Multi Sectoral Approach to Tackle Unhealthy Habits. The Healthy Living Project: Actions to Increase Awareness and Health Promotion

Key Contextual Factors

• “Healthy Living” was adopted by the Government as a continuously implemented National Health Promotion Program “Healthy Living” in 2015. From 2016 it received co-financing by the European Social Fund.
• “Healthy Living” is a comprehensive, multidisciplinary health promotion project. The activities are implemented on a national level and aim to create accessible, healthier environments in local communities in addition to informing, educating, and raising awareness of the positive aspects of healthy lifestyles.
• Croatian Institute of Public Health is implementing the “Healthy Living” project in partnership with county public health institutes and in collaboration with many stakeholders including ministries, government agencies, schools, industry, NGOs, etc.

Key Components/Steps

• To achieve a comprehensive approach, to reach people of all age groups and to implement activities in different environments, “Healthy Living” project is organized into five Elements:
• Element 1, “Health Education” consists of three sub-elements: “Physical Health”, “Mental Health”, and “Sexual Health”.
• “Physical Health” aims to improve children’s physical health by implementing programs that support the development of healthy dietary and physical activity habits. Through the project schools are offered monthly school menus in line with National Dietary Guidelines for Schoolchildren. Also, to raise levels of physical activity in children “Everyday 10-minute exercises for schoolchildren” program that aids in both in-class and recess time physical activity is implemented. Additionally, the “Polygon for Physical Activity of Schoolchildren” program is carried out to ensure access to physical activity to children in schools without sport facilities. In this program “the Polygon”, a set of physical education equipment is distributed, and the school staff is educated on possibilities to use “the Polygon” during Physical Education class but during other classes and recess as well in schools without gyms. This program was recognized by the European Commission as best practice to help reach the Sustainable Development Goals.
• “Mental Health” aims at strengthening the school-staff to recognize the first signals of mental health problems and to provide students with mental health first aid.
• “Sexual Health” aims to educate and inform students, youth, and the general population in sexual and reproductive health.
• Element 2, “Health and Physical Activity”, a program “Walking Towards Health” aims to organize professionally guided walking events to support a regular physical activity and promote its protective effect on health. Within this Element, the community intervention is also implemented by creating 21 exemplary walking trails nationwide. World Health Organization acknowledged this program as a success story in Promoting Physical Activity in Health Sector.
• Element 3, “Health and Nutrition” aims to make healthy nutritional choices easier by labeling food products with the "Healthy Living" trademark. This trademark can serve as a guide for consumers when making food choices and also motivate the industry to reformulate their product to meet the food criteria and receive the “Healthy Living” trademark. It was endorsed as one of the most relevant front-of-pack labels within the European Union.
• Element 4, “Health and the Workplace” targets the working population and aims to award „Health-friendly Company” certificate to workplaces that create a work environment that motivates employees to develop healthy habits, promote workplace health, and show positive health care for employees, and environmental protection. World Health Organization acknowledged this program as a success story in Promoting Physical Activity in the Workplace.
• Element 5, “Health and the Environment”, „Volunteers in Parks” program aims at promoting healthy lifestyles, prosocial behavior, and environmental protection through the organization of active, free time activities outdoors. In addition to organized activities, community intervention is implemented by creating 21 exemplary parks nationwide. The multisectoral collaboration in creating exemplary parks received the University of Zagreb Rectors Award.
• Within all project Elements education materials were created and distributed to relevant stakeholders.

Main Impacts / Added Value

• The personal value of the project is that it helps people pursue the decision to lead healthier lifestyles.
• The technical value is the long-term implementation of the project will result in more people leading healthy lifestyles which will ultimately result in decreasing the rates of morbidity and mortality of NCDs.
• The allocative value can be attributed to the fact that the project is implemented on a national level and in various settings.
• The societal value of the “Healthy Living” project is that it is multisectoral, includes people of all socioeconomic backgrounds, and is implemented in collaboration with local communities.

Lessons Learned

• To achieve continuous implementation and sustainability on local levels it is crucial to include local communities.
• Due to multiple tender processes that are often rather complex, it is important to have a network of people knowledgeable in the field of public procurement, legal procedures, and other administrative risks.
• As the project is implemented during six years it is important to have a well-coordinated team with strong project management, clear professional input, and flexibility to adapt to unpredictable circumstances such as the pandemic.

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