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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]