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National strategy(ies)

The Decree of 21 November 2003 on preventive health policy provides for the formulation of Flemish health objectives for prevention. The strategic plan describes a proposal of health objective, the prevention strategies to achieve them and the budgetary framework for this and is based on the health conference prevention of 16 and 17 December 2016 with a view to revising the Flemish health objectives around Nutrition and Exercise and around Tobacco, Alcohol and Drugs that expired in 2015. At the health conference, the choice was made to focus on a policy aimed at important life domains such as the family, leisure time, education, work, care and welfare and neighbourhood and local community, based on the importance of a faceted policy. The strategic plan is called “Flemish people will live healthier in 2025” (De Vlaming leeft gezonder in 2025). This plan is coordinated by the Minister of Health in Flanders.​ In the strategic plan, it was chosen to formulate sub-objectives at the level of different settings. Two of those settings are especially relevant for youth, namely the family and education. One of the policy initiatives is to systematically follow-up children and young people through Centres for Student Guidance (Centrum voor Leerlingenbegeleiding (CLB). Each school collaborates with a Centre for Student Guidance. Specific attention is paid to vulnerable (young) people. The process for a new strategic plan is in preparation.

There is also a Policy Paper on Welfare, Public Health, Family and Poverty Reduction (Beleidsnota Welzijn, Volsgezondheid, Gezin en Armoedebestrijding) submitted by the Flemish Minister for Welfare and Poverty Reduction, Culture and Equal Opportunities Caroline Gennez. The Policy Paper covers 2024-2029 – see 7.8 – current debates and reforms. 

For more information on the policy domain of Welfare, Public Health and Family, see ‘Governance’ at 7.2 – Administration and Governance. 

Encouraging healthy lifestyles and healthy nutrition for young people

The Department of Care (Departement Zorg - for more information, see 7.2 – administration and governance) is working towards better health and quality of life for the entire Flemish population. The Department of Care aims to inform and motivate people to make choices or adopt habits that strengthen their mental and physical health and reduce their risk of disease or health damage. They also aim to create an environment with as few health-damaging factors as possible. 

Child and Family (Kind en Gezin) is an important actor in encouraging healthy lifestyles, including healthy nutrition and sufficient exercise. The services of Child and Family are financed by the Flemish Government and are part of the Flemish Agency of Growing Up that monitors, evaluates and implements the policy of preventive family support. Child and Family is the contact point for all (expectant) parents and young children growing up in Flanders and Brussels. They aim at letting every child grow up promising. Child and Family offers universal services to every child and every family, with an additional offer that is adapted to the needs of specific families. Special attention is paid to supporting socially vulnerable groups. The preventive services focus on combating child poverty, preventing child abuse, medical prevention and supporting development, parenthood and upbringing.

Centres for Student Guidance (Centrum voor Leerlingenbegeleiding (CLB) are important for encouraging healthy lifestyles. It helps free, independent and in confidence. It helps pupils, parents and schools in primary and secondary education with learning problems, study choices, psychological and social problems, such as bullying, problems at home and fear of failure. It also monitors pupils' health (see 7.6 – Mechanisms of early detection and signposting of young people facing health risks).

Local health consultation (Lokaal gezondsheidsorverleg – Logo) is a networkorganisation that connects organisations working on preventive health policy. On behalf of the Flemish government, Logo works to reduce health complaints caused by environmental problems and contributes to the realisation of Flemish health objectives at the local level. 

The Flemish Institute for Healthy Living (Gezond leven) offers funding opportunities for preventive health. They have an important mission in encouraging, promoting and protecting healthy lifestyles and support various sectors, including schools.

 Preventive health policy

The Department of Care is responsible for the Preventive Health Policy (preventief gezondheidsbeleid). Since 1998, the Flemish Government developed Flemish Health Objectives (Vlaamse gezondheidsdoelstellingen) to set priorities in the Preventive Health Policy. These objectives are measurable, generally accepted and should be realised within a certain period. A health goal is approved by the Flemish Government and the Flemish Parliament. To implement health goals, there is structural cooperation with partner organisations. 

