4.6 Access to quality services
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- Social Services
- Health Care
- Financial Services
- Quality Assurance
At a national level, there are some policies whose goal is to facilitate the young population’s access to housing.
Porta65 Jovem programme
The Porta 65 Jovem is a financial support system for renting a house.
It is intended for young people aged between 18 and 30, and the application may be done individually or as a ‘young couple’ (in this case, one of the couple’s members can be 32 years old).
Support is given through a monthly allowance equal to a percentage of the rent's value.
The goal is regulating incentives to young tenants by promoting:
- The autonomy of young people living alone, in family or in young cohabitation;
- The regeneration of degraded urban areas;
- The revitalisation of the rental market.
At a regional level, some city councils possess their own housing programmes for young residents in the municipalities, which include support measures for renting; buying not too expensive houses; or youth housing programmes in the historical centres of the cities, promoting, at the same time, its urban regeneration.
The Social Security Institute, IP provides a set of integrated responses to care and social support for children and young people.
This support consists of the assignment of funding within the scope of Cooperation Agreements entered into with Private Social Solidarity Institutions and similar entities, and the technical monitoring of specific social responses aimed at Children and Youth with a view to promoting their development and social inclusion, promoting their well-being and equal opportunities, such as:
Childhood and Youth
Disabled Children and Young People
Endangered Children and Young People
From the data known in December 2018, 5868 social responses were supported under the cooperation programme, aimed at 273903 users (children and young people).
We highlight the last group of responses:
The independence flats (Apartamentos de Autonomização) are intended for young people, aged between 15 and 21, in transition to adulthood.
The responses regarding the sheltering and institutionalisation of children and young people are provided by the National Commission for the Promotion of Rights and Protection of Children and Youth (CNPDPCJ). The CPCJ are non-judicial official institutions whose mission is to protect children and young people in danger.
Borderless Programme (Sem Fronteiras) The Borderless Programme is a programme of holiday activities for children and young people aged between 10 and 18 (young people up to 21 years hold can be considered when suffering from slight mental fraility) sheltered in homes and temporary reception centres of public and private institutions, in foster families, monitored by Children and Youth Protection Committees and other programmes, as well as beneficiaries of Social Insertion Income. This Programme is carried out during the summer school holidays, with a duration of 7 days. It is supported by the National Youth Tourism Network, through Youth Inns. The Programme was created in 1999 and its operation is the responsibility of the Social Security Institute (ISS), the Portuguese Institute for Youth and Sports (IPDJ) and Movijovem. On 1 June 2009, the Cooperation Protocol of the Borderless Programme for 2009 was signed between the Social Security Institute, the Portuguese Youth Institute and Movijovem, following the collaboration established, having already provided around 6400 children and young people with holiday and leisure periods.
The Institute of Social Security, PI ensures the integral payment (100%) of the financial charges related to the programme, including activities, accommodation, food and insurance for young people. The main indicators of the latest editions of this programme are the following:
- 2018: 8 entities and 511 young people took part and 15 projects were carried out;
- 2017: 13 entities and 615 young people took part and 18 projects were carried out;
- 2016: 7 entities and 373 young people took part and 11 projects were carried out;
- This programme did not take place in 2020 due to the outbreak of the Covid-19 pandemic.
PROTECTING SEAL Project The Protecting Seal project is an integrated risk and danger management system and represents an opportunity for self-diagnosis and training for Competent Entities in Children and Youth Affairs (ECMIJ) in the promotion and protection of the Children Rights, in accordance with Article 7 of the Law on the Protection of Children and Young People in Danger.
National Social Emergency Line
The 144 number – National Social Emergency Line (LNES) – is a public telephone service, free of charge, which functions non-stop, 24 h per day, every day of the year.
It aims to give an immediate response to situations that need a fast and urgent intervention in the scope of social protection, as well as ensuring access to further social forwarding/follow-up, from an insertion and autonomy perspective.
It is aimed at all citizens, but mainly at those who are in a situation of vulnerability, particularly:
- Victims of domestic violence;
- Children and young people in danger;
- People in situations of loss or absence of autonomy;
- Homeless people.
House Plan (Plano CASA) Aiming to promote the educational success of children and young people in residential care (Residential Homes and Nursing Homes), the Home Plan was created for children and young people who are in a situation of reception in Nursing Homes or in Temporary Nursing Centres, as well as in Nursing Homes as a social response that succeeds them, from the public or solidarity network.
The House Plan is a partnership between the Ministry of Labour, Solidarity and Social Security and the Ministry of Education.
