National Health Programme
I. NATIONAL HEALTH PROGRAMME:
THE POLICY OBJECTIVES AND GUIDING PRINCIPLES
1. PREREQUISITES FOR HEALTH
"Health is a state of complete physical, mental and social well-being and not merely the absence
of disease or infirmity."(5) Health also means the capacities and abilities to play useful roles in
society, to adjust ourselves to environmental changes and to cope with all related problems.
The WHO strategy "Health for all by the year 2000" (adopted also in Poland(6)) and the
philosophy of health promotion(7) underline that health is:
- the value that empowers individuals or groups of people in accomplishing their aspirations,
satisfying the need for success, changing and managing the environment,
- the wealth that ensures the society its social and economic development; only healthy society
can create cultural values, enlarge national property and enjoy high quality of life,
- the means to achieve better quality of life.
The quality of life should be considered as functional capacity throughout the all years of life,
higher productivity, better wages and satisfaction from own life. To this end, one can agree with a
saying: "good health is a good business". This saying speaks particularly for itself during the
period of political, economic and social transformations, when more and more people become
aware that ilness is not "worth while".
Health is not a static condition. Throughout the all years of life it must be:
- protected - what is defined as disease prevention,
- improved - what is defined as health promotion,
- recovered - what is defined as treatment and rehabilitation.
Fundamental prerequisites for health are as follows: peace, sustainable economic development, a
positive sense of global and local wellbeing and security, including ecological safety, decent
housing, food, education, secure work and decent wages, social justice and equal opportunity for
all.
There are four groups of factors which affect the human health:
- lifestyle which affect mostly (50-60%), however, changes in lifestyles lay within the reach of
each individual,
- physical and social factors in the living and working environment (20%),
genetic factors (20%),
- health services which are able to solve 10-15% of health problems of the population.
The objectives and targets identified in the National Health Programme (NHP) focus on these
three groups of factors indicated in Fig.1.
Fig. 1. Health determining factors.
National Health Programme
2. HEALTH PROMOTION
The modified National Health Programme is based on the health promotion concept and
strategy.
Health promotion helps people:
- to increase the control over own health (identification of own health problems), and
- to improve the health condition by making choices and taking decisions conducive to health,
increasing community awarness, developing competences to solve health problems and
increasing health potential.
Health promotion covers five areas of activities:
- the development of public health policy,
- the promotion of living and working environment supportive to health,
- the encouragement of the whole population to work for health,
- the advancement of individual skills to promote health,
- the reorientation of health services.
Health promotion is also defined as a skill to intefere into social systems and to encourage people
to promote healthy environment(8) . To this end, the NHP tends to "incorporate" health issues into
different social systems (politics, economy, education, sport, science, family etc.) and their
organizations by integrating health promotion with key objectives of a given system/organization.
National Health Programme
3. PUBLIC HEALTH POLICY
Each sector of economic and social policy (e.g. wages, taxes, social security, education, transport
etc.) is related to health. Therefore, health policy should be developed at all levels and by all
actors participating in public life. Bearing this in mind, the present NHP sets the objectives of the
public health policy which has replaced the former idea of the state health policy. That permits
to bring the governing mechanisms closer to people, moving them from the central level of the
management and the state administration to the local level, commiting at the same time all people
and public institutions.
National Health Programme
4. NATIONAL HEALTH PROGRAMME: THE POLICY OBJECTIVES AND
GUIDING PRINCIPLES
The document specifies:
- one superior, strategic goal: improving the health status of the population and enhancing the
health-related quality of life;
- the three key areas of activities aimed at accomplishing the strategic goal:
- changing lifestyles,
- developing the living and working environment supportive to health, and
- reducing inequalities in health and access to health services; and
- eighteen operational targets and tasks designed to achieve them.
Many positive changes in the health status of the population are expected due to the
accomplishment of tasks identified in accordance with each target. It is also hoped that adverse
effects of major health problems will be also reduced.
All tasks identified are given the highest priority, and they serve as the basis for the development
of detailed plans of action and various programmes to be implemented at all levels by individual
sectors. Flexibility is one of essential features of the NHP. The Programme can be further
modified, individual targets and tasks changed, their number extended or limited according to
arising needs and health problems.
It should be also stressed that while developing the present version of the NHP an attempt has
been made to define more precisely expected outcomes of actions planned with the aim to attain
the policy objectives and expected health gain.
In addition, much concern has been given to monitoring and evaluation of the outcomes of
individual actions and programmes(9). To this end, indicators currently available, and those likely
to be introduced, such as target studies, analysis of public opinion etc., as well as sectors and
institutions responsible for monitoring and evaluation are listed under each target.
National Health Programme