The budget of the Flemish Health Objectives and action plans is funded by the Flemish Government. The Flemish Government has annual budget allocated to Preventive Health Policy and this budget is allocated to actors, initiatives and projects in this field. The partners, organisations and individual care providers which are recognised and/or subsidised by the Flemish Government for tasks of the Preventive Health Policy, are accountable and monitored. The Flemish Government defines detailed rules.

Currently, there are five Health Objectives: 

1. Flemish people live healthier by 2025
2. Prevention of suicide
3. Population screenings for cancer
4. Vaccination
5. Environmental health

Next to these five Health Objectives, the Department of Care also offers, together with partners, methods, material and services for professionals specifically aimed at the preventive health of families. 

Flemish people live healthier by 2025

This health goal expires in 2025. The process for a new strategic plan is in preparation. Meanwhile, the evaluation and situation analysis are ongoing. Both are the starting point to propose new health goals and priorities. For more information, see ‘National Strategy’.  

Prevention of suicide

See 7.5 – mental health – National Strategies

Environmental health

The aim of this objective is to have a healthier live for Flemish people by reducing the impact of climate change, exposure to substances of very high concern and factors that determine the quality of the living environment such as air and noise pollution.

Since 2023 there is a Flemish Plan for Environmental health (Vlaams Klimaatgezondheidsplan). It has three compartments:

1. A strategy concerning health and environment
2. A vision on how small climate actions can be a win-win situation for our health
3. An overview of actions that are being taken already. 

Children and young people are recognised as being more vulnerable to the effects of health and climate change. 

Health promotion

Local health consultation (Lokaal gezondsheidsorverleg – Logo) offers information and trainings on health promotion. 

The Flemish Department of Care commits to health promotion. In Belgium, more than a third of deaths are due to unhealthy behaviour such as smoking, excessive alcohol consumption, unhealthy diet, too little exercise and too much sitting. By helping people live healthier lives, the Department of Care does  not only increase their well-being and opportunities, they also relieve the overburdened healthcare system. They do not only focus on citizens, but also on promoting healthy policies in organisations, such as schools, local governments and care facilities.

The Department of Care focusses on the following areas for health promotion:

• Prevention of substance abuse 
• Working on mental health (see 7.5 – mental health)
• Adequate exercise on limited sedentary behaviour
• Healthy nutrition 
• Sexual health (see 7.4 – raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people)
• Prevention of eat- and weight-problems (see 7.4 – raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people)
• Oral health (see 7.4 – raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people)
• Getting pregnant healthy (see 7.4 – raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people)

Prevention of substance abuse

The Flemish government supports various campaigns and prevention methodologies to prevent substance abuse (alcohol, tabaco, gaming, gambling, …). The Drugline (Druglijn) for example has a campaign and a dedicated website page aimed at informing young people about the consequences of alcohol: Alcohol: information for youth (Alcohol: informatie voor jongeren). 

On 14 December 2022, the Interfederal Strategy 2022-2028 for a Smoke-Free Generation was adopted. 

On 29 March 2023, the Inter-federal Plan 2023-2025 to combat harmful alcohol consumption was adopted.

Healthy nutrition

The Flemish government supports various campaigns and prevention methodologies to encourage more conscious healthy food choices. The environmentally responsible food triangle is the basis for these methodologies. The food triangle clearly shows how best to combine different foods for a balanced and healthy diet.

Among other things, they organise initiatives to create healthy nutritious environments in schools and public places. The project ‘Healthy public spaces’ (Gezonde publieke ruimte) provides support to local governments and actors for the realisation of a healthy food environment. It also takes into account other health aspects, such as exercise-friendliness, mental and social wellbeing, air quality, soundscape and smoke-free environments.

Disease prevention and monitoring and detection of risks

The Flemish Government invests in free vaccines, takes measures when there are outbreaks and focuses on prevention via Flemish population screening programmes. 

Some of the population screening programmes are specifically aimed at children and young people, such as the population study on congenital disorders. All parents of newborn babies in Flanders can have a blood sample taken from their baby from 48 to 96 hours after birth in which a number of serious congenital conditions are detected. Child and Family focuses on, among other things, the promotion, administration and monitoring of vaccinations, neonatal hearing screening and eye test at the age of 12 and 30 months. Centres for Student Guidance execute periodic preventive examinations of school-aged children and adolescents (Centrum voor Leerlingenbegeleiding (CLB)). 