The House Plan thus aims to strengthen their school education processes as an indispensable condition for a true project of autonomy and family (re)integration, implemented through pedagogical support, through the placement of teachers in groups of schools and ungrouped schools to perform functions with children and young people sheltered in the Nursing Homes (LIJ) and the Temporary Nursing Centres (CAT), as well as the Nursing Homes (CA) as a social response that will succeed them and ensure the pedagogical technical monitoring of teachers.
ASE (School Social Support)
The School Social Support (ASE) is a support measure that contributes to the school expenses of students, particularly books, school material, meals and the transportation necessary for the attendance of primary and secondary education.
The goal is to support children and young people of unprivileged families, in order to fight social exclusion and the school dropout rate, by promoting equal educational opportunities.
Students with special education needs have additional support in the acquisition of technology that assists in learning.
Social Welfare Services (SAS)
The social welfare system of public higher education offer scholarships, through a money allowance that contributes to the costs inherent to the attendance of a higher education degree or of carrying out a mandatory professional internship.
It is given as a non-refundable grant, in the same year, for students that lack financial resources.
The conditions for granting scholarships are defined in the current legislation, and in the Rules for Granting Scholarships for Students in Higher Education .
Support in transportation
In the majority of the Portuguese public transportation services, there are discounts and different student bus tickets for young people. The discount is established according to each family’s School Social Support category.
- email@example.com – intended for young people aged between 4 and 18;
- firstname.lastname@example.org – intended for students aged under 23, attending private or public establishments of higher education.
Legislation and intersectoral strategies intended for vulnerable groups:
Intervention in child and juvenile health:
- National Youth Health Programme 2006-2010 (Regulation no. 12045/2006);
- Health Intervention for Children and Youth at Risk (Regulation no. 31292/2008);
- Take Care of Yourself programme (Decree no. 655/2008);
- National System of Early Intervention – SNIPI (Decree-Law no. 281/2009).
Programmes and services for access promotion
Support Programme for Health Promotion and Education
According to the concept of Health Promoting Schools (HPS) of the World Health Organization (WHO, 2009), the Directorate-General of Education developed the Support Programme for Health Promotion and Education (PAPES), with guidelines in the following fields:
- Mental health and prevention of violence;
- Nutrition education and physical activity;
- Addictive behaviours and dependencies ;
- Affections and sex education.
National Programme for Oral Health Promotion (PNPSO)
The National Programme for Oral Health Promotion (PNPSO) is developed in private services, in conjunction with school health and child and youth health programmes.
The PNPSO provides access to oral healthcare in the areas of prevention, diagnosis and treatment to certain population groups, including children and young people, through dentists' checks.
"Cuida-te +” Programme - taking good care of youth health
Cuida-te + Programme is coordinated by the Portuguese Institute for Sport and Youth (IPDJ, I.P.), with the involvement of several partner entities in the field of education and health. Dedicated to minimise the likelihood of non-communicable diseases, by promoting health education, health literacy, early detection, counselling and referral to young people, ultimately leading to more meaningful and productive lives, this programme aims to promote youth health and healthy lifestyles and is not only targeted at young people between the age of 12 and 25, but also teachers, parents, leaders of associations, health professionals and other intervention players in the youth health promotion field. Among its specific objectives, the following stand out: encouragement of regular physical activity; healthy diet; adoption healthy and responsible lifestyles; prevention of addictive behaviours; mental health promotion and sexual and reproductive health promotion. Likewise to most approaches at the time (first version of the programme, “Cuida-te” was launched in 2008), this programme has primarily focused on warning and informing young people of the consequences of risky behaviour and/or informing them of healthier and safer lifestyles, complementary to competences development to avoid risks. Despite the Portuguese Institute for Youth and Sports has consistently been committed to ensuring that young people have a voice in identifying their health needs, in planning and delivering solutions, and in innovating and experimenting to advance practice, its former intervention model, “Cuida-te”, failed to take into account the active role of cognitive functions, which calls for other dimensions that complement the more traditional approaches. On the other hand, environmental prevention interventions underline the importance of limiting exposure to risky behaviour opportunities, targeting the automatic system of behaviour.
In 2019 a renovation process of the programme (“Cuida-te +” Programme) was undertaken with the purpose of addressing recommendations emerging from recent literature reviews, which points to:
- Dramatic increases in socioeconomic inequality in many domains of adolescent health and overlaps with unequal distribution of income.
- A need of competencies and expertise on prevention principles, theories, and practice among those who develop prevention interventions, namely trained and/or specialized professionals.
