Департамент общественного здоровья муниципалитета




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САНКТ-ПЕТЕРБУРГСКИЙ ГОСУДАРСТВЕННЫЙ УНИВЕРСИТЕТ

Факультет психологии

Социологический институт РАН

ДЕПАРТАМЕНТ ОБЩЕСТВЕННОГО ЗДОРОВЬЯ МУНИЦИПАЛИТЕТА
Г. БЕРГЕН

РЕГИОНАЛЬНАЯ ОБЩЕСТВЕННАЯ ОРГАНИЗАЦИЯ СОЦИАЛЬНЫХ ПРОЕКТОВ В СФЕРЕ БЛАГОПОЛУЧИЯ НАСЕЛЕНИЯ «СТЕЛЛИТ»


СБОРНИК ИНФОРМАЦИОННО-МЕТОДИЧЕСКИХ МАТЕРИАЛОВ В СФЕРЕ СОХРАНЕНИЯ И УКРЕПЛЕНИЯ ЗДОРОВЬЯ ДЕТЕЙ И ПОДРОСТКОВ

Авторский коллектив: докт. психол. наук, проф. Гурвич И.Н. (С.- Петерб. гос. ун-т), канд. социол. наук, доц. М.М. Русакова (С.- Петерб. гос. ун-т), О.С. Левина,
О.И. Колпакова, В.А. Одинокова, М.С. Куцак, Н.А. Фатеева, Е.В. Тросман.
Рецензенты:
Сборник информационно-методических материалов в сфере сохранения и укрепления здоровья детей и подростков: Методическое пособие/ Под. ред. И.Н. Гурвича. – СПб., 2009 . –
Представленные в сборнике материалы содержат описание ситуации в сфере сохранения и укрепления здоровья детей и подростков в Норвегии и Северо-Западном федеральном округе Российской Федерации, а также описание теоретических основ профилактической работы и существующих в регионах программ и методик в сфере формирования здорового образа жизни и первичной профилактики различных видов поведения «риска» среди детей и подростков.

Данный сборник предназначен для специалистов государственных и негосударственных организаций, действующих в сфере разработки и управления реализацией программ сохранения и укрепления здоровья детей и подростков, профилактики рискованного поведения.

Сборник подготовлен в рамках международного партнерского проекта «Дети как основа здорового общества», который осуществлялся РОО СПСБН «Стеллит» с российской стороны и Департаментом общественного здоровья Муниципалитета г. Берген с норвежской стороны в период с 2005 по 2009 год, при финансовой поддержке Министерства здравоохранения и социального обеспечения Норвегии (в рамках программы «Партнерство стран Баренц-региона «Северное Измерение» в сфере общественного здоровья и социального благополучия») и при участии администраций Санкт-Петербурга, Архангельска, Калининграда, Мурманска и Бергена.

Summary
Government policy on children and youth issues in European countries is a part of a wider national social policy, is not isolated from its other elements and has an inter-agency nature. Children and youth policy has been developed with regard to social economic policy, demographic policy, family policy and national policies on other issues, both in the Russian Federation and in other European states. Thus we can say that development and intensification of cooperation internationally and regionally and also of inter-agency interaction on the issues of protection and maintenance of children's/youth's health is critical.

"Children are the Basis for a Healthy Society" – is a Russian-Norwegian partner project in the field of primary prevention of risky behaviour among children and adolescents. The project's goal is to improve and develop activities directed toward promotion of healthy lifestyle and prevention of various risky behaviours among teenagers and youth, through better inter-agency cooperation between different bodies and agencies involved in prevention, and through improvement of methodological tools available to specialists.

The project "Children are the Basis for a Healthy Society" was initiated by Regional Public Organization of Social Projects in Sphere of Population’s Well-Being "Stellit" and by the Public Health Authority in the City of Bergen, Norway. The project has been realized in 2005 – 2009 with financial support from Norwegian Ministry of Health and Care Services (as part of the program "Co-operation Programme on Health and Related Social Issues in the Barents Euro-Arctic Region and the Northern Dimension Partnership for Public Health and Social Well-Being").

