SLOVAK REPUBLIC

INTIATIVES OF COMMUNITY IN PUBLIC HEALTH PROMOTION

PARTNERSHIP AIHA project

METROHEALTH SYSTEM, MEDICAL CENTER, CLEVELAND, OHIO, USA

and

TOWN TURCIANSKE TEPLICE, SLOVAK REPUBLIC

Conference AIHA 2001, Washington 8. - 11. April 2001

Alena CHLAPIKOVA, MDvicemayor of town Turčianske Teplice

SLOVAK REPUBLIC

Public health is what we, as a society, do collectively to assure the conditions in which people can be healthy.

Institute of medicine

GOAL OF PUBLIC HEALTH:IMPROVE HEALTH THROUGH PREVENTION:

• promote healthy behaviors

• protect the population from hazards in the environment

• prevent disease and injury

SLOVAK REPUBLIC

SUBJECT OF INTEREST:• Environment (social, economical, physical)• Healthy lifestyle• Health care promotion (availability, quality)

PARTNERSHIP established through AIHA financed by USAID• Town Turčianske Teplice, SLOVAKIA• MetroHealth System Medical Center Cleveland, OHIOTurčianske Teplice is a small district in Middle Slovakia with 17 200 citizens, which center is a spa town Turčianske Teplice - a foundingmember of National Healthy Cities Network in Slovakia - 1994.Definition of a healthy community partnership:“A relationship between equals that seeks to accomplish more by jointeffort than can be accomplished by any single member alone.”

SLOVAK REPUBLIC

STEPS:

• data collection and analysis of the current situation in health of inhabitants

• official signing of the MEMORANDUM OF UNDERSTANDING

(JANUARY 1996)

• definition of regional problems

• study stay of the Slovak leaders of the project in MHS, OHIO, USA

• objectives short term and long term

• contacts with Slovak community in USA

• preparation of three concrete projects

• mobilization of all sectors of the community

SLOVAK REPUBLIC

DEFINITION OF REGIONAL PROBLEMS:

• stress originating from present political and social changes

• alcoholism

• family dysfunction

• decreasing trend on the birth rate

• high presence of cardiovascular diseases

• unsatisfactory status of technical equipment in the health sector

• a late resuscitation due to a slow transport

!SLOVAK REPUBLIC

COOPERATION:• local government elected by representative• non-government organizations - public associations, Slovak Red Cross, sports clubs, Retired People´s club, Disabled People´s Associations• state sector - health facilities, employment office• schools• profit organizations

PROJECT PROMOTION:• councils of the Municipal Parliament• local massmedia• art and literature school competition• billboards, posters

SLOVAK REPUBLIC

Mobilization of the public - by way of the Health council of the MunicipalParliament with different clubs, citizens,associations, committees

Healthy lifestyle and cultural activities promotion - financial contributions for sport clubs, cultural agency, Primary Art School and other school-- 10% of the town budget, festivals for young people

Health sector - sponsorship, support of blood donation, active supportof privatisation in the health sector

Intermunicipal collaboration - (for example - building of the dump with 16 viliges)

SLOVAK REPUBLIC

PROJECTSAMBULANCEParticipants: Foundation for the support of Horny Turiec Health Sector,

AIHA, Turcianske Teplice, villages of Horny Turiec, profit organizations, particular inhabitants, Community of Slovak Originin Cleveland Bratislava Sister City

Public collection revenue = 765 000 SkResult: ambulance CITROEN - 1.2 mil. SkJanuary 1997 obtained for the use of the health sector

October 2000 - established Emergency Medical Service for district Turčianske Teplice in cooperation local government, employment office, Ministry of health and University Hospital in Martin

SUCCESS

SLOVAK REPUBLIC

FAMILY STRESS - pilot project

Objectives:• to determine the number of children with “risk profile” in the district• to cooperate internationally in the data collection concerning the problems of today's young generation• to identify the main problems, which should be the priority of interest in the future

Subject of the research: Children and teenagers of the age between 10-18 living in T.T. district,

parents in 500 families

Number of respondents: 1850 = 85% of all children and teenagers

Professional leader of the project: Mrs. Elaine Borawski, behavioural epidemiologist,

Medical Faculty of Case Western Reserve University, Cleveland, who analyses the results

of this research.

