as well as on some but not all other forms of (MICS) and Türkiye child survey 2022. direct and/or indirect advertising. Green: Ban on all forms of direct and indirect advertising (or at least 90% of the population covered by subnational Measles vaccine coverage: Percentage of children who received the second legislation completely banning tobacco advertising, promotion and dose of measles-containing vaccine. Source: WHO/UNICEF Estimates of sponsorship). Source: WHO report on the global tobacco epidemic, 2025: National Immunization Coverage. warning about the dangers of tobacco. Geneva: World Health Organization; 2025. Licence: CC BY-NC-SA 3.0 IGO. Breastfeeding initiation within 1 hour: Percentage of newborns breastfed within the first hour of life. Sources: Baby-Friendly Hospital Initiative Network, Tax on alcohol: Implementation of a national tax or pricing policy to reduce the WHO Child and adolescent health in Europe: report on progress to 2021. affordability of alcohol. Source: WHO/Europe MS Survey 2025. Copenhagen: WHO Regional Office for Europe; 2024. Licence: CC BY-NC-SA 3.0 IGO; UNICEF TransMonEE. Ban on corporal punishment: Corporal punishment of children is punishable by law. Source: WHO/Europe MS Survey 2025. Multiple health complaints (well-being and mental health) (11–15): Percentage of 11–15-year-olds who report two or more health complaints (from a list Age to access health care without parental consent: Legal minimum age at including headache, stomach ache, backache, feeling low, irritability, which adolescents can access health services without parental consent. nervousness, difficulty sleeping, and dizziness) at least weekly in the past six Sources: WHO/Europe MS Survey 2025 and WHO Child and adolescent health months. Source: Health Behaviour in School-aged Children (HBSC) study in Europe: report on progress to 2021. Copenhagen: WHO Regional Office for 2021/2022. Europe; 2024. Licence: CC BY-NC-SA 3.0 IGO. Being cyberbullied (11–15): Percentage of 11–15-year-olds who report Involved adolescents in a national child and adolescent health strategy: experiencing cyberbullying (e.g. being sent mean or threatening messages, Adolescents participated in the development, implementation or review of having photos/videos shared without permission) at least once or twice a national child and adolescent health strategies or policies. Sources: month in the past couple of months. Source: HBSC study 2021/2022. WHO/Europe MS Survey 2025 and WHO Child and adolescent health in Europe: report on progress to 2021. Copenhagen: WHO Regional Office for Violence against children (1–14): Percentage of children aged 1–14 who have Europe; 2024. Licence: CC BY-NC-SA 3.0 IGO. experienced any physical punishment and/or psychological aggression by caregivers. Source: TransMonEE: MICS or Demographic and Health Surveys School health services onsite or through linkages: Health services are available (DHSS). in schools or through linkages with the health system according to policy. Source: WHO/Europe MS Survey 2025. No fruits/vegetables daily (11–15): Percentage of 11–15-year-olds who report eating neither fruit nor vegetables daily. Source: HBSC study 2021/2022. Monthly salary (PPP) for general paediatricians: Average monthly salary of general paediatricians before tax adjusted for purchasing power parity (PPP). Soft drinks daily (11–15): Percentage of 11–15-year-olds who report daily Sources: WHO/Europe MS Survey 2025 and WHO Child and adolescent health consumption (at least once per day) of sugary soft drinks. Source: HBSC study in Europe: report on progress to 2021. Copenhagen: WHO Regional Office for 2021/2022. Europe; 2024. Licence: CC BY-NC-SA 3.0 IGO. Insufficient physical activity (11–15): Percentage of 11–15-year-olds not Asylum applicants: Percentage of children (0–18) of total asylum applicants reporting daily physical activity for at least 60 minutes. Physical activity was disaggregated by those who arrive in the country accompanied and those defined as any activity that increases the heart rate and makes the person get who are unaccompanied (separated from both parents and not cared for by a out of breath some of this time, with examples provided. Source: HBSC study guardian or other adult who is legally or customarily responsible for them); 2021/2022. number of children (0–18) seeking asylum per 100 000 child population (0–18); total number of children (0–18) seeking asylum. Sources: UNHCR Refugee Overweight and obesity (6–9): Percentage of children aged 6–9 classified as Data Finder, Eurostat and national government reported statistics. overweight or obese (WHO criteria). Source: WHO European Childhood Obesity Surveillance Initiative (COSI). Public spending on health (% of total public spending): Domestic general government health expenditure (GGHE-D) as % of general government Current e-cigarette use (13–15): Percentage of 13–15-year-olds who report expenditure (GGE). Source: WHO Global Health Expenditure Database. using electronic cigarettes at least once in the past 30 days. Source: HBSC study 2021/2022. Out-of-pocket payments (% of current spending on health): Percentage of current health expenditure paid directly by households out-of-pocket. Source: Current cigarette use (13–15): Percentage of 13–15-year-olds who report using WHO Global Health Expenditure Database. cigarettes at least once in the past 30 days. Source: HBSC study 2021/2022. Public spending on health: availability of data disaggregated by age (0–18): Current alcohol use (13–15): Percentage of 13–15-year-olds who report drinking Availability of data on total government spending on health for children and alcohol in the past 30 days. Source: HBSC study 2021/2022. adolescents aged 0–18. Source: WHO/Europe Member States Survey 2025. Drunk in last 30 days (13–15): Percentage of 13–15-year-olds who report being drunk at least once in the past 30 days. Source: HBSC study 2021/2022. Page 4 / A healthy start for a healthy life: a strategy for child and adolescent health and well-being in the WHO European Region, 2026–2030 / Country profile: Estonia