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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)

Official document and timeframe

A national Health Strategy 2014-2020 was adopted through Government Decision no. 1028/2015. The Strategy had no dedicated objectives or activities for young people, and no objective dedicated directly to the promotion of a healthy lifestyle and healthy nutrition. The strategy included, among its actions, the standardisation of the schools evaluation of health condition for children and adolescents until 19 years old.

The Youth Strategy 2015-2020, adopted by Government Decision no. 24/2015 had a dedicated pillar to youth health and well-being, including specific objectives to promote healthy life and healthy nutrition among the young people. A separate strategy on healthy life and healthy nutrition as such does not exist in Romania.

Although, generally, in line with the EU Physical Activity Guidelines, none of the two mentioned strategy is directly and explicitly referring to the EU document.

Main elements and key objectives

The specific objective of the Youth Strategy 2015-2020in the area of healthy life and healthy nutrition among the young people was to support youth health and quality of life and prevent injuries, eating disorders, substance use and addiction. Planned actions included:

1. School and high school campaigns on topics like health education, including healthy eating and reproductive health;
2. Promoting road safety education and defensive driving among youngsters;
3. Facilitating youth access to youth-friendly medical services and support enhanced accessibility, efficiency and quality of public health education services, including their delivery by the private sector or social enterprises;
4. Encouraging peer health education by supporting projects aimed at STD prevention and HIV harm reduction;
5. Carrying out actions in line with the National Anti-Drug Strategy 2013-2020 to prevent drug, alcohol and tobacco use among adolescents and young people.

Another relevant objective of the Youth Strategy 2015-2020was the one aiming at improving leisure time opportunities for young people. Planned actions included:

1. Extending the network of centres, clubs, leisure facilities managed by public and private entities or under public-private partnerships, with low costs and utmost effectiveness in attracting youth to different leisure activities;
2. Making more of the education system infrastructure after school for the leisure activities conducted by youth and/or youth NGOs;
3. Involving youth NGOs and youth in leisure facility development and management, including on a volunteering basis;
4. Developing and improving the quality of holiday camps, student cultural centres, sports facilities for youth, children’s clubs and centres, school sports clubs, and ensure improved use of the already existing ones through their joint management by youth NGOs and public government authorities or through public-private partnerships;
5. Providing facilitators and youth workers with professional training, development and skills to attract young people to leisure activities that have a positive impact on their personal development;
6. Providing guidance and support to local public government authorities in order to develop the infrastructure needed for the practice of proximity sports: playfields, swimming pools, skate parks, bike lanes, etc.

Target groups

According to the Youth Strategy 2015-2020, young people that had been the main target group of the actions under the specific objective on health among young people of the Youth Strategy are:

• young drug and/or alcohol users
• young people with unhealthy eating habits
• young persons with disabilities
• young mothers aged 15-19
• young people infected with HIV/AIDS
• young people affected by different mental illnesses
• young people whose lifestyle doesn’t include sporting or cultural activities

Government authority responsible for the implementation

The Ministry of Health was the main government authority responsible for the implementation of the Health Strategy 2014-2020. County offices of the Ministry of Health: the Directorates of Public Health are responsible to carry out most of the activities planned.

The Ministry of Youth and Sports was the main government authority responsible for the implementation of the Youth Strategy 2015-2020, including the specific objectives on health and quality of life and on leisure time of young people.

An action plan allowing systematic implementation, monitoring and evaluation the strategy was not adopted.

Monitoring/assessment/evaluation of the implementation of the strategy

No evidence-based monitoring/assessment/evaluation of the implementation of the national Youth Strategy 2015-2020 has been conducted.

Concerning the Health Strategy 2014-2020, in September 2016 the Ministry of Health published a report on the strategy’s implementation in 2015. No updated report has been published.

Major revisions/updates

In 2020 the Ministry of Youth and Sports started preparing the youth strategy 2021-2027. In December 2020 a needs assessment was provided by the Life Quality Institute to support the elaboration of the strategy in 2021. Additionally, the Youth Barometer 2020 was released with the same aim. Other than that, consultations with the Counties’ Directorates on Youth and Sport and with other governmental institutions with responsibilities in the field of youth were organized. Based on the outcomes of the research and the consultation processes and after consultation with the National Council for Youth, a preliminary proposal for the new Youth Strategy, in line with the European Youth Strategy, was published in 2021. A cooperation protocol with the Government’s General Secretariat was signed by the Ministry of Youth and Sport in order to be provided with additional support for the coordination of the development and adoption process of the new Youth Strategy. In 2022, the consultation processes with the governmental and non-governmental organisations will continue, aiming to have the final project adopted by the end of the year.

Encouraging healthy lifestyles and healthy nutrition for young people

A Multiannual Plan for Health and Health Educationhave been developed in 2016 by the ministry of Health and the Presidential Administration for the period 2016-2020. The Multiannual Plan included the development of the legal framework for planning and managing national initiatives in the field of health promotion and health education, this field being decentralised at the moment in Romania. As a result, the Law no. 152/2020 on health promotion and disease prevention was adopted.

The Ministry of Youth and Sport funded projects implemented by youth organisations and dedicated to young people in the area of health, sport and leisure, supporting small projects (up to 5 000 euro/project) for a healthy lifestyle and health education. The projects’ implementation is monitored by the funding authority: the Ministry of Youth and Sports, but their impact have not been evaluated directly concerning youth health. An overall evaluation of the Ministry of Youth and Sports programmes for young people 2010-2015 have been conducted and published in 2016. On the other hand, the impact of these projects can be observed in the results of the Youth Barometer.

