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1. National strategy(ies)

2. Encouraging healthy lifestyles and healthy nutrition for young people

3. Health education and healthy lifestyles education in schools

4. Peer-to-peer education approaches

5. Collaboration and partnerships

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

National strategy(ies)

National Programme “Healthy Living”

The Croatian Public Health Institute has started to promote healthy nutrition in schools. Through the “Health education” programme component, special emphasis was placed on the role of proper nutrition in health preservation, with the support of the Ministry of Agriculture, the Croatian Employers Association, the Croatian Chamber of Trade and Crafts, The Croatian Food Agency and the Faculty of Food Technology and Biotechnology.

Another measure aimed at better informing consumers and facilitating their selection of food products with recommended proper nutritional balance is the programme of marking food products with a “Healthy Living” guarantee brand, awarded for a period of three years. Also, another aim of highlighting the “Healthy Living” guarantee brand on food products is to stimulate manufacturers to develop or reformulate their products in accordance with recommended criteria for energy and nutritional intake as per Annex XIII B of the EU Regulation no. 1169/2011.

In order for the brand to be awarded to certain food products, the food industry and distributors have to apply to the Croatian Public Health Institute where the product is verified to fulfil the requirements based on individual elements of declared nutritional content. The food products can be analysed in any accredited laboratory pursuant to the 17025 standard but the verification is always conducted by the Croatian Public Health Institute during the evaluation process. If the product fulfils the required criteria, it is awarded the “Healthy Living” guarantee brand. By awarding the brand, the information on proper nutritional food products becomes more publicly accessible in order to ensure proper nutrition for everyone. The guarantee brand is distinctly designed so as to provide the consumers with simple insight into proper nutritional food products. This makes it easier to select products with proper nutritional balance without the need for reading the nutritional labels.

This project builds on the Strategic Plan to Reduce Table Salt Intake in the Republic of Croatia 2015-2019 by 16% in the stated period. On average, Croatian citizens consume more than 11 grams of salt daily, which is almost twice the WHO recommended intake, and which has significant consequences for public health.

There are a growing number of small family farms and small manufacturing plants (mini dairy farms, cheese dairies, meat processing plants, honey manufacturers, tea producers, fruit and vegetable product manufacturers) in Croatia which offer products of proper nutritional balance. The “Healthy Living” guarantee brand aims to specially certify these products, while at the same time encouraging national production and civil society and associations cooperation.

Encouraging healthy lifestyles and healthy nutrition for young people

Besides numerous activities provided for by the aforementioned interdisciplinary framework, Croatia also participates in the implementation of numerous EU projects aimed at improving and encouraging healthy lifestyles and diet in young people in Croatia.

Joint Action on Nutrition and Physical Activity (JANPA)

JANPA is a project within the framework of the Third EU Health Programme oriented at improving diet and physical activity. The overall aim of the project is to contribute to halting the rise of overweight and obesity in children and adolescents in EU member states by 2020. In implementing this joint action, Croatia is participating in activities within work package 4 “Cost of Childhood Obesity” and work package 7 “Early interventions”. The activities in Croatia are carried out by the Health Promotion Service of the Croatian Public Health Institute.

Reducing Alcohol Related Harm (RARHA)

The Joint action for Reducing Alcohol Related Harm (RARHA), funded by the European Union under the second EU Health Programme, is a 3 year action aiming at supporting Member States to take forward work on common priorities in line with the EU Alcohol Strategy and strengthen Member States’ capacity to address and reduce the harm associated with alcohol. The project implementation has 32 associated partners and 28 collaborating partners. In Croatia, these are the Croatian Public Health Institute (associated partner), the Office for Combating Drug Abuse of the Government of the Republic of Croatia and Dr. Andrija Štampar Institute of Public Health (collaborating partners). Croatia is involved in the Monitoring and Guidance work packages.

The project is aimed at providing a foundation for comparative evaluation and monitoring of alcohol epidemiology, including the amount of alcohol consumed and consumption patterns and alcohol-related harm in the EU; strengthening the capacity for comparative methodology in alcohol research and a growing interest for future use of comparative methodology; clarifying the scientific basis and implications of a public health policy of using low risk drinking guidelines to reduce alcohol-related harm; facilitating the exchange of good practice examples between public health institutions of member states by using information approaches to reduce alcohol-related harm; providing guidelines and tools to plan public health policy for using information approaches to reduce alcohol-related harm within a broader public health policy framework. This joint action will provide EU member states with support for reducing alcohol-related harm and in this way improve the health of EU citizens and reduce the disease burden.