Health education and healthy lifestyles education in schools

Health education

Every school in Flanders is expected to develop a health policy. This is not required by decree, but there is a regulatory framework for the development of health policy in schools:

1. the attainment targets/cross-curricular targets in school curricula (onderwijsdoelen)
2. the decree on student support
3. the reference framework for educational quality 

Physical education is part of the curriculum in preschool, primary education and secondary education. In primary education, student are required to be able to distinguish healthy and unhealthy lifestyles (among other things). In secondary education, one of the key components of the educational goals is ‘Physical and mental health’. Students are required to develop health competences related to their physical and mental wellbeing, such as basic hygiene, sexual health and development, addiction and healthy nutrition and sufficient movement. 

The Flemish Institute for Healthy Living (Gezond leven), with the support of the Flemish Minister of Education and Training and the Flemish Minister of Welfare, Public Health and Family, provides a website with pedagogical tools and teaching material to develop a health policy and to support teachers responsible for health education in primary and secondary education and universities or colleges of higher education. 

From the preventive health policy perspective, the operation of the Centre for Pupil Guidance (CLB) is supported through the Flemish Scientific Association for Youth Health Care (VWVJ). On 1 October 2022, the methodology Healthy Living? Check it out! launched by the VWVJ (What is ‘Healthy living? Check it out!’ | VWVJ) . The methodology is applied from 1 January 2022 as part of the systematic contact organised by CLB for pupils in the 3rd year of secondary education. The methodology consists of a questionnaire pupils can fill in online in class under the guidance of a CLB staff member. The questions gauge physical, mental and social health (weight and body satisfaction, depression, diet and exercise, substance use, bullying and abuse, etc.). ). This methodology aims to support pupils online in their behaviour (with tailored online info, e.g. referral to VAD website, sensoa, eating expert), detect risk behaviour and offer (blended) assistance from CLB if a worrying signal is identified in the answers.

Warm schools (Warme scholen) is a network that offers advice and counselling to schools in order to educate resilient students. Autonomous teams of teachers guide learning communities (learning networks) to turn schools into ‘Warm Schools’. These teams work on four core missions of education: qualification, learning ability, talent development and participation, with specific attention paid to resilience. In addition, pupils' wellbeing is monitored in “Warm schools” so that mental health problems could be detected early.

Sex education and personal relationships education

Pre-primary education works with developmental goals. Developmental goals are minimum goals in terms of knowledge, insight, skills and attitudes. In kindergarten, the developmental goals within the learning area 'People and society' are especially relevant to sex education. There are also connections with the developmental goal ‘Physical education’. For example:

Toddlers:

• show a calm presence in one's own body, feel one's own limits and show a familiarity with the individuality of the body (3.4);
• can express themselves emotionally within acceptable limits (3.8);
• can respectfully take into account the safety and abilities of other preschoolers in movement situations and adjust their actions (3.9).

Additionally, there are connections to the developmental goal of ‘Science and technology’:

In primary education, attainment targets apply, divided into different learning areas. The following learning areas are particularly relevant for sex education: 

• Social skills
• People and society

Additionally, there are relevant objectives in the following learning areas: physical education, science and engineering and ICT skills.

For example, in physical education: 

Pupils: 

• show spontaneity, expressiveness and authenticity in a socially accepted way (3.5);
• see uncontrolled and undesirable expressions in themselves and rectify them (3.6).

In secondary education there are no longer any attainment targets that are specifically about sexual health. Schools have the freedom to decide themselves to make the link to sexual health based on what they consider relevant. There are several minimum goals in secondary education that can be linked to sexual health, such as minimal goals on general health, media literacy and identity and diversity. The pedagogical counselling services (pedagogische begeleidingsdiensten) support schools with implementing the educational objectives. 

