7.2 Administration and governance
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The Ministry of Health (ministère de la Santé) and the Ministry of Social Security (ministère de la Sécurité sociale) are the main governmental authorities responsible for health policy, youth health and well-being. Both ministries cooperate closely and share responsibility for the organisation, legislation and financing of the health system. This includes implementing health policy, ensuring that health is considered in all aspects of policy, and coordinating actors and activities in the system.
The Ministry of Health develops health policy, enacts laws and regulations that apply to health providers, plans and organises the delivery of care, authorises large hospital investments, and directly finances public health programmes.
The Ministry of Social Security develops social policy, enacts laws and regulations relating to social policy, and oversees public institutions funded by the health, accident and long-term care insurance schemes.
The division of medical care at school, the health of children and adolescents (Division de la Médecine Scolaire, de la Santé des enfants et des adolescents) within the Ministry of Health is the main governmental authority responsible for the implementation of health policy for adolescents. It supervises the medical care at schools (médecine scolaire) and is in charge of the promotion of health and well-being of children and adolescents within their different living environments. It manages several national programmes and initiatives (e.g. National Action Plan of Healthy Eating and Physical Exercise (GIMB; Gesond iessen Méi bewegen), promotion of emotional and sexual health (promotion de la santé affective et sexuelle) and collaborates with other partner institutions for specific projects (e.g. HBSC study in cooperation with the University of Luxembourg and the Luxembourg Institute of Health, the perinatal health monitoring system in cooperation with the Luxembourg Institute of Health).
The National Office of Childhood (ONE; Office National de l'Enfance), founded in 2008, is a one-stop shop of child and youth welfare services which is administered by the ministry of Education, Children and Youth. It carries out many functions, including:
- Supporting children, young adults and families facing psychosocial distress
- Mandating the travelling services and institutions for individual aid measures
- Supervising the reception, including emergency placements, of children placed by their parents or on the orders of the Juvenile Court (Tribunal de Jeunesse).
The coordinating service for educational and technological research and innovation (SCRIPT; Service de Coordination de la Recherche et de l'Innovation pédagogiques et technologiques), with its Competence unit for pedagogical and technological innovation (SCRIPT-INNO; Cellule de compétence pour l'innovation pédagogique et technologique), coordinates several activities in the field of youth health and well-being in schools (classroom interventions, projects, campaigns, national studies, conferences, etc.).
Additional ministries involved in policy-making in the field of youth health and well-being are the Ministry of Sports, the Ministry of Equal Opportunities, the Ministry of Sustainable Development and Infrastructure, and the Ministry of Home Affairs.
Besides these governmental authorities, other agencies, foundations or organisations are involved in the development and implementation of policy programs regarding youth health conditions (selection):
- The National Centre for the Prevention of Substance Abuse (cnapa; Centre National de Prévention des Addictions) is a foundation whose mission is to develop, promote and disseminate ideas and strategies for a healthy and positive lifestyle, in particular by preventing behaviours that may lead to addiction. It is funded by the Ministry of Health and offers different services which aim to disseminate methods and strategies for prevention and promotion of health. The different target groups of these services are the general public, socio-educational professionals and public institutions
- The Family Planning (Mouvement Luxembourgeois pour le Planning Familial et l'Éducation Sexuelle) is a non-profit organisation funded by the Ministry of Health. The Family Planning runs 3 regional centres in Luxembourg which provide help desk services, medical services and consultations which are all free of charge (for an overview, see: Family Planning)
- Ligue Médico-Sociale operates 12 medical-social centres which offer a wide range of different medical services on the local level (e.g. consultation and prevention with regard to respiratory diseases, smoking, or diabetes; medical care at local schools)
- The Youth Psychotherapy Centre (Psy-Jeunes) of the Luxembourg Red Cross offers support for young people aged between 12 and 21 years. This service is aimed at young people as well as their families and offers psychotherapeutic treatment of psychological problems
- The Luxembourgish Mental Health Organisation (Ligue Luxembourgeoise d’Hygiène Mentale) offers counselling and social-therapeutic treatment services, day services, a meeting centre, a housing service, a coaching service and social and home-based care for people with psychiatric problems. Its additional mission is to invest in the field of information and prevention
- ALUPSE-DIALOGUE (Association luxembourgeoise de pédiatrie sociale) service of the Luxemburg Association for the Prevention of Child Abuse (ALUPSE; Association Luxembourgeoise pour la Prévention des Sévices à Enfants) supports children, adolescents and young adults up to the age of 21 who are victims of psychological, physical, sexual or traumatic situations. The service offers therapeutic care and child protection and it implements measures to prevent violence
- The Cancer Foundation (Fondation Cancer) provides information on the prevention and fight against cancer and the encouragement, through all available means, of any initiatives, scientific research or information campaigns in a broad sense in the fight against cancer. Prevention campaigns focusing on the consumption of substances with adverse health effects (tobacco and alcohol) are an integral part of the foundation's work
- Jugend- an Drogenhëllef is a foundation funded by the Ministry of Health. It organises services and activities within the framework of its counselling and socio-therapeutic treatment service, offers 24-hour availability and accommodations for young people suffering from various medico-psycho-social problems in relation to acquired diseases, including drug dependency
- Service IMPULS of the 'Solidarité Jeunes a.s.b.l.' is funded mainly by the Ministry of Health. It provides psychosocial and therapeutic assistance to young people, their families and the institutions involved in the protection of young people below 21 years of age when they are confronted with the consumption of legal and illegal psychoactive substances
- The National Focal Point (NFP) collects, validates, produces and disseminates data on drug use and misuse, as well as their implications and consequences in Luxembourg. It is co-financed by the Luxembourgish Ministry of Health and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). It publishes the annual European Drug Report, a national report on the situation of drugs and drug addiction in the Grand-Duchy of Luxembourg by the system of the Luxembourgish information network on drugs and drugs addictions (R.E.L.I.S.; Réseau Luxembourgeois d'Information sur les Drogues et les Toxicomanies) (MS, 2022)
- The KannerJugendTelefon (KJT) is a helpline for children and young people in distress and also for educators and the general public.
The National Health Observatory (Observatoire national de Santé) is an important stakeholder as it contributes to the steering of the health system and the improvement of its quality and efficiency. The law of 2 March 2021 defines five main tasks of the national observatory on health:
- Evaluation: the observatory evaluates the health status of the population in terms of morbidity and mortality, risk behaviour and determinants of health and the quality and efficiency of the health system and the identification of health inequalities
- Studies: the observatory studies the evolution and adequacy of health professional resources intervening in the health system to respond to the health needs of the population
- Dissemination: the observatory publishes and disseminates information on the health status of the population and the health system
- Recommendation: the observatory suggests priorities of public health to the minister in order to improve the health status of the population or the health system
- Drawing the 'health map' ('carte sanitaire'): the observatory draws a detailed overview of the hospital sector.
Regional or local authorities are not involved in the development of policies in the field of health and well-being.
Policies and measures on youth health and well-being are determined in close cooperation among the involved ministries, departments and agencies. Most programmes and initiatives are initiated and developed based on proposals of the individual ministries (e.g. the Ministry of Health) but are implemented and supervised in close cooperation with other ministries. Which specific ministries are involved depends on the particular focus of the program.
Some youth-specific policies and measures are also defined and implemented by the established mechanisms of youth policy decision-making (see: 1.4 Youth policy decision-making).