Governance

The governance of health and well‑being policies in Portugal involves a broad institutional ecosystem, characterised by interministerial cooperation and shared responsibility across several policy domains. At the core of this system is the Ministry of Health, responsible for designing and regulating the National Health Service (SNS). Within its administrative structure, the Directorate‑General of Health (Direção‑Geral da Saúde, DGS) plays a central role by coordinating the National Health Plan and a set of Priority Health Programmes and thematic programmes that directly or indirectly target the young population. 

The Regional Health Administrations (ARS), together with Groups of Health Centres (ACES), Local Health Units (ULS) and hospital networks, ensure territorial implementation of national strategies. These bodies operate in coordination with DGS to adapt national priorities to regional specificities and local needs. This multi‑level governance structure guarantees that policies in health and well‑being reach young people through proximity‑based services and community‑level interventions. 

In the education sector, the Ministry of Education and the Directorate‑General for Education (DGE) share responsibility for embedding health promotion in formal education, curriculum development, and the nationwide School Sport system. This ensures that health‑related themes—such as physical activity, nutrition, sexual and reproductive health, and prevention of addictive behaviours—are introduced into school environments in a structured manner. 

The governance of sport and youth well‑being policies further includes the Portuguese Institute for Sport and Youth (IPDJ, I.P.), supervised by the Minister of Culture, Youth and Sport. IPDJ plays a cross‑cutting role, coordinating programmes such as the National Sports for All Programme (PNDpT), supporting community sport facilities, and participating in awareness‑raising and educational initiatives on health and well‑being. Its action involves both autonomous initiatives and partnerships with ministries and local authorities. 

Non‑governmental organisations, private entities and Private Institutions of Social Solidarity (IPSS) complement public action by offering services, local outreach and specialised interventions, particularly in areas such as mental health, prevention of harmful consumption and social inclusion through sport. 

National Authorities and Institutional Responsibilities

Ministry of Health provides strategic direction for health policies affecting young people, while DGS ensures the operationalisation of the National Health Plan through Priority Health Programmes addressing determinants of health (e.g., physical activity, nutrition, mental health, tobacco control). These programmes are implemented in coordination with ARS, ACES, ULS, hospitals and community‑based structures. 

Ministry of Education operationalises formal education measures, including the curricular integration of physical education and the development of the nationwide School Sport Programme. DGE develops guidelines for the school environment, ensuring that health promotion is matched by curricular development and teacher training. 

IPDJ, a central actor in youth and sport policy, ensures articulation between health, education and sport sectors. It acts both as a coordinator and as an implementing body for actions targeting young people—through youth health programmes, sport promotion, management of sports infrastructure and partnerships with municipalities, federations and civil society. 

Cross-sectorial cooperation

Interministerial coordination is essential to the implementation of health and well‑being policies. The National Strategy for the Promotion of Physical Activity, Health and Well‑being (ENPAF 2016–2025) is the clearest example of this cooperative architecture. ENPAF establishes a comprehensive approach to physical activity, involving education, health, sport, social inclusion, labour, science and local authorities. 

To facilitate coordination, the Government created the Intersectoral Commission for Physical Activity Promotion (CIPAF) through Order No. 3632/2017. CIPAF unites representatives from six ministries and oversees the National Action Plan for Physical Activity, ensuring coherence between national guidelines, sectoral policies and local implementation efforts. The Commission disseminates good practices and strengthens interinstitutional cooperation through planning, monitoring and evaluation. 

Additionally, DGS maintains the PANAF platform, a national resource for sharing methodologies, indicators and successful practices in physical activity promotion. The PNPAF (National Programme for the Promotion of Physical Activity) also integrates sectoral coordination by engaging with the Ministry of Education and schools in promoting active lifestyles among children and adolescents. 

Implementation Tools and Delivery Mechanisms

Public health measures for young people are implemented through a multi‑layered delivery system:

• Health sector: ARS, ACES, ULS and hospitals implement national programmes, coordinate local responses and engage with schools, municipalities, social services and community organisations.
• Education system: schools operationalise health education, physical activity promotion and local components of national sport programmes.
• Youth and sport sector: IPDJ coordinates youth health initiatives, supports community sport networks and manages facilities that promote healthy lifestyles.
• Civil society and municipalities: NGOs, Private Social Solidarity Institutions (IPSS) and local authorities deliver complementary initiatives, extending the impact of national strategies through local action. 

Monitoring is carried out through programme‑specific tools, including evaluation frameworks under ENPAF, annual reports from DGS programmes, IPDJ’s sport‑related monitoring instruments and school‑based assessment mechanisms.