Second Steering Group Meeting

Bruxelles, September 15-17, 2008

Dana-Elena Caleap

City of Bacău

Building Healthy Communities

BUILDING HEALTHY COMMUNITIESThematic Network and Co- co-financed by the

URBACT II ProgrammeCity of Turin Urban Regeneration and Development

Sectorin collaboration with QeC - ERAN

HIA and the use of urban health indicators

City experience in the field:Bacău Municipality has no experience in this field.

Needs and challenges:

In order to achieve the overall aim and the specific objectives for the period 2007-2013, the measures and the actions taken in view are grouped within six national priorities of development:

• The increase of the economical competitiveness and the development of the economy based on knowledge;

• The development and the modernization of the transport infrastructure;

• Protecting and improving the quality of the environment;• Human resource development, promotion of employment

and of social inclusion and strengthening the administrative capacity;

• The development of the rural economy and the increase of the productivity in the agricultural sector;

•Diminishing the development disparities between regions of the country.

Enviroment objectives according to the NDP – The National Development Plan

Priority Targets The connection with the six environment issues

The deficiencies repair of the services and the environmental units in the whole country and especially in rural areas

Water and soilAir and climate changes (and human resources)

Protecting biodiversity and environmental heritage, unique in Romania

Biodiversity(air and climate changes), natural resources

Increasing the importance of sustainable development and advancement on the list of commercial, political and social priorities

The cultural heritage and the landscape The quality of lifeAir and climate changes together with the natural resources.

The North-East Regional Strategy 2007-2013, in which is part the Bacău Municipality too has at the priority 'Infrastructure and Environment' one of the measures: Rehabilitation and development of the educational, social and health infrastructure. The objectives of this measure are:

• Improving the conditions of instruction;• Increasing the health degree of the population from the region; • Supporting the social inclusion of the marginalized and the socially

excluded categories through the rehabilitation and the modernization of the infrastructure related to these services.

For the Bacau Municipality we consider that we confront with the following needs and challenges: 1. Implementation of a pilot project in the city of Bacau on the assessment of quality of life based on a set of indicators with a similar composition to that of the EU; 2. Monitoring of pollutants factors that can affect health and quality of life in the city of Bacau according to the above mentioned indicators;3. Achieving a local action plan which has as main objective improving the quality of life for the people from Bacau City. Organizations and local administrations involvement in order to achieve and implement the local action plan.

Expectations:

Our expectations regarding the HIA implementation and of a set of health indicators from our town are:

• Implementation of the national health programs which respond to the primary problems of public health and to the needs of vulnerable groups;

• Capacity development of the rapid reaction to the health threats;• Reducing the transferable diseases with major impact (HIV, tuberculosis,

infections with sexual transfer), and the chronic diseases as well;• Organizing prevention actions, addressing to the population with a high

degree of infection; • Promoting health through interventions towards the determinants of

health estate;• Moving attention towards the preventive health services and developing

the educational level of the population in order to raise the standard of living;

• Assuring the continuity of the medical act by developing the domicile treatment, the primary medical assistance and the specialty services given in the ambulatory;

• Developing the professional qualifications of the medical personal;• Identifying some facilities for attracting the medical personal;

• Unit medical practices based on guides of practice and on clinical protocols;

• Growing the living standards and the quality of life, by improving quality and the medical act;

• Growing the patients satisfaction;• Growing the medical personal satisfaction;• Improving the activity indicators of the medical units;• Growing the quality life for all the people of the town, including

the people which are living on the South Area of the City – the critical area;

• Development and modernization of infrastructure providers of medical services and equipping them with apparatus / medical equipment and specific means of transport stipulated in the local development strategy in the medical field must have a correspondent in the results of quality of life assessment in the town of Bacau according to HIA and the set of indicators of health. Promoting and Developing an Action Local Plan for a “good and healthily life”;

• Also, Romania aims to reduce pollution factors, one target objective being that of increasing the share of electricity produced from renewable energy resources until 2015, with 33%.

Policies and actions for an healthy and active ageing

City experience in the field:

The Local Authority wants to promote a new policy regarding the measures, the actions for an active and healthy aging.