Health education and healthy lifestyles education in schools

Health education

According to Law no. 272/2004 on the Protection and Promotion of Child Rights, article 46, life education, including sex education shall be provided in schools. However, health education is an optional subject.

A national curricula approved by the Ministry of Education is available for the optional subject, covering issues as hygiene, work-rest balance, environmental health, mental health, nutrition, sexual health and family life, use of substances (including Tobacco, alcohol, drugs), accidents, violence and abuses, bioethics. According to the national curricula at the end of the health education programme, young people of 19 years old should be able to:

• Identify the factors that influence the physical and mental development of the individual;
• Use the notions of anatomy, genetics, legislation to explain some aspects of bioethics;
• Analyse the consequences of decisions concerning sexual life at individual, family level;
• Investigate the influence of environmental factors on individual and collective health;
• Explore the impact of risk situations on the individual and the community;
• Evaluate the reproductive health information and services;
• Build personal strategies to support a healthy lifestyle;
• Evaluate some concepts, theories and personal opinions on health issues;
• Analyse the interrelations between physical, mental, mental and personal health;
• Assess the conditions for maintaining a healthy relationship between partners;
• Apply strategies to minimize the effects of potentially dangerous situations;
• Assess the socio-cultural influences on the expression of sexuality;
• Analyse the incidence of abuse and violence on personality development in adolescence.

Within a project funded by the Norwegian and EEA Grants, the National Institute of Public Health developed in 2016 the Guidelines for Health Nutrition and Physical Activities in Schools and Kindergartens, covering activities that can also be implemented for young people in the secondary schools.

Sex education and personal relationships education

Sex education is not provided separated from health education in Romanian schools.

Peer-to-peer education approaches

No top-level guidelines, programmes, projects or initiatives facilitating or relying on peer-to-peer education as a form of non-formal or informal learning have been developed and implemented in Romania regarding health education.

Collaboration and partnerships

No top-level support for collaboration and formation of partnerships between schools, youth workers and health professionals promoting youth health is developed and implemented in Romania.

Probably the most preeminent health NGO active in the field of health policies, including health policies with young beneficiaries is the Centre for Health Policies and Services (CHPS). It acts as a think tank and advocacy NGO being both a dialogue partner and a funds receiver for assessments needed to develop health policies. Among CHPS activities it worth mentioning: 'Developing a costing model for the primary health care services for mothers and children' (in partnership with UNICEF), 'Promoting a healthy lifestyle in schools' – project resulting in an educational toolkit for children and for young people between 14 and 15, parents and teachers. UNICEF office in Romania is also active, providing information, studies and advices at the level of policy planning as well as testing and piloting social assistance models at local level. Their models are targeting primarily children, but young people between 14 and 18 are also an important target group for UNICEF office in Romania.

Trade unions, employers and NGOs with activities relevant for the youth health participate in policy making using two main methods:

1. the participation mechanism provided by the law no. 52/2003 on decisional transparency (providing the obligation of any regulatory authority to publish draft legislation, to receive and analyse comments and amendments from citizens and to organise a public debate at demand of an NGO or other legally constituted organisations). Although the law provide for this mechanism, debates are rarely requested and organised (e.g. in total the Ministry of Health organised 12 debates in 2019 between the January 1^st and December 30^th and published for debate 120 bills).
2. the Economic and Social Council, a consultative body of the Parliament and the Government, organised as an autonomous tripartite public institution of national interest, having the function of an advisory board for all bills in the social or economic field.

There are three types of organisations participating to the Economic and Social Council:

1. nationally representative trade unions, according to the Law no. 62/2011 on social dialogue;
2. nationally representative employers associations, according to the Law no. 62/2011 on social dialogue;
3. NGOs appointed by the Minister of Labour, according to representation criteria. However, the criteria are not public. An umbrella youth organisation: the Romanian Youth Council is part of the Economic and Social Council. No NGO specialised in health policy is a member of the Economic and Social Council.

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

Information providers / counselling structures

Among the 32 national programmes on health funded by the Ministry of Health (15 programmes) and by the National Health Insurance House (17 programmes), one of the programmes is dedicated to the assessment and promotion of health and health education. Funds are allocated from the national budget of the Ministry of Health to the Public Health Directorates at county level. The Directorates have autonomy to develop their own projects/activities to promote a healthy lifestyle at local level and have to report back to the Ministry.

Among the recommended health promotion campaigns, the most relevant for young people (although young people are not targeted directly) are: the campaign on the importance of physical activity and exercise, the campaign against alcohol consumption, the campaign on reproductive health.

At national level, the Romanian National Council for Audiovisual approved the free broadcasting of advertisements including the following messages promoting a healthy lifestyle:

• ‘The excess of salt, sugar and fats severely damage health’
• ‘Consume daily fruits and vegetables!’
• ‘Move at least 30 minutes each day!’
• ‘Drink daily at least 2 litters of liquid!’
• ‘Respect the main meals of the day!’

Youth-targeted information campaigns

No large-scale, youth-targeted information campaigns on healthy lifestyles and factors affecting the health and wellbeing of young people have been implemented in Romania.

The advertisements including messages promoting a healthy lifestyle have no specific target groups, being addressed to the general public.