Sensoa (Flemish expertise centre of sexual health), with the support of the Flemish Minister of Welfare, Public Health and Family, supports schools with learning pathways. They provide pedagogical tools and training to teachers responsible for sex education. Sensoa has a database with teaching material on their website and also organises training in schools for students. They also provide sexual education curricula that are embedded on the educational goals. 

Pimento, for example, supports primary education teachers with trainings and methods concerning sexual education. 

Peer-to-peer education approaches

There are no measures for peer-to-peer educational approaches aiming to enhance young people’s knowledge and understanding of factors related to their health and well-being. 

In Flanders, school governing boards have broad autonomy and can decide freely on their teaching methods, timetables and curricula.

Collaboration and partnerships

With a focus on health in all policies, the Flemish Department of Care wants to make sure that health is part of all policy domains and policy levels that have an impact on health. In order to achieve this, they collaborate with other policy domains and governments. These cooperations can be ad hoc or more structural. Structural cooperation can be formalised by setting up a Flemish working group. Currently, there are 12 thematic working groups, such as the working group on population-based congenital disorders screening. 

The Policy Paper on Welfare, Public Health, Family and Poverty Reduction 2024-2029 aims to strengthen the health in all policies approach. They are committed to cooperation and ask for a clear commitment from colleagues in the Flemish government to the aspects of preventive health within their policy domains. Because important levers for sustainable behavioral change (excise duties, age prohibition, advertising, etc.) are located with the federal government, they are committing to participate in the inter-federal action and policy plans on alcohol, drugs, gambling and tobacco.

Every school in Flanders is expected to develop a health policy. The school health policy pays attention to collaboration with school services (centres for educational guidance and educational guidance services) and external partners (expertise organisations and local health organisations).

The (content-specific) collaboration with schools, CLB’s (centres for educational guidance) and external healthcare organisations is regulated through protocols. At the school level, the policy contract with CLB also sets out cooperation arrangements. 

Raising awareness on healthy lifestyles and on factors affecting the health and well-being of young people

Information providers

Children and young people have access to several contact points to receive information. The Centres for Student Guidance (Centrum voor Leerlingenbegeleiding (CLB’s)) answer question from children and young people concerning health and related areas. Other organisation, such as What What (Wat Wat), the Youth Advice Centres (Jongerenadviescentrum-JAC) and Awel also provide information to children and young people. However, there is not one specific contact point which young people can access to receive information or a dedicated website for young people about youth health and related areas. There is also no top-level framework for youth information and counselling structures. 

The Flemish Department of Care promotes healthy lifestyles and nutrition. Together with the Flemish-funded partner organisations, the Agency provides advice and information on healthy nutrition, physical activity and mental resilience. There are several Flemish-funded organisations responsible for disseminating information about youth health and related areas. They are also responsible for health promotion. They give information and advice, develop methodologies and other material and support the implementation and the use of it. 

The cooperation between the Flemish Government and these partner organisations is defined in a management agreement and further concretized in annual plans and budget plans. 

The Flemish Institute for Healthy Living 

The Flemish-funded expertise centre, the Flemish Institute for Healthy Living helps the Flemish Government to achieve the Flemish Health Objectives. The Flemish Minister of Welfare, Public Health and Family defines the policy priorities and budget allocation through a management agreement between the Flemish Institute for Healthy Living and the Flemish Government. 

The Flemish Institute for Healthy Living, as partner organisation, is responsible for the general health promotion and for promoting health policy in settings (schools, local authorities, the workplace, etc.) and to target groups (general population, persons of lower socioeconomic status, etc.). By doing so, the Flemish Institute for Healthy Living has projects and campaigns for general health promotion. 

YAC

The Youth Advice Centres (Jongerenadviescentrum-JAC) are part of the Flemish Centres of General Welfare (CAWs). JAC’s are financed through the CAW centres by the Ministry of Welfare. Most of them receive some additional money from local and provincial government and private sponsoring. In Flanders, YAC’s offer advice, support and guidance to young people between the ages of 12 and 25. All sorts of question are treated anonymously: housing advice, (student) work, sexual health, children’s rights, emotional well-being, substance abuse, etc. 

