policy framework and strategy
Part 3. Health 2020: enhancing effective implementation – requirements, pathways and continuous learning
Introduction
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Leadership, including strengthening the roles of health ministers and the health sector Developing, implementing and evaluating national and subnational health policies, strategies and plans, drawing on the contribution of various sectors
Adding value through partnerships and partners for health
Creating whole-of-society and whole-of-government responsibility for health work monitoring, evaluation and priorities for public health research
Health at the crossroads of challenges for the 21st century A strong role for WHO
Looking forward References
Annex. glossary of working definitions and explanatory notes on concepts and terms used in Health 2020
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It gives me great pleasure to welcome you to Health 2020, the European health policy framework for all. Whether you are a president, prime minister, mayor, policy-maker, public health worker or community activist, Health 2020 contains information that can help you make healthier, safer and economically wiser decisions and choices.
All member States in the WHO European Region endorsed Health 2020 in September 2012, in two forms (both of which are included in this publication).
The European policy framework for supporting government and society for health and well-being provides politicians and key policy practitioners with value- and evidence-informed strategic policy advice for putting Health 2020 into practice. The longer Health 2020 policy framework and strategy provides much more detail in terms of evidence and practice related to health and well-being. It is meant especially for people who practice policy development and implementation at operational levels. It should also serve as a valuable resource for health advocates, researchers and practitioners who are looking for more in-depth information related to the various action recommendations in the shorter policy framework. moreover, our plan is to make this longer document a living guide, providing ongoing updated links to changes in evidence and practice for everyone – in the health and other sectors – involved in developing and implementing policy.
To ensure that the best available evidence has been identified and included, the WHO Regional Office for Europe has actively worked with hundreds of public health, economic and other experts from a wide variety of academic disciplines across the WHO European Region and beyond. These experts were asked to not just describe problems but, importantly, to identify evidence about what is working and what is not working well in addressing today‘s health challenges in different parts of the European Region. Our focus throughout has been on ensuring that everyone experiences more equally the significant improvements in health status that have been realized across the European Region in recent decades.
newly commissioned studies on actions to address inequities, the social determinants of health the governance approaches and the economics of disease prevention and health promotion informed the development of this evidence-informed framework. This process has made Health 2020 a unique distillate of the best public health policy evidence available.
The Health 2020 consultation involved the WHO’s governing bodies in the European Region, most notably the WHO Regional Committee for Europe, whose endorsement of Health 2020 in September 2012 was a landmark for health improvement across the Region. Beyond this it also involved the Region’s member States in other ways, through their own multi-layered forms of government and through their professional and lay interests. The involvement of civil society was central to the consultation process, as was the involvement of WHO’s networks, including Healthy Cities and Regions for Health. Health 2020 states clearly that today’s governance for health is horizontal, dispersed and networked, and every effort has been made to involve the full richness of these influences as the development of Health 2020 was taken forward.
Our aim throughout has been to provide the scientific rationale for action: to capture and ignite the interest and involvement of everyone who will need to
be engaged now and in the future. To this end, the policy framework examines both challenges and opportunities and aims to be a tool that can be used in deciding the ways forward. Too often across the Region, these opportunities are simply not being taken up, and there are even fears that the unfolding economic crisis significantly threatens our present public health gains. We continue to spend far too little on health promotion and disease prevention compared with treatment. Health 2020 argues strongly that this balance needs to change in favour of upstream interventions to prevent the later human and economic burden of end-stage disease and disability.
Key challenges and issues Health 2020 addresses include:
• new collaborative leadership approaches to bring different partners together and mobilize broad-based political and cultural support for health development;
• insights into new leadership roles and opportunities, to reach out more effectively to others within and outside government in order to arrive at joint solutions;
• ways to make an economic case for investing in health, including evidence on the benefits of and effective approaches to achieving health in all policies;
• ways to better facilitate citizen and patient empowerment as key elements for improving health outcomes, health system performance and satisfaction with health care;
• effective and efficient ways to take advantage of new networking, partnership, communication and technological opportunities;
• a common regional mechanism to build, support and maintain unity and coherence of messaging within the public health community;
• identifying gaps in knowledge and new research priorities;
• creating an ongoing communication platform for sharing the practical experiences of policy-makers and public health advocates across the Region; and
• a focus on health and well-being as barometers of development.
The Regional Office will support the adaptation of Health 2020 approaches at the national levels by:
• helping to analyse the public health situation of countries, identifying assets and needs and making recommendations for policy priorities and ways to implement and monitor impact;
• encouraging presidents and prime ministers and all other country sectors and actors to establish mechanisms for of-government and whole-of-society approaches and to monitor progress; and
• supporting capacity development where needed and requested, relating to leadership, governance, engagement and communication.
Health 2020 is a WHO policy and yet a policy for everyone. It builds on a long history of global and regional policy thinking, and it is fully aligned with the WHO reform process. The Regional Office will actively promote and support its implementation in member States. WHO alone, however, cannot succeed
in making this policy framework the cornerstone of health and improving health and well-being, and will work with many partners to this end. Together we can ensure that policy-making and governance for health is better aligned with today’s needs and take action to improve the health and well-being of the present and future generations.
Zsuzsanna Jakab WHO Regional Director for Europe
The 53 member States in the WHO European Region have agreed on a new common policy framework – Health 2020.
Their shared goals are:
… to significantly improve the health and well-being of populations, reduce health inequalities, strengthen public health and ensure sustainable people-centred health systems that are universal, equitable, sustainable and of high quality.
Health 2020 is intended to reach out to many different people within and outside of government, to provide inspiration and direction on how better to address the complex health challenges of the 21st century. This new policy framework and strategy identifies two key strategic directions, with four policy priority action areas. It builds on the experiences gained from the previous Health for All policies to guide both member States and the WHO Regional Office for Europe. It accompanies Health 2020: a European policy framework supporting action across government and society for health and well-being, which is part of this publication.