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Centro Region, Portugal Challenges

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Centro Region, Portugal Challenges © Turismo Centro Portugal © Turismo Centro Region Rural Centro Region, Portugal Village General overview Situated in the geographic centre of Portugal, the 8.9% of the gross domestic product (1). Centro Region occupies a strategic position in Portugal is not regionalized (except for the the country, with the city of Coimbra serving as Autonomous Region of the Azores and the its main educational, cultural and health-services Autonomous Region of Madeira) and its health centre. The city prides itself on being the location system follows a strong model of central of one of Europe’s oldest and most distinguished governance and financing, according to universities (the University of Coimbra, established which five administrative health regions were in 1290), Portugal’s largest hospital (Coimbra established in 1993. Each region has its own University Hospital Centre, which belongs to health administration board, answerable to the the National Health Service), the oldest and Minister of Health, and assumes responsibility largest Portuguese nursing school (Coimbra’s for the management of population health and the Nursing School), and one of the best science- provision of health-care services. The regional based incubators in the world (Pedro Nunes health administration of the Centro Region Institute). These institutions share a long history of is carried out by the Central Regional Health delivering much admired education, research and Administration, which is responsible for the transversality in the fields of medicine, health-care implementation of national health policies and services, and health sciences and technologies. the coordination of all levels of health care at the Since 2015, the consortium, Coimbra Health, regional level, in accordance with the current established by the University of Coimbra and the National Health Plan. Coimbra University Hospital Centre, has been a member of the world network, M8 Alliance With a land area of 23 671 km² and a population of Academic Health Centers, Universities and of 1 674 660 inhabitants (2011) (population National Academies. density 71/ km²), the Centro Region comprises 78 municipalities, which are home to 17% of the The national health-care system in Portugal, population of mainland Portugal. The average established in 1971, comprises three life expectancy in the Region is 81.7 years (78.5 complementary parts: (i) the National Health years for men and 84.6 for women); infant mortality Service, the functions of which are the financing, (2016) is 2.1 per 1000 (mainland Portugal: 3.2 per regulation, management and provision of health- 1000). The Region hosts an ageing population: care services; (ii) the social and private sectors, in 2015, it recorded one of the highest ageing which provide health-care services; and (iii) indices (190.4) and one of the lowest fertility subsystems of public and private insurance, which rates (1.17 births per woman) in Europe (2). As deal with the financing and provision of health these challenges have been recognized as major care. In 2016, national health expenditure was societal issues for the Centro Region, and taking providing care of the elderly and adults and into account the performance of the consortium, children with physical or mental disabilities. Ageing@Coimbra (a partnership among the The Central Regional Health Administration – in University of Coimbra, the Coimbra University cooperation with relevant stakeholders, such as Hospital Centre, the Central Regional Health municipalities and schools – manages several Administration, the Pedro Nunes Institute and the public health programmes and health-promotion Coimbra City Council), the European Commission activities in different areas. Examples of these are considers it as one of the 74 European reference child immunization, screenings (cervical cancer, sites for active and healthy ageing. breast cancer and diabetic retinopathy, the Currently, in the Centro Region, the National last-mentioned being pioneered at the national Health Service has 85 primary-health-care level), child and maternal health, children’s centres, 18 hospitals (corresponding to 4695 oral health, healthy eating, childhood obesity, beds), and 101 long-term health-care units adolescent mental-health and suicide prevention. (corresponding to 2427 beds) (3). They are all Environmental-health activities are developed at administered by the Central Regional Health the local level by public health units and include Administration and work alongside an extensive waste management and water surveillance (the use health-care network, including hospitals for active of water for drinking and recreational purposes) treatment, centres for specialized and primary in cooperation with municipalities, regional outpatient care, nurseries, and institutions environmental authorities and water-pipe suppliers. Strengths The Centro Region’s strengths are: its diversified regional economy, encompassing both collaboration with the regional health network and 9 low-technology-level industrial sectors and sectors with charities administered by the Central Regional Health medium- and high-technology levels, such as those Administration); dealing with health services, biotechnology and IT; EU’s recognition of the Region as one of the 74 9 a relevant critical mass for high-quality research reference sites for active and healthy ageing; 9 activities and regional competencies related to health the Region’s extensive, quality network of health-care 9 services (several hospitals have gathered leading services (in both the National Health Service and the national and international knowledge on various health private sector); topics and are supported by the universities in the the presence of quality education and research region, for example, the consortiums, Coimbra Health 9 and Ageing@Coimbra); centres, the Region being the location of several public universities, medical and nursing schools, the “health hub” in Coimbra, which brings together 9 and numerous incubators for innovative businesses resources, professional competencies and (the University of Coimbra is the reference point for quality services (the University of Coimbra and the higher education and research and development in Coimbra University Hospital Centre work in close Portugal). Aspirations The Centro Region is aiming to: develop an ecosystem of good practice in health promoting health gains in accordance with the 9 care associated with active and healthy ageing, national and regional health plans; and in monitoring the social determinants of health strengthen health-system integration and health 9 in relation to the Sustainable Development Goals information systems at the regional level; (SDGs) (4); 9 develop an intersectoral health approach according 9 develop an effective regional health strategy for to the Health in All Policies (HiAP) (5,6) model. Centro Region, Portugal Challenges These are: demographic and societal challenges related to an lack of political decision-making at the regional level 9 9 increasingly ageing population; (regional resources for health policies depend on low population density: there is an asymmetry in national policies/decisions); 9 the Region characterized by a desertification of the the proneness of the Region to natural disasters 9 “inland” areas (apart from the urban centres located (namely wildfires) due to its extensive forested area, in there) in contrast to the coastal areas, which are combination with the factor that the elderly population mostly populated and urbanized; resides mostly in rural areas. health inequalities among urban/rural and socially 9 disadvantaged groups; Potential areas of collaboration The Centro Region is interested in collaborating with other regions on: establishing health-promotion/public health ensuring highly qualified health-care/health-services 9 9 programmes; staff and exchanging experience on working in tackling health planning and health-policy international projects, for example, on international 9 implementation and evaluation with a view to public health care and health management/ achieving the SDGs (4) at the regional level, based on administration; the principles of HiAP (5,6); addressing environmental health (including health- 9 impact assessment and health-contingency planning for heat-waves and extreme cold). Working Groups The Centro Region is interested in participating in working groups on: the Sustainable Development Goals (SDGs) (4)/ the all-of-government approach/intersectoral action. 9 9 equity; 9 environment; People active in the Regions for Health Network (RHN) Political focal point João Pedro Pimentel Rosa Reis Marques Head, Department of Public Health Chair, Directive Board Regional Health Administration of Central Portugal Regional Health Administration of Central Portugal Regional Medical Officer Coimbra Coimbra Email: [email protected] Email: [email protected] Technical focal points Others Paula Santana Eugénio Cordeiro Full Professor of Health Geography Head, Planning and Research Unit Department of Geography and Tourism Regional Health Administration of Central Portugal Faculty of Arts and Humanities Deputy Regional Medical Officer University of Coimbra Coimbra Email: [email protected] Email: [email protected] Centro Region, Portugal António Morais Cláudia Costa Senior Medical Officer, Regional Health Administration of Research Assistant Central Portugal Department of Geography and Tourism Advisor to the Directive Board of the
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