Over the years of the partnership between Bergen Commune, Public Health Authority in the City of Bergen (Norway) and RNGO "Stellit" (Russia), 250 specialists have participated in the project activities including 226 Russian and 24 Norwegian specialists, thanks to support from City Administrations of St.Petersburg, Arkhangelsk, Murmansk and Kaliningrad, and also of the city of Bergen.
The implementation of "Children are the Basis for a Healthy Society" project and publication of the present brochure has been made possible due to invaluable contributions and help from RNGO "Stellit"'s partners and initiators of the project – the Public Health Authority in the City of Bergen and a number of persons as listed below:

  • Mr. I.Tveit, head of the Public Health Authority in the City of Bergen, Norwegian head of the project "Children are the Basis for a Healthy Society";

  • Ms. A.B.Reigstad, project coordinator at the Public Health Authority in the City of Bergen, Norwegian coordinator for the project "Children are the Basis for a Healthy Society".


Also we would like to thank the following persons and institutions for their kind help and assistance:

  • Ministry of Health and Care Services in Norway, Norwegian Barents Secretariat

  • the city of Bergen, Mayor Herman Friele and Mayor Gunnar Bakke;

  • Commissioner for Health and Social Welfare  Trude Drevland and Commissioner for Health and Care in the City of Bergen Liv Røssland;

  • City of St. Petersburg Administration, and also The Law, Order and Safety Committee and personally its First Deputy Head – Mr. V.S.Sukhoruchenko;

  • Arkhangelsk Oblast Youth Policy Committee and personally Ms. S.V.Bysova – a.i. Head of the Committee ;

  • Education Ministry of Kaliningrad Oblast and personally Mr. A.Y.Gorshkov – head of the Department for Prevention of Asocial Phenomena and Organization of Inter-Agency Cooperation;

  • Youth Committee of the Administration of the City of Murmansk and personally
    Ms. A.I.Martynova, its Head.

The project initiators would like to extend their deep gratitude to the "Co-operation Programme on Health and Related Social Issues in the Barents Euro-Arctic Region and the Northern Dimension Partnership for Public Health and Social Well-Being" for financial support.
In this summary you will find a short overview of the project and its substantial results.
Short overview of the project and its main results
The project "Children are the Basis for a Healthy Society" has been realized in four cities of the Northwestern region of Russia (St.Petersburg, Arkhangelsk, Kaliningrad and Murmansk) and also in the city of Bergen (Norway) and covered the following main areas of focus:

  1. Development of inter-agency interaction, inter-regional and international cooperation.

  2. Presentation of best practices and methodological advances by all project participants.

  3. Formulating guidelines and a methodological framework for efficient programs of primary prevention of risky behaviours and illnesses among children and teenagers.


The project was implemented in consecutive steps: meetings and seminars were the main instruments for achieving the project goals. At the first stage of the project, key groups of professionals working with children and juveniles were identified. Then specialists from different participant-regions learnt about each other's work. During the project, a series of seminars on various aspects of protection and maintenance of children's and juveniles' health was held, which allowed the participating specialists to share their experience and learn more about the methods Norwegian and Russian professionals use in their work. As a result of these activities, the methods of work presented by the participants made a basis for this publication.
"Children are the Basis for a Healthy Society" international partner project was highly appreciated by the participants. Thus, according to training seminar attendees and specialists, all events were high-level ones; they acquired a lot of new information and expertise, learned how they work with problem families in Western countries, and systematized the knowledge they already had. These events helped to extend cooperation with other agencies and institutions. Training participants expressed their willingness to use some of the presented methods in their everyday work.

As the project efficiency evaluation shows, among the project's results are such as improved primary prevention interaction between institutions and specialists in the Northwestern region of the Russian Federation and Norway. The project as well as editing of the present brochure was assisted and helped by: representatives of regional Healthcare, Labour, Social Protection Committees, Youth Policy and Interaction with the Public Sector Committees; representatives of various Commissions on Minor Affairs and Protection of their Rights; by the personnel of Centres for Prevention and Relief of AIDS and other Infections; by some faculties/schools of St. Petersburg State University; by the staff of the Penal Colony for Underage Convicts, town of Kolpino near St. Petersburg; by representatives of St. Petersburg City Court, by specialists from government-owned and public institutions/organizations involved in helping risk-group children.