Joint Action on HIV and Co-Infection Prevention and Harm Reduction (HA-REACT)

HA-REACT (Joint Action on HIV and Co-Infection Prevention and Harm Reduction) is a project co-financed by the EU Health Programme. The project represents a joint action of 23 associated partners from:

• Finland
• Croatia
• Czech Republic
• Denmark
• Estonia
• Germany
• Greece
• Hungary
• Iceland
• Italy
• Latvia
• Lithuania
• Luxemburg
• Malta
• Poland
• Portugal
• Slovenia
• Spain

The goal of the project is to advance the capacity for responding to HIV infection and co-infection risks and provide harm reduction programmes aimed at people injecting drugs in the EU. Total project duration is 36 months (from 1st of October 2015 to 30th of September 2018).

The joint action on HIV and Co-Infection Prevention and Harm Reduction addresses existing gaps in the prevention of HIV and other co-infections (especially tuberculosis and viral hepatitis) in EU priority areas. Despite great progress in treatment and successful preventative interventions based on evidence from many EU member states, these infections still remain unchecked in certain target groups and areas. The HA-REACT project directly builds upon the Communication from the European Commission [COM(2009)569] on Combating HIV/AIDS in the European Union and neighbouring countries 2009 -2013 and the prolonged EU action plan on combating HIV/AIDS 2014-2016. The project was envisaged as a practical action, not limited to providing theoretical approach or guidelines. The HA-REACT project provides for pragmatic action aimed at people who inject drugs. Project activities are organised in five specialised areas: Testing and linkage to care, Scaling up harm reduction, harm reduction and continuity of care in prisons, integrated care, Sustainability and long-term funding.

In implementing this joint action, Croatia is participating in activities within work package 5 “Scaling up harm reduction”. The project activities in Croatia are carried out by the Health Promotion Service of the Croatian Public Health Institute.

Health education and healthy lifestyles education in schools

The goal of health education in Croatia is the improvement of the physical, mental and social health of young people, as well as the overall community health. Despite numerous social debates, it is absolutely clear that the health education implementation must follow scientific knowledge and understanding of negative social influences on young people, and use youth suitable approaches. In order for young people to adopt positive changes to their own health-related behaviour during growing up and in adulthood, it helps to influence them on a peer-group level in a school environment. For them to adopt new knowledge and question their negative attitudes leading to various health risks, it is necessary to use a positive approach to their development, including caring for youth, supporting their personality development by personal contribution and linking youth to their environment. A standardised multi-sectorial cooperation is necessary to achieve these prerequisites. Although people implementing health education have received the required methodological preparation, it takes a continuous effort to adopt a non-formal approach required for developing a trusting relationship with young people, which is the only way of initiating permanent behaviour changes. Peer education has proven to be an excellent bridge-building method, and exceptionally successful if conducted in cooperation of adults and youth as a form of building intergenerational trust. When working with young people, it is necessary to continually keep in mind the social influence on youth health and empower them to create a healthier community by analysing and changing society. It is necessary to realise in what ways social influences stimulate risky behaviour and use an evidence-based approach to encourage youth to realise their own rights while building responsible behaviour towards their health and the health of the community.

Health education implementation is a unique opportunity to involve young people in the processes of improving community health, by viewing them as a solution instead of a problem. The yearly evaluation of education and training systems of the European Commission - Education and Training Monitor lists the need for continuous investment into the lifelong training of school personnel as one of the key challenges. Among others, this measure responds to that need. Since the school year 2012/2013, Croatian primary and secondary schools have been implementing a health education programme as an integral part of the curriculum. The health education programme defines methodological units, learning outcomes and performers. The health education programme also includes educating the youth on the importance of organ, tissue, cells and blood donation with the goal of sensitising them and raising their awareness of and responsibility towards the community health. The implementation of the programme is the responsibility of professors and teachers, while some topics are covered by competent school physicians and nurses, as well as mental health professionals and the police.

Peer-to-peer education approaches

Currently, there are no peer-to-peer approaches on the national level.

Collaboration and partnerships

Collaborations are happening mostly between state level actors and civil society organizations. 

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

Besides the aforementioned strategic frameworks within which awareness-raising activities on youth health in Croatia are implemented, numerous civil society associations are implementing activities from the same field through their projects, financed by the Ministry of Health, other governmental bodies, local communities, and EU funds.