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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 Institute of Public Health (CIPH) 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. It received support from 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. This recognition is awarded for a three-year period. The additional aim of promoting the ‘Healthy Living’ guarantee brand on food products is to stimulate manufacturers to develop or adjust their products in accordance with the recommended criteria for energy and nutritional intake outlined in Annex XIII B of the European Union (EU) Regulation no. 1169/2011.

For a brand to be awarded to specific food products, the food industry and distributors have to apply to the CIPH. The product is then verified to fulfil the requirements, and assessed based on individual elements of declared nutritional content. Food products can undergo analysis in any accredited laboratory according to the 17025 standards. However, the verification is always conducted by the CIPH during the evaluation process. If the product meets the required criteria, it is awarded the Healthy Living guarantee brand. Granting the brand makes the information about proper nutritional food products more publicly accessible, promoting proper nutrition for everyone. The guarantee brand is distinctly designed to offer consumers a simple understanding of proper nutritional food products. This simplifies the selection of products with proper nutritional balance, eliminating the need to read nutritional labels.

This project aligns with the Strategic Plan to Reduce Table Salt Intake in the Republic of Croatia 2015-2019, aiming to achieve a 16% reduction within that period. On average, Croatian citizens consume more than 11 grams of salt daily, nearly double the WHO recommended intake. This may have significant implications for public health.

A growing number of small family farms and small manufacturing plants, including mini dairy farms, cheese dairies, meat processing plants, honey manufacturers, tea producers, and fruit and vegetable product manufacturers, in Croatia 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 fostering cooperation with civil society and associations.

Encouraging healthy lifestyles and healthy nutrition for young people

In addition to the various activities outlined in the aforementioned interdisciplinary framework, Croatia is involved in implementing numerous EU projects. These projects are designed to enhance and promote healthy lifestyles and diets among 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 under Work Package 4, Cost of Childhood Obesity, and Work Package 7, Early Interventions. The activities in Croatia are carried out by the Health Promotion Division of the CIPH.

Reducing Alcohol Related Harm (RARHA)

The Joint action for Reducing Alcohol Related Harm (RARHA), funded under the second EU Health Programme, is a three-year initiative. It aims to support Member States in advancing common priorities aligned with the EU Alcohol Strategy and enhancing their capacity to address and reduce the harm associated with alcohol. The project implementation involves 32 associated partners and 28 collaborating partners. In Croatia, the associated partner is the CIPH, while collaborating partners include the Office for Combating Drug Abuse of the Government of the Republic of Croatia and the Teaching Institute of Public Health ‘Dr. Andrija Štampar’. Croatia is involved in the Monitoring and Guidance work packages. 

The project aims to provide a foundation for the comparative evaluation and monitoring of alcohol epidemiology within the EU, including the amount of alcohol consumed, consumption patterns, and alcohol-related harm. The project also seeks to:

• strengthen the capacity for comparative methodology in alcohol research
• foster interest in future comparative methodology use 
• clarify the scientific basis and implications of a public health policy utilising low-risk drinking guidelines to reduce alcohol-related harm 
• facilitate the exchange of good practice examples among public health institutions in member states by using information approaches to reduce alcohol-related harm 
• provide guidelines and tools for planning public health policies for using information approaches to reduce alcohol-related harm within a broader public health policy framework 

This joint action will provide support to EU member states in reducing alcohol-related harm, thereby improving the health of EU citizens and reducing the associated disease burden.

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

Joint Action on HIV and Co-Infection Prevention and Harm Reduction (HA-REACT) was a project co-financed by the EU Health Programme. The project represented a joint action involving 24 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 was to advance the capacity for responding to HIV infection and co-infection risks, providing harm reduction programmes aimed at people injecting drugs in the EU. The total project duration is 36 months, spanning from 1st October 2015 to 30th 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, particularly tuberculosis and viral hepatitis, in EU priority areas. Despite significant 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 is directly based on the Communication from the European Commission [COM(2009)569] on Combating HIV/AIDS in the European Union and Neighbouring Countries 2009-2013, as well as the extended 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, and Sustainability and long-term funding.

In implementing this joint action, Croatia participated in activities within Work Package 5, Scaling up Harm Reduction. The project activities in Croatia were carried out by the Health Promotion Division of the CIPH.

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, along with promoting overall community health. Despite numerous social debates, it is clear that the implementation of health education must follow scientific knowledge and understanding of negative social influences on young people. It should also employ approaches suitable to youth. To encourage young people to adopt positive changes in their health-related behaviour as they develop and into adulthood, it is beneficial to influence them at the peer-group level in a school environment. In order for them to acquire new knowledge and question negative attitudes that may lead to various health risks, it is necessary to employ a positive approach to their development. This includes caring for youth, supporting their personality development and connecting them to their environment. Standardised multi-sectorial cooperation is necessary to achieve these prerequisites. While individuals implementing health education have undergone the required methodological preparation, adapting a non-formal approach is an ongoing effort essential for building a trusting relationship with young people. This is the only way to initiate lasting behaviour changes. Peer education has proven to be an excellent bridge-building method and it is exceptionally successful when conducted in cooperation between adults and youth, serving as a mean to build intergenerational trust. When working with young people, it is necessary to consistently consider the social influences on youth health and empower them to create a healthier community by analysing and changing society. It is necessary to understand how social influences stimulate risky behaviour and employ an evidence-based approach to encourage youth to recognise their own rights while fostering responsible behaviour for their health and the health of the community.

The implementation of health education is a unique opportunity to involve young people in the processes of enhancing community health, considering them as a solution rather than a problem. The annual evaluation of education and training systems of the European Commission – Education and Training Monitor – highlights the necessity for continuous investment in the lifelong training of school personnel as one of the key challenges. This measure is one of the responses to address that particular 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 those responsible for implementation. The health education programme also includes educating youth about the importance of organ, tissue, cells, and blood donation. The objective is to sensitise them and raise their awareness and responsibility towards community health. The implementation of the programme is the responsibility of professors and teachers, with certain topics 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 at the national level.

Collaboration and partnerships

Collaborations primarily occur between state-level actors and civil society organisations. 

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

 In addition to the aforementioned strategic frameworks, various civil society associations in Croatia implement awareness-raising activities on youth health through projects financed by the Ministry of Health, other governmental bodies, local communities, and EU funds.