VAD

The expertise centre VAD is a partner organisation of the Flemish Government regarding the Preventive Policy on Alcohol and Drugs.

Among other things, they recently developed a vision text on working with nitrous oxide in schools. 

They also organize a training for parents to discuss parenting questions in group. The formation starts from the reality that children sooner or later come into contact with tobacco, alcohol and other drugs. Parents often do not know how to deal with this and what they can do to prevent problems. It is important that parents do not underestimate their influence and know how to use it.

The Drugline is the public service of VAD for all questions about alcohol, illegal drugs, psychoactive medication and gambling. The Drugline is a telephone and online helpline. It offers information about drugs and helps with questions about assistance, prevention and documentation material. 

Stop Tobacco

Stop Tobacco (Tabakstop) is a telephone and online helpline. It offers information on tobacco and quitting smoking. 

Eat expert 

Eat expert (Eetexpert) works as an independent knowledge centre to support and professionalise the prevention, early detection and early intervention and care and treatment (first-line to specialised care) of eating and weight problems in all age groups.

What What

What What (Wat Wat) is a website that gives answers to questions young people have. This can be about various topics, also concerning healthy lifestyles. They also inform young people where they can find more information on certain topics. 

OnlinePsycHelp

OnlinePsyHelp (Onlinepsyhulp) is a platform where citizens can find information about (and support for) mental health problems. They have a specific module for young adults (16-23 years) where they can find information about (specifically at that age) common mental health problems such as anxiety, depression, loneliness, grief, eating problems, self-injury, problems with alcohol/ drugs/ gaming/ gambling. 

Flemish Institute of Oral Health

The Flemish Institute of Oral Health (Gezonde Mond) is the Flemish partner organisation for preventive oral care in at-risk groups. There is a particular focus on vulnerable target groups such as pregnant women, children and the elderly.

Youth-targeted information campaigns 

The Flemish Government takes several actions aimed at young people specifically. 

VAD developed ‘Game(L)over’ – an informative game for young people and parents who are looking for a new balance between gaming and other activities such as school, friends, hobbies, family, ...

The Flemish Institute for Healthy Living sets up different projects and actions to encourage every Fleming to live healthy, eat healthy and exercise more. There are a lot of practical instructions to live healthy on their website. Some actions and initiatives target the population in general, others are specifically meant for young people. Examples of such projects and initiatives are:

• The ‘Bullshit Free Generation’ project is aimed at all Flemish schools to make young people more critical and assertive towards smoking and vaping. Through the project, schools can find teaching materials on smoking/vaping and concrete tools to develop a smoking policy at school.
• ‘Eye for Tasty Stuff' (‘Oog voor lekkers’) is a Flemish school project to promote the consumption of vegetables, fruits and/or milk at school. Together with the mascots, students discover different kinds of vegetables and fruits. They are also given a taste of milk. The aim of this project is to inform and sensitize students.
• ‘Woogie Boogie’: together with Disney Benelux, the Flemish Institute for Healthy Living tries to tackle inactivity among toddlers by the project Woogie Boogie (3-6 years). 
• ‘SWEEP’: With this project, the Flemish Institute for Healthy Living want to inspire, activate and bring together young people aged between 12 and 18 to exercise and have fun doing so.

‘Generation Smokefree’ 

'Generation Smokefree' is an initiative of the Alliance for a Smokefree Society. The organisation Fight against Cancer (‘Kom op tegen Kanker’) and the Foundation against Cancer (‘Stichting tegen Kaker’) launched the initiative. The implementation happens together with the Flemish Institute for Healthy Living, the Flemish association for Respiratory Healthcare and Combating Tuberculosis (VRGT) and the Foundation for Respiratory Infections (FARES). This initiative aims to contribute to the creation of a society in which children and young people can grow up smokefree, can play and have fun in smokefree environments. Such smokefree environments are important because children and young people are likely to copy behaviour, also smoking behaviour. Children and young people who observe that other young people or adults smoke might get the idea that smoking is a normal aspect of daily life rather than an unhealthy addiction. A website is developed and provides an overview of different initiatives that are yet undertaken and that can inspire parents, schools, municipalities, etc. to create smokefree environments for young people.