SEECP Health Ministerial Meeting

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The Republic of Croatia Ministry of Health and
Social Welfare
SEECP Health Ministerial Meeting
Achievements and challenges of strenghtening
health system performance through addressing
inequalities in health services in Croatia
Chisinau, November 7, 2008
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Basic documents proclaiming the right to health

• Constitution of the Republic of Croatia
• Health Care Act
• Compulsory Health Insurance Act
• Communicable Disease Control Act
• Occupational Health and Safety Health Insurance
  Act

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Basic health rightsEvery citizen has health
insurance
Structure of ensurees
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Basic health rights

• Every citizen has
• chosen family physician
• chosen stomatologist
• women chosen gynecologist
• preschool children chosen pediatrician or
  family physician

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Basic health protection rights

• At population level
• epidemiological care through the public health
  institutes network
• preventive care of school children and youth -
  through the public health institutes network
• prevention and treatment of occupational diseases
  and injuries (according to the Act)
• health safety monitoring for foods, other object
  of common use and drinking water

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Compulsory Health Insurance Actand regulations
based thereon include the rights to

• primary health care
• emergency medical care
• specialist health care
• hospital health care
• drugs administration
• dental-prosthetic care and substitutes
• orthopedic and other aids
• health care abroad

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Plan and programme of health care measures
resulting from Compulsory Health Insurance Act
includes

• Health care measures provided by
• primary health care
• specialistic and hospital care
• county public health institutes and Croatian
  National Institute of Public Health
• transfusion medicine
• Health care measures for priority health problems
  (cardiovascular diseases, malignant diseases,
  mental disorders, injuries etc.)

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Monitoring the implementation of Plan and
Programme

• Example preventive examinations for age groupe
  50
• GOAL
• Early detection of illnesses and risk factors
• TARGET POPULATION
• Insurees aged 50 who had no clinical
  examination or dg procedure for a minimum of two
  years
• METHODOLOGY
• General check-up and basic diagnostic procedures
• INDICATOR
• of persons in need covered by preventive
  examinations

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NATIONAL PROGRAMMES
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National Breast Cancer Screening Programme

• STARTED
• October 2006
• TARGET POPULATION
• women aged 50-69 (covered 586,912 women ni
  Croatia)
• GOAL
• to reduce breast cancer mortality by 25 within 5
  years of the beginning of the programme and to
  increase the proportion of breast cancers
  detected in initial stage
• SCREENING TEST
• mammography (double-reading)
• SCREENING INTERVAL
• 2 years
• SCREEN-DETECTED CANCERS
• About 900 /October 2008/

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Colorectal Cancer Screening Programme

• STARTED
• November 2007
• TARGET POPULATION
• men and women aged 50-74 (about 1,200,000
  Croatian citizens)
• GOALS
• to reduce colorectal cancer mortality by 15
  within 5 years of the beginning of the programme
• SCREENING TEST
• Fecal occult blood testing (FOBT) followed by
  colonoscopy
• SCREENING INTERVAL
• 2 years
• SCREEN-DETECTED CANCERS
• 77 cancers, 421 polyps /October 2008/

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National Diabetes Programme

• STARTED
• 2008
• TARGET POPULATION
• adults aged 50 and younger with risk factors,
  pregnant women
• diabetic patients
• GOALS
• increase the number of new diagnosed cases at
  early stage
• reduce the number of complications
• SCREENING TEST
• Fasting plasma glucose OGTT
• SCREENING INTERVAL
• 2 years / 1year
• ESTIMATED PREVALENCE
• 8,9 adults (18)

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HIV/AIDS Prevention Programme 2005-2010.

• Diagnostics and treatment of HIV positive person
  and AIDS patients free of charge, including HAART
  therapy
• Educational programmes
• Widening of voluntary counselling and HIV testing
  services (VCT) through the network of centers for
  voluntary, anonimous, free of charge testing
• Second generation surveillance including not only
  surveillance of HIV prevalence and AIDS
  incidence and mortality but also other STDs and
  risk behaviour
• Seroprevallence investigation in most at risk
  populations
• Harm reduction and outreach programmes in
  population subgroups with risk behaviour

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SPECIAL PROGRAMMES
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Prevention of overweight and obesity in childhood

• Co-operation project between
• Flanders, Croatia and Slovenia
• Implementation of a
• methodology for the development
• of evidence-based
• guidelines in school health care
• Started in 2005

• .

• Phases
• Developing guidelines applicable in daily
  practice
• Disemination of the guidelines to authorities and
  target
• professional groups
• Implementation of the guidelines at the national
  level

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Thank you for your attention!