National strategy(ies)

The National Youth Strategy 2017-2021, adopted by the Government of Montenegro in 2016, introduces two measures directly related to promoting youth health and healthy lifestyles: “establishment of efficient inter-sectoral information and counselling services for young people and parents” and “supporting the development of young people’s psychological and physical health”. The Youth Strategy recognises that young people lack access to adequate support and guidance regarding their health and that particularly vulnerable groups of young people in this respect are the poor, young people from rural areas, Roma and Travellers1 , LGBT people, ethnic minorities and young people with disabilities.

In the latest action plan for the implementation of the Youth Strategy for the period 2020- 2021, it is planned to conduct a set of activities to promote healthy lifestyles. These include raising capacities of counselling centres for youth through commissioning experts in the area of sex education, conducting research on trends of use of psychoactive substances and nonchemical addictions among adolescents and carrying out programmes and campaigns for the prevention of health risk behaviours (such as smoking, alcohol and substance abuse, risky sexual behaviour and behaviours connected to obesity).
 

As yet, there have been three monitoring reports on the implementation of action plans for implementation of the Youth Strategy for 2017, 2018 and 2019, respectively. The reports include information on monitoring the implementation of activities concerning youth health, healthy lifestyles, sexual health and fighting health risk behaviours.
 

The National Strategy for Sustainable Development until 2030 (Nacionalna strategija održivog razvoja do 2030. godine), adopted by the Government of Montenegro in December 2015, includes as one of its main strategic goals “improving the health of citizens of all ages and reducing inequality in health, with an emphasis on children”. The strategy defines a set of priority measures to achieve this goal: improving health protection of vulnerable groups and putting the focus on the promotion of healthy lifestyles, disease prevention and control.
 

The Programme for Adapting the Health System to Climate Change in Montenegro for period 2020-2022 with an action plan for the period 2020-2021 (Program adaptiranja zdravstvenog sistema na klimatske promjene u Crnoj Gori za period 2020-2022. godine sa Akcionim planom za period 2020-2021. godine) has as one of its main goals “raising awareness on climate changes and their impact on health”. One of the measures is educating young people on protection from diseases that are related to climate change in every municipality in Montenegro. The Ministry of Health, the Ministry of Education, Science, Culture and Sports and the Institute for Public Health are in charge of implementing this measure.

Encouraging healthy lifestyles and healthy nutrition for young people
 

Youth counselling centres located in health care centres in municipalities conduct individual and group health education programmes aimed at promoting youth health and healthy lifestyle and preventing risky behaviour. The work of counselling centres is focused on raising knowledge of young people on healthy nutrition, the importance of physical activities, prevention of health risk behaviours (alcoholism, drug addiction, and smoking), sexual and reproductive health, prevention of sexually transmitted diseases and prevention of unintended pregnancy. The youth counselling centres conduct their programmes through group activities, individual counselling, lectures and workshops in schools and events in the local community. Services are provided by nurses, paediatricians, hygiene specialists and, if necessary, gynaecologists, psychiatrists, psychologists, epidemiologists and social workers.
 

In 2019, a programme aimed to increase young people’s knowledge of the importance of healthy nutrition and the nutritional values of fresh fruit and vegetables, milk and milk products was launched by the Ministry of Agriculture, Forestry and Water Management. The programme Fruit, Vegetables, Milk and Milk Products for Schools (Program voće, povrće, mlijeko i mliječni proizvodi za škole) aims to contribute to increasing students’ intake of fresh fruits and vegetables, milk and milk products and to reduce intake of foods that are high in fat, sugar and salt. The programme has been piloted in elementary schools, with the plan to upscale it in the future. Moreover, in the vicinity of several schools, including one secondary vocational school, greenhouses have been placed to educate students and raise their level of knowledge about food production and the importance of healthy nutrition. It is planned that the programme also include other educational measures, such as visiting farms and cooking workshops.

Health education and healthy lifestyles education in schools

Students of the first and second year of general secondary education have an opportunity to choose the optional subject “healthy lifestyles” (Zdravi stilovi života). This subject covers the following topics: health and healthy lifestyles; development in adolescence; diet and physical activity; mental health; body image and taking care of your body; the impact of psychoactive substances on health; sexual and reproductive health; HIV/AIDS; prevention of injuries and violence. Instruction time is 70 school hours in total, out of which 10 hours can be used for additional topics in line with the needs and interests of students.
 

The stated goal of the programme is to enable students to find and use relevant and reliable health information, to know how to critically evaluate the information they find and use it when making a health-related decision and to build basic competencies that contribute to the protection and improvement of health.
 

The specific goals of the subject for students are as follows:
•    expand previous and acquire new functional knowledge in the field of health and healthy lifestyles;
•    understand the causes and consequences of the most common health risks in adolescence, learn to assess risks and understand ways to reduce or avoid them;
•    gain information about the available health services;
•    develop existing and practice new skills, which are part of the necessary repertoire of life skills and skills for maintaining overall health;
•    develop positive attitudes towards healthy lifestyles and take responsibility for one’s own health;
•    understand one’s own role and responsibilities in creating and maintaining a healthy environment.

In general, it is advised that around 30% of class time should be devoted to the introduction of new concepts and 70% should be dedicated to interactive exercises and other forms of active involvement of young people. Teachers are provided with a training programme containing information on expected learning outcomes of the subject and a teaching manual with ideas on structure and content of classes.

Peer-to-peer education approaches
 

There are no top-level guidelines facilitating peer-to-peer education as a form of non-formal or informal learning about factors related to health and well-being. However, action plans for implementing the youth strategy include activities for establishing and improving peer-to-peer education and they are often applied in projects and initiatives in this field. 

Many NGO projects dealing with healthy lifestyles and improving the health of young people supported by the state include peer-to-peer education approaches. The monitoring reports on the implementation of action plans for implementation of the youth strategy include information on initiatives in which students in secondary schools are trained as peer educators on topics such as reproductive health.

Collaboration and partnerships

One of the measures foreseen by the Youth Strategy 2017-2021 is “establishment of efficient inter-sectoral information and counselling services for young people and parents” since it was recognised that meeting the health needs of young people requires the collaboration of the health and other sectors, including non-governmental organisations and local government. One of the activities planned in the latest action plan for the implementation of the youth strategy is to establish regular co-operation between youth counselling centres in primary health care centres with non-governmental organisations, schools and universities.

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

The Centre for Promotion of Health within the Institute for Public Health is responsible for preparing national public health programmes and strategies for promotion and prevention in the area of public health. Campaigns for the promotion of health are conducted in line with the calendar of health, which contains dates of awareness-raising activities concerning healthy lifestyles and factors affecting health (such as Sexual and Reproductive Health Awareness Day; the Month of Healthy Eating; Pink October – the latter raising awareness of breast cancer). In some of these activities, special attention is dedicated to raising awareness of young people on these topics. This centre regularly conducts lectures and workshops for youth in schools on reproductive health, sexually transmitted diseases, prevention of smoking and substance abuse and other relevant topics. It also produces publications and brochures for the promotion of healthy lifestyles among youth (for example on the reproductive health of young people and the role of paediatricians in preventing health risk behaviours among youth). Informational materials for students providing guidance on topics related to the Covid-19 pandemic have also been prepared.

Awareness-raising activities are also conducted by youth counselling centres in primary healthcare centres (more information is provided under the subsection 7.4 “Encouraging healthy lifestyles and healthy nutrition for young people”). NGOs also conduct activities such as campaigns, lectures and workshops on the promotion of healthy lifestyles, negative consequences of substance abuse, smoking and alcoholism, promoting healthy eating habits and reproductive health.