In a report on Russia-Norway cooperation on healthcare and social protection issues1 the project "Children are the Basis for a Healthy Society" was mentioned as an example of successful cooperation between various regions' administrations with the help of a facilitator-organization – RNGO "Stellit".

Further enhancement of international, inter-regional and inter-agency cooperation between representatives of government agencies involved in organizing the work of and supporting child-care institutions, shall help consolidate the gains in implementing most efficient methods of prevention work on national level, which can make them more available to all groups of a country's population in need of social support.

As the results of these projects have shown, one participant from Kaliningrad used some presented methods of work with decision-makers, and also some approaches to management, during the implementation of Kaliningrad component of the program of social support development for the most underserved groups of population. Specialists in Arkhangelsk pointed out that they were most interested in methods of early problem detection among children and their parents. Today it seems quite promising to implements this experience in young family clubs in the city of Arkhangelsk. In particular, in Murmansk they regarded some approaches to planning prevention programs as very useful, and they already are trying to do it in a comprehensive way, to analyze programs within the theoretical framework presented during the project. Project visits to Norway as well as learning more about government policies on prevention in this country helped to cast a new light on local legislation and local programs under way in St. Petersburg. It was found that prevention programs in such a large city as
St. Petersburg are obviously lacking. As a result, they in St. Petersburg Legislative Assembly raised a very complex issue of a need to have more preventive programs to protect and maintain children's and youth's health.

Continued and extended international exchange of expertise between professionals in primary prevention of risky behaviours and promotion of healthy lifestyle among the underage shall facilitate those specialists in broadening their knowledge, systematizing their experience and using most efficient methods in their day-to-day work.

For instance, the project showed that most interesting and topical issues for participating specialists are: reproductive health, prevention of HIV/AIDS, prevention of drug use/abuse and child neglect, healthcare at schools and other childcare institutions, methods of working with children and their parents. Each participating region presented its own methods of work in these areas. Among visits and presentations made by Russian specialists most interesting were: methods of work at youth centres in Kaliningrad Region (Oblast), methods of work at the regional centre for prevention and relief of AIDS and other infections in Arkhangelsk, methods of work at the City of Murmansk Municipal Institution "Multi-purpose Social Service Centre for Youth", at State Institution "City Abandonment and Drug Use Prevention Centre "Kontakt" and at City Counselling & Diagnostic Centre for Reproductive Health "Uventa". Most popular ones among presented Norwegian best practices used to work with juveniles were: the 5-step Oregon model program of work with family, youth-friendly health services, methods of prevention of addictive behaviour, methods of planning prevention measures at schools.

Enhancement and further development of the partnership between NGOs in different countries and regions shall help professionals to test and approve the efficiency of most innovative methods of primary prevention, and also to expand the very toolkit of strategies at hand to promote the most interesting decisions on state level.

The experience RNGO "Stellit" has had during the project "Children are the Basis for a Healthy Society" shows that a public organization can work as a coordinator and facilitator within an international partnership/cooperation at different levels: strategic decision makers, operational decision makers, specialists, coordinators. Also RNGO "Stellit" successfully worked as a methodological think-tank that evaluated the efficiency of events (seminars, training, and round-tables) and analyzed the data collected and methods of work presented in this brochure.

Description of a publication containing information and methodological materials on the issues of protection and maintenance of health of children and youngsters
This publication has been designed to be used by specialists who work in government agencies and NGOs and are involved in the development and management of programs of protection and maintenance of health of children and youth, and also in prevention of risky behaviours.

This collection of articles and reports has been based upon the project activities carried out in 2005 - 2009; it includes presentations made by representatives of public organizations and government executive and legislative bodies and of their subordinate institutions involved in prevention among youth, with regard to local/regional peculiarities. Among others, the following presentations have been used for the brochure:

  1. Presentation by Ms. A.I.Antonova (Drug monitoring specialist at State Unitary Enterprise "St.Petersburg Information and Analysis Centre", Drug Situation Monitoring Department);

  2. Presentation by Ms. I.V.Bublikova (Senior nursing specialist at the Healthcare Committee of St.Petersburg City Administration);

  3. Presentation by Ms. S.V.Byzova, a.i. Head of the Committee for Matters Relating to Women, Family and Youth of Archangelsk Oblast);