Presently, in the Bacau Municipality functions:

a) an institution of social assistance for elderly people, with a capacity of 212 seats;

b) partnerships between local authorities (Public Department of Social Assistance) and government organizations for the home care of the elderly people:

- provision of social services, counselling, treatment and recovery;

- provision of personal assistants for elderly persons with disabilities / special needs;

- Hospitalizing them in the Placement for Elderly Persons;

- inclusion in welfare programs at home carried out in partnership with NGOs;

- guiding the elderly persons towards the day centres.

Note: the funds allocated to these programs are from the local budget.

Needs and challenges:• A grown number of pensioners; • A grown number of persons who live alone;• A grown number of feminine old people; • The families incapacity of taking care on their own of their old family

members;• The grown need of medical social services, for the personal attendance; • The old peoples are feeling alone and they are isolated;• Grown risk of presenting disabling diseases. This kind of diseases generate

disabilities, and as a result of this, dependence; • Need of long term medical and social assistance;• Small earnings represented by pension;• The progressive grown of the accommodation costs, food and medicaments;• We encounter with the old persons a particular situation because they need 2

types of support – social services and medical services; • Extension of poverty in the families with small incomes; • Old people losing property;• The changes registered in the family’s structure; • The changing of the lifestyle; • The transfer of the young population in the urban areas from the rural ones; • The limitation of the familial support and the diminution of the traditional

attendants; • More and more expensive healthcare services, especially if we talk about

assistance offered in an institutionalized system.

Expectations:

• conceiving a Local Action Plan which includes the development of services for elderly people from the Bacau County is a starting point for the more efficient organization of the existing services and establishment of new services, qualitative which would meet the real needs of elderly persons;

• developing a coherent system of socio-medical assistance for the immovable elderly people;

• reducing the feeling of solitude and isolation felt by the elderly people by creating and developing appropriate services in order to integrate them actively in the community life;

• improving the medical insurance for the elderly persons;• the expansion of the social services offer, that would

respond to the needs of the elderly persons;• improving legislation concerning social protection of elderly

people;• creating a specifically fund for the urgent socially cases of

elderly persons.

Healthy places and healthy environment

City experience in the field:

1. Bacau Municipality has initiated a series of projects for modernization, rehabilitation and growth of green spaces and of those intended for entertainment;

2. Projects for the rehabilitation and development of the environment infrastructure:

• integrated waste management;

• supply of drinking water from new sources;

• sewerage network rehabilitation.

3. Actions initiated by the Agency of Environment Protection in partnership with the Bacau Town Hall, economical operators and non-governmental organizations, such as:

- actions of awareness of the local community for the selective depositation of wastes;

- actions of awareness regarding environmental protection on 'Environment Day', 'Earth Day', etc.

Concrete actions developed in health problems:

• Monitoring the way in which there are respected the quality criteria of the medical act, at hospital level and at the level of the primary medical assistance, through mixed inspections realized by CAS Bacau (Health Assurance Bureau);

• Objective evaluation for the need of specialty personal according to the recommendations of MSP;

• The support of authorized institutions for professional training through continuous medical education of the medical personal;

• Monitoring the developing of the national health programs;

• IEC CAMPAIGNES for the problems of public health identified at local or national level for emergency situations ;

• Participation to the European Week of Immunization by organizing workshops, sessions of training with community assistants and sanitary mediators regarding the importance of vaccinations;

• Immunisation actions in communities that do not have access to the health services;

• Lifestyle and health;

• Preventing contraction through respiratory virosis and flu;

• The woman’s health: breast and cervix cancer;

• National Day without Tobacco;

• Preventing the negative effects of the sultriness/broiler.

Also, PSSA (Public Service of Social Assistance) , institution under the authority of the Local Council, possesses an important experience regarding the resolution of cases as well as special social assistance for disadvantaged social categories:

1. Identifying and analyzing the needs of the old people in order to establish a plan of intervention, as it follows:

– For the persons who cannot move;– For the persons who can move;– For the persons who need permanent supervision.

2. SERVICES OF DOMICILE ATTENDANCE

3. SERVICES IN THE DAILY CENTRE

4. SERVICES OF ATTENDANCE IN THE SHELTER FOR THE OLD PERSONS

The last realization of the Bacau Town Hall is the establishment of the Pensioners Club which offers different services:

Main principles of the Day Centre “The pensioners Club”:

• The principle of respecting the human rights;

• The principle of promoting the social inclusion;

• The principle of equal rights;

• The principle of cooperation and of partnership.