- Prevention interventions should form part of a coherent long-term prevention plan, monitored on an ongoing basis allowing for necessary adjustments.
- Prevention delivered should be based on scientific evidence as an investment in the well-being of young people.
Thus, complementary information was considered:
- Wide multicomponent intervention programmes are the most adequate to serve the purpose of promoting healthy lifestyles and to prevent risky behaviours among young people.
- The concept of wide includes intervention at macro level (state policies), the meso level (recreational settings, schools), and at microlevel (families and young people) ; and the notion that there are beneficial effects beyond substance use per se.
- Young people tend particularly to be influenced by surrounding culture; as such, their risky behaviours are not simply a result of health illiteracy.
- These facts entail prevention programmes to go beyond information/warning and skill/competence development approaches.
Hence, key adjustments were put forward:
- Coherence, matching the results of local needs assessment with intervention mechanisms;
- Adequate training to strategic players and professionals;
- Coverage of a range of community settings (youth associations, families, schools, universities, entertainment venues, etc.);
- Need to involve university to support the implementation of the programme and its monitoring and evaluation.
The new operational mechanism is structured in two intervention measures: • Measure 1: Customized Services • Measure 2: Health Literacy Promotion Services
Measure 1 includes:
- Mobile Units: awareness raising initiatives on the move, carried out by youth health professionals, made available in geographic areas strongly attended by young people;
- Youth Health Counselling Services: confidential counselling services (in premisses consulting rooms) provided by health professionals to young people;
- Sexual Health Help Line: support and counselling provided by phone/written by sexual health professionals, dedicated to young people;
Measure 2 includes:
- Youth Health Portal: web-based system designed to provide general information to young people in the Programme intervention areas;
- Health Education: artistic and non-formal activities to promote youth health through role-playing and other active methods;
- Capacity Building to Intervention Players: varied and complementary training on the Programme areas, to promote intervention quality.
Children and Youth Health Appointments
It is a monitoring appointment, for health promotion and disease prevention, for children and young people under the age of 18.
The appointments must take place according to the schedule established by the regulations of the Directorate-General of Health (DGS) and the strategic guidelines of the National Health Plan.
In addition to the strictly clinical issues related to growth and development, information is provided about health and wellness: nutrition, prevention of infectious diseases, accident prevention, vaccination, recreational and leisure activities, sports and sexuality.
Support Centres for Children and Youth at Risk
A network of support centres for primary health and hospital care, available in health centres and hospitals.
It promotes the protection of children and young victims of abuse and neglect. The intervention should be made, initially, by formal and informal entities, public and private, that deal with children and young people in the sectors of health, education, and social service.
Implementation of pilot experiments in the field of Integrated Long-term Mental Health Care (ICMS)
Ministry of Labour, Solidarity and Social Security and Ministry of Health
The expansion and improvement of the National Network of Integrated Continuous Care (RNCCI) focused on the mental health component, and units and teams providing Integrated Continuous Mental Health Care (CCISM) were implemented for the adult population and for children and adolescents (Order no. 1269/2017, of 2 February). The CCISMs are therefore innovative in that they also include types of units and teams for children and adolescents, an age group with a marked lack of structures in this area. The development of new responses for children and young people up to the age of 18 is, in fact, one of the most striking and positive contributions of the implementation of Continuous Mental Health Care, an area in which there is an effective lack of responses. Within the scope of integrated continuous mental health care, 22 units and teams are operating (pilot experiments), covering 280 users.
Literacy, Information and Guidance
National Education for Health, Literacy and Self-care Programme
Under the National Programme for Education in Health, Literacy and Self-care, the launch of a mobile app – Youth Mobile – is to be expected.
SOS Children, affiliated with the Child Support Institute (IAC), is an anonymous and confidential service for children, young people, families, professionals and the community.
Sexualidade em Linha (Sexual Health Helpline) Sexualidade em Linha is a branch of the "Cuida-te +” Programme - taking good care of youth health. This service promotes support and counselling provided by phone/written by sexual health professionals. This tool is exclusively dedicated to young people and ensures a free, anonymous and confidential service, provided by a sexual health specialized team.
In Portugal, regarding access to healthcare, there are local strategies through the creation of Community Councils, with representatives of several entities in the field of health and education, with the goal of promoting the local management of healthcare.
They are constituted by representatives of local authorities, social security, schools, social solidarity institutions, associations, the reference hospital, social volunteering teams and the National Commission for the Promotion of Rights and Protection of Children and Youth.