  4. Ms. M.Voltersvik (Public Health Officer at the Public Health Authority in the city of Bergen);

  5. Presentation by Ms. M.B.Gagina (Consultant for the Department of Prevention of Asocial Phenomena and Organization of Inter-Agency Cooperation under the Education Ministry of Kaliningrad Oblast);

  6. Presentation by Ms. T.V.Garkusha (Leading Specialist Officer of the Department of Family Policies and Protection of Mother and Child of the Committee, Leading Specialist Officer of the Social Policies Committee of St.Petersburg Government);

  7. Presentation by Mr. A.Y.Gorshkov (Head of the Department of Prevention of Asocial Phenomena and Organization of Inter-Agency Cooperation under the Education Ministry of Kaliningrad Oblast);

  8. Presentation by Mr. I.N.Gurvich (Dr. Psych., senior researcher at the Institute of Sociology of the Russian Academy of Sciences, Professor at St.Petersburg State University, Director for Research of RNGO "Stellit");

  9. Presentation by Ms. V.V.Ilyushina (Senior secretary of the Regional Commission on Minors Affairs and Protection of Their Rights, Advisor for the Department of Administrative Bodies of the Administration of Arkhangelsk Oblast);

  10. Presentation by Mr. S.G.Kasansky (Staff Psychologist at the City Counselling & Diagnostic Centre for Reproductive Health "Uventa", moderator of the "Uventa'"s web-site);

  11. Presentation by Ms. V.V.Kostrova (Senior Secretary of the Inter-agency Commission on Fighting Drug Abuse and Illegal Drug Trafficking, under the Government of Murmansk Oblast);

  12. Presentation by Ms. V.G.Kudryasheva (Deputy Director, Centre for Protection of the Rights of Non-adults “Dousha” (Eng. "Soul", City of Arkhangelsk);

  13. Presentation by Ms. A.I.Martynova (Head of the Committee for Youth Affairs under the Administration of Murmansk);

  14. Presentation by Ms. Y.R.Mishustina (Obstetrician-Gynaecologist at St.Petersburg Centre for Prevention and Relief of AIDS and other Infections).

  15. Presentation by Ms. V.E.Osipenko (Program Coordinator for the program "Health and Life of Youth" in Kaliningrad Oblast, Regional Coordinator for the project "Development of the System of Social Services for the Most Vulnerable Groups of Population III")

  16. Presentation by Ms.A.B.Potapova (Director, Centre for protection of reproductive health of the young, City of Kaliningrad);

  17. Presentation by Ms. I.V.Presnova (Senior Inspector of the Organizational and analytical Department of the Penal Colony for Underage Convicts, town of Kolpino);

  18. Presentation by Ms. N.D.Salieva (Deputy Head Doctor of the Clinical Department of Murmansk City Centre for Prevention and Relief of AIDS and other Infections);

  19. Presentation by Ms. S.M.Skotheim (Head of Department of Environmental Health at the Public Health Authority in the City of Bergen);

  20. Presentation by Mr. O.Sobstat (Chief Medical Officer for the Prevention of Infectious Diseases at the Public Health Authority in the City of Bergen);

  21. Presentation by Ms. T.A.Sorokina (Head of the Prevention and Anti-Epidemiological Department at Arkhangelsk Regional Clinical Centre for Prevention of AIDS and other Infections);

  22. Presentation by Mr.V.S. Sukhoruchenko (First Deputy Head of the Law, Order and Safety Committee, Professor, corresponding member of the Russian Academy of Science and of the Russian Academy of Rocket and Artillery Sciences, General-Lieutenant).