End of the project: august 1997

Results are used by schools, Municipal Health Advice OFFICE for healthy education teenagers:• drugs, Alcohol and smoking• teen pregnancy prevention - contraception• sexually transmitted diseases• cardiovascular and cancer diseases•education for healthy life style

SLOVAK REPUBLIC

MUNICIPAL HEALTH ADVICE OFFICE (HAO)In cooperation with the State Health Institute (SR), with a partner expert team of METROHEALTH SYSTEM, CLEVELAND, OHIO, USA, under thecoordination of AIHA, Washington USA and USAID.

Activities: - Health Advice Office aimed to:Limit the level of the health risk of the client with regarding risk factors of

long-term non-infections diseases especially cardiovascular diseasesand diabetes, using selected biochemical markers suitable forscreening examinations

Advise on interventions in all spheres having influence on life styleEducate healthy lifestyles by means of lectures on proper diet at schools, aimed

at groups of citizens, in enterprises, in massmedia and by providinghealth educational materials

date of opening HAO: 24. November 1997

SLOVAK REPUBLIC

NORMAL AND INCREASED LEVELS OF THE BLOOD CHECKS (IN %) OF HAO CLIENTS

CHOLESTEROL LEVELS GLUCOSE LEVELS

LEVELS OF THE BLOOD PRESSURE OF THE HAO CLIENTS

67%Increased levels

Normal levels 33%

Normal levels 80%

Increased levels20%

Normal levels 45%

Increased levels55%

Number of visitors : 1998: 18851999: 2036

2000: 2309

Number of biochemical examinations:1998: 9681999: 13182000: 1823

SLOVAK REPUBLIC

Educational Themes Number of Educated Children: 2246

First Aid Age 6 - 11 716

Drug Prevention Education 11 - 15 923

Preventing of smoking 16 - 18 607

Non-Smoking Promotion

Consequences of Smoking

Healthy Lifestyle Promotion

Prevention of CVD, Diabetes etc.

Importance Of Exercise For Health

Healthy Eating

Family Planning Education

SLOVAK REPUBLIC

All three projects are the result of hundreds of hours of a hard work by bothteams and a self sacrificing personal approach of partners from METROHEALTH SYSTEM

Contribution of the partnership:

• acquirement of professional experience in the area of prevention

• qualified professional leadership from MHS

• acquirement of skills needed to mobilize the public

• knowledge concerning the willingness and charity principle leading to volunteerism

• computer equipment (computers, modem, internet )

• creation of contacts and friendly relationships with the perspective

of continuing to development

• creation of the basis for further cooperation in the wider region

SLOVAK REPUBLIC

SLOVAK REPUBLIC

IN CONCLUSION I WOULD LIKE TO EXPRESS OUR HEARTY THANKS TO ALL

PEOPLE FROM METROHEALTH SYSTEM MEDICAL CENTER IN CLEVELAND

OHIO, TO AIHA, US AID, TO OUR FRIENDS FROM CLEVELAND-BRATISLAVA

SISTER CITY ORGANIZATION AND ESPECIALLY TO OUR LOVELY FRIEND

MRS MARY JO KESHOCK AIHA SLOVAKIA COUNTRY COORDINATOR, DURING

THE PARTNERSHIP PROGRAM , ALSO TO MRS. BERNICE BENETT, AIHA

HEALTHY COMMUNITIES PROJECT COORDINATOR, TO PRIYA CHANDRA

FORMER SLOVAKIA COUNTRY COORDINATOR Dr. ELAINE BORAWSKI,DR.

GEORGE WIENER AND ALL, WHO HELPED US TO

SUCCESFULLY BRING OUR PROJECTS INTO LIFE.

THE ROAD TO COMMUNITY CHANGE