Vulnerable youth's access to credit
National Microcredit Programme
The microcredit is a small loan to support people who have no access to a normal bank credit and that wish to perform a small investment to create their own job or business.
It proposes to promote entrepreneurship and individual autonomy, allowing social inclusion through economic initiative.
It is intended for people with difficulties entering the labour market, which are at risk of social exclusion.
Priority is given to unemployed young people aged between 16 and 34.
The programme is a measure promoted by the Institute for Employment and Vocational Training, PI, in partnership with António Sérgio’s Cooperative for Social Economy (CASES).
For more information, see chapter 3 – Employment and Entrepreneurship; sub-chapter 3.9 – Startup Funding for Young Entrepreneurs.
Measures against financial exclusion
National Plan for Financial Education - Everyone Counts (Todos Contam)
The Bank of Portugal has developed programmes to promote inclusion and financial literacy, covered in the G20 Principles for Innovative Financial Inclusion and in the OCED Principles (International Network on Financial Education).
The National Plan for Financial Education (PNFF) 2016-2020 is an instrument to promote financial inclusion, created by the National Council of Financial Supervisors (NCFS), consisting of three financial regulators:
- Bank of Portugal;
- Portuguese Securities Market Commission;
- Supervisory Authority of Insurance and Pension Funds.
Financial education in schools
As a result of a collaboration protocol between the Ministry of Education and the Bank of Portugal, signed in 2011, , a Financial Education Framework was developed, through the Directorate-General of Education and the National Agency for Qualification and Professional Education, outlining guidelines for the implementation of financial education in the spheres of education and training in different educational levels:
- Preschool education;
- Basic education;
- Secondary education;
- Adult education and training.
Financial education manuals (2015-2017)
Didactic and pedagogical materials for students and teachers in basic and secondary education, covering subjects from the Financial Education Framework.
In its production, the following partners are involved:
- Ministry of Education;
- APB – Portuguese Banking Association;
- APS – Portuguese Association of Insurers;
- APFIPP – Portuguese Association of Investment Funds, Pension Funds and Asset Management;
- ASFAC – Association of Specialised Credit Institutions.
Global Money Week
An international initiative to raise the awareness of young people to the importance of financial issues, hosted annually by the Child and Youth Finance International (CYFI), which involved 20 Portuguese schools, working on financial training activities with students from different levels of education.
"Everyone Counts" Competition
A competition in partnership with the Ministry of Education, which rewards and encourages the development of financial training projects in schools.
Financial Training Day
A day (2 November) to raise the population's awareness about the importance of financial training.
A training programme for educators and teachers of all education levels, with the goal of promoting the introduction of the Financial Education Framework in the schools' curricula.
It is intended for educators, teachers and preschool, basic and secondary education students.
In the scope of the partnership between financial supervisors and the Ministry of Education and Science, the Financial Education Framework was published for preschool, basic and secondary education and the education and training of adults, which was intended to guide the implementation of financial training in the field of education.
The technical monitoring of the various responses in order to ensure compliance with the provisions of the cooperation agreements with the social institutions that develop the various social responses and to verify the quality of the services provided is carried out in two dimensions:
Governmental Area: 1. Permanent Commission for the Social and Solidarity Sector: meetings are held with the Government members responsible for this area, policy measures are defined in accordance with the priorities for the sector, as well as the updating of the annual contribution. The heads of the representative entities are represented: National Confederation of Solidarity Institutions, Portuguese Union of Misericord, Portuguese Union of Mutual Funds, Portuguese Cooperative Confederation, CCRL (CONFECOOP). Follow-up forum (social services and institutions) 2. National Cooperation Commission: the National Cooperation Commission (CNC) is responsible for monitoring and evaluating issues raised within the context of cooperation. Periodic monitoring meetings are held to discuss the implementation of policy measures and the respective technical and regulatory instruments necessary for the proper functioning of social responses.
Social Security Institute (ISS) The ISS is the organism of the MTSSS responsible for monitoring social responses and is responsible for:
The Social Security Institute (ISS) is the body responsible for the monitoring of social responses at a national and district level, promoting the system’s efficiency and the efficacy of its management (according to its aims and principles). The regular monitoring of social trends and the statistical production in different fields (inclusion, employment, family allowances, etc) is frequently updated and available to the public in their website.
At central level: (by the central services of the Social Security Institute): Propose measures, regulate and define parameters for compliance with regulations, with a view to the development and implementation of social action policies, measures to combat poverty and promote social inclusion and the promotion of cooperation with social sector entities or others necessary for the respective implementation of its activity.