  23. Presentation by Ms. I.Tangen (Public Health care Professional/Nurse at the Public Health Authority in the City of Bergen);

  24. Presentation by Mr. I.Tveit (Head of the Public Health Authority in the City of Bergen);

  25. Presentation by Mr. Y.A.Fesenko (Deputy Head Doctor at the Centre for Medical Rehabilitation "Child Psychiatry", Doc. Med., Professor of the School of Clinical Psychology at St.Petersburg State Medical Paediatrics Academy);

  26. Presentation by Mr. O.Hetlevik (Chief Medical Officer at the Public Health Authority in the City of Bergen);

  27. Presentation by Ms. G.A.Shulyak (Head Paediatrician of Kaliningrad Oblast, Head of the Organizational and Methodical Department of the Regional Children's Hospital)

The publication's contents, the methods and models presented by Norwegian specialists and included in the book, were selected and decided upon at a round table focused on the issue of adaptation of work methods in the field of protection and health maintenance among children and youngsters within the project "Children are the Basis for a Healthy Society"; the round table took place in St.Petersburg in 2008. The round table was attended by specialists-representatives from the Healthcare Committee of St.Petersburg City Administration and its subordinate institutions; from the City Court of St.Petersburg; from the Penal Colony for Underage Convicts, town of Kolpino; from the Education Committee; from the Committee for Youth Affairs; from the City of Murmansk Municipal Institution "Multi-purpose Social Service Centre for Youth"; from the Committee for Matters Relating to Women, Family and Youth; from the Centre for Protection of the Rights of Non-adults “Soul”; from the City AIDS Centre in Arkhangelsk; from The Centre of Youth's Reproductive Health, and from a Regional Public Youth Organization called "Yula" (Kaliningrad).
The publication contains information about: peculiarities of primary prevention of diseases and various risky behaviours among children and youth in the Northwestern Federal District of Russia and in Norway; characteristics of existing prevention systems (chapter 1); a theoretical framework for the development of efficient prevention programs (chapter 2); examples of successful prevention programs and methods proven in Norway and in the Northwestern Federal District of Russia (chapters 3 and 4). Below we shall describe each of the chapters in greater detail.
At the beginning of the brochure there is a summary of a speech given by the First Secretary of Russian Embassy in Norway Mr. A.L.Kolesnikov at a conference "Protection of children's and youngsters' health in the regions of Russia and Norway" (Bergen, January 24th, 2008); this address gives an overview of the context in which friendly and partner-like relations of the two states have been developing; each of the country's political priority is good health and well-being of their children.


Specificity in protection and maintenance of juveniles' health in the Northwestern Federal District of Russia and in Norway
In the first chapter of the present publication you will find a review of the situation in the regions that took part in the project. The information given there primarily concerns the areas of work linked directly or indirectly to children's and youth's health (social-economic peculiarities and demographics of a particular region). In addition to this, the first chapter describes examples of inter-agency cooperation in the area of protection of health of younger generations, and also those aspects of the health of the underage that require particularly close attention on the part of those stakeholders of interagency cooperation in each of the regions who are involved in its protection and maintenance.
Bergen

Bergen has a population of 250 000 people, i.e. about 5% of the total Norway's populace. Generally, children and youth in this country are in good health condition. Developments in healthcare and social situation in Norway demonstrate a quite positive trend; however, social and economic gaps between different groups of population have been growing. In the existing healthcare situation, Norway's government is making extensive efforts in order to organize a wider system of prevention among various groups. A basis for this concept is a motto that goes: "Prevention is part of treatment". Healthcare professionals also point out that inter-agency cooperation and coordination is crucial: "…It seems to be very important that young people and their families should see different services as an integrated coherently working system. This concerns cooperation between child-care centres, schools, healthcare institutions and social services. Another important point is that the work of all those systems and services should be transparent. The principle of coherence relates to all services: municipal, governmental and private..." (from "The Government's Plan on the Improvement of Mental Health of Young People").

A notable progress has been achieved in such areas as development of inter-agency cooperation and coordination aimed at promotion of healthy lifestyle and prevention of diseases among children and youngsters. Groups of children were identified according to various risk factors, and inter-agency work aimed at follow-through of each of the groups with regard to their specificity was organized. These groups of children are: pre-natal period babies (support to pregnant mothers), children in problem families (social support to those children, training for their parents, new houses and new families); children with serious health problems (material and other support to such families, education integrated into the general school system, institutions where disabled children can be temporarily placed); children with a poor school performance and behavioural problems (pedagogical and psychological councils at schools, support provided to school personnel, specialized schools and projects for such children, cooperation with healthcare institutions, with social support systems and with police); children with various addictions (prevention programs at schools; cooperation between schools, medical personnel at schools, system of social support to children and police; psychiatric teams working with problem youngsters)2.

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