Needs and challenges:

• Reduced number of specialty medical personal from the emergency medical assistance;

• Absence of permanent centres through which it is assured the continuity of the primary medical assistance;

• Approximate 50% from the estimated population present a risk in developing a chronic affection

• the need to implement a project of urban regeneration in several neighbourhoods of the city, and especially in the south area;

• increasing the green area of the city per inhabitant, in accordance with the rules set by the European Union;

• the diminution and the elimination of pollution having as source the economic agents from the city;

• clean air and healthy drinking water;

• Reducing the discrepancies between the areas of the city, regarding infrastructure of streets and utilities, service quality and standards of living;

• increasing the number of areas for leisure and entertainment;• improving the quality of life by enhancing the quality of

medical services and of the social assistance, the consumer protection and the economic development as in the other regions of the EU, but also by promoting healthy living standards (healthy supply and outdoors moving);

• To resolve some of the health problems of the Bacau Municipality, like this:

- Increasing the number of people with severe chronic diseases: diabetes, cardio-vascular diseases, cerebral vascular diseases, cirrhosis and chronic hepatitis, malignant tumours;

- Reduced access to the homecare services, for recovery or for palliative care;

- The poor public awareness regarding healthy lifestyle.

Expectations:

- increasing the quality of life by improving the quality and the safety of the medical act;

- increasing patients satisfaction;

- increasing medical personal satisfaction;

- improving the activity indicators of the sanitary units;

- ensuring a healthy environment for relaxation and study;

- increasing life expectancy - increasing the average of life.

Use of Structural Funds in actions aiming at developing ‘health gains’

City experience in the field:Bacau Local Administration has developed different projects with

the help of the Structural and the Cohesion Funds. These are: • Building subterranean roadway between the streets Oituz and

Stefan Guse;• Rehabilitation of the buildings and modernization of the Social

Centre from the street Henri Coanda;• Rehabilitation and endowment with equipments of the Old

People Social Centre, from the street Aleea Ghioceilor;• Rehabilitation and modernization of the Entertainment Island;• Building an Entertainment and Tourism Centre – The Tamas

Forest;• Rehabilitation of the road Calea Moldovei;• Building of the Bacău Urgency County Hospital.

For all these projects has been signed the financing contracts for technique assistance.Building of the Bacău Urgency County Hospital. BBuilding of the Bacău Urgency County Hospital. uilding of the Bacău Urgency County Hospital.

Needs and challenges:• exchange of good practices;• supporting the sustainable development of the Bacau City - urban growth

pole; • development of Bacau metropolitan area as a new form of partnerships

and territorial governance among urban and rural areas for the development and the promotion of the region;

• promoting a policy of European territorial cooperation so Bacau Municipality to make part of a regional group of competition and innovation in the EU;

• development of green areas and of recreational areas;• enhancing the quality of medical services and of social assistance;• development and rehabilitation of areas and of tourist targets;• development and rehabilitation of transport infrastructure and of public

utilities;• implementing a program of cultural exchanges with the regions in the EU.

Expectations:• to absorb as much as we can from the Structural and Cohesion Funds in

order to create partnerships with cities and regions for advice and expertise and for transfer of good practices.

The Bacau Local Support Group

• Presently, we are in the phase of approval and signing the partnership agreement.

• We request a model of Partnership Agreement or Elaboration Protocol in order to be presented to the members of the Support Group.

The actors who will represent this project are:• The Authority of Public Health; • The Agency for the Environment Protection; • The County Office for Consumer Protection;• The Public Service for Social Assistance – Bacau Municipality; • County Department of Statistics;• The Bacau Town Hall;• Bacau Local Development Agency; • “Lumina” Association; • House District Health Insurance;• Social Centre for Elderly People;• “Betania” Association;• Foundation for Community Support.For the moment the Institution haven’t estabilished their targets.The meetings are organized by the Local Development Agency, the

institution which supports the project from the part of the partner - Bacau Municipality.

We propose the permanent consultation on e-mail with the Leader Partner, the other partners from the project, experts and collaborators and the consultation with the members of LSG.

Thank you !

Dana-Elena CALEAP

Bacău Local Development Agency

Bacau Municipality

agentia@adlbacau.ro

Building Healthy Communities

BUILDING HEALTHY COMMUNITIESThematic Network and Co- co-financed by the

URBACT II ProgrammeCity of Turin Urban Regeneration and Development

Sectorin collaboration with QeC - ERAN