. Monitor and issue guidelines on the assessment of accounts and budgets of IPSS and similar institutions and support them in the preparation of budgets and accounts, as well as carry out their assessment and approval of accounts; and
. Contribute to the production of indicators of coverage and use of social facilities, identifying needs and proposing investment strategies.
At district level: (by the district centres in each geographical area where social responses are developed): Carry out regular technical monitoring of social responses, propose the entering into of cooperation agreements with the IPSS to the ISS Board of Directors, as well as develop the necessary actions for the exercise of the ISS, I.P. supervisory action, under the terms of the law.
House Plan (Plano CASA)
The House Plan is monitored and evaluated jointly by the General Directorate of School Administration (DGAE) and the ISS, IP. This evaluation consists of the diagnosis of teachers' needs by the Central Services and District Centres of the ISS together with the IPSS and equivalent institutions that develop the above-mentioned social responses and preparation of reports by both the ISS and the DGAE regarding the annual evaluation of the implementation of the protocol, namely with the evaluation of the degree of satisfaction of children and youth, teachers and staff of the LIJ, CAT or CA and on the effectiveness and efficiency of the placements made.
Implementation of pilot experiments in the field of Integrated Long-term Mental Health Care (ICMS) A working group (WG) was set up to monitor the CCISM pilot experiments, which includes members of the competent services of Social Security - Social Security Institute (ISS) and General Directorate of Social Security (DGSS) - and Health (Central Administration of the Health System - ACSS) and the National Programme for Mental Health (PNSM). The Working Group has already prepared an annual report on the monitoring carried out, namely on the various stages of the referral process, including the organisation of referral services, the process of integrating mental health elements into the RNCCI’s coordination teams (regional and local), the characterisation of the units and teams implemented and the compliance with the quality indicators established for this project. The main difficulties and contributions collected by the WG from the various stakeholders in the pilot experiments and the ongoing monitoring work are also noted.
Choices Programme (Programa Escolhas)
The Choices Programme’s (Programa Escolhas) projects and the services provided by them are evaluated technically and financially. At the financial level, the accounting assessment is also monitored by external audits. The technical part, which is the basis for intervention for all projects supported by the Choices Programme, has two dimensions: individual and global. The technical evaluation of each project’s performance foresees a process of self-assessment and an internal evaluation: - Self-assessment promotes the project’s local evaluation day by day with the participants and mandatorily every two months with the young participants assemblies and the project’s partners. These assessments contribute to the biannual, progress and final reports, at the end of each civil year, for the measurement of the previous targets established for each general and specific goal. The Choices Programme makes available an application for the registration of all information (mandatory use). - Global evaluation is carried out through two mechanisms: external evaluation by an independent entity that evaluates the programme according to pre-defined parameters. On the other hand, “general objectives of the Programme” are defined, composed by a set of indicators to which all the projects supported by the Choices Programme should contribute, amongst which the following should be highlighted:
a) Global success rates at school b) Orientation to school and training c) Guiding to employment d) Professional Training integration e) Employment integration f) Partners’ involvement in the activities developed g) Certification in the ICT field h) Number of organizations/associations created i) Number of entrepreneurial initiatives established j) Number of participants in activities that promote citizenship and participation k) Global participants/attendees l) Total of sessions with attendances. In parallel, the Choices Programme provides an online platform for the control and assessment of each project (AGIL – Aplicação da Gestão da Informação Local).
The different programmes and measures are evaluated individually by the various existing mechanisms at the European, national and institutional level.
The programmes subject to European funding are submitted to regular assessments, taking into account the production indicators of each measure/programme.
At a national level, institutions involved in the development and implementation of measures/programmes, either in the quality of coordination or of partnership, are subject to external and internal evaluations, in particular by the Assessment and Accountability Framework (QUAR), through a series of performance indicators.
In addition, some entities, such as the Institute of Employment and Vocational Training, PI (IEFP, I.P.), produce reports with indicators of effectiveness, efficiency and quality, including Youth Guarantee indicators.
Generally, all the public services in Portugal are subject to quality evaluations, in particular by the Assessment and Accountability Framework (QUAR), which is mandatory by law. Moreover, several public services (including the Portuguese Institute of Sports and Youth) have voluntarily implemented specific complementary tools and methodologies for assessing the quality of the services provided, such as the Common Assessment Framework (CAF). The programmes subject to European funding are submitted to regular assessments, with the production indicators of each measure/programme.