CCM 2018

Project title: Equity in Regional Prevention Plans in Italy

Duration of the project: from 31/01/2019 to 30/07/2021

Project Summary

European initiatives. Social inequalities in health are present both within and between European countries. Even in Italy significant differences in life expectancy, morbidity and disability are observed among the different social groups. The European Commission in 2009 drafted a document entitled “Solidarity in health: reduction of health inequalities in the EU”, approved by the main European institutions with the commitment to promote strategies to combat health inequalities.

Italian contribution. Italy has accepted the demands of Europe, and produced a document entitled “Italy for Equity in Health”, containing a detailed strategy addressed to all the “centers of responsibility” and aimed at promoting health and non-health policies to combat health inequalities. From 2018, Italy coordinates the Joint Action Heath Equity Europe (JAHEE), actively participating in the study also with actions chosen among those recommended in the report “Italy for health equity”. As for prevention, Italy aims to put health inequalities as a priority in its agenda.

The National Prevention Plan. The National Prevention Plan (PNP) 2014-2018, extended and still in force, had given the Regions the mandate to include the fight against inequalities between the principles of activity of the Regional Prevention Plans (PRP), mandate reinforced by the fact that the equity would have been one of the criteria for evaluating and approving the proposals by the Ministry of Health. The critical analysis of all the PRPs presented, made it possible to classify the Regions on the basis of the ability to include the principle of combating inequalities in PRPs. To this result was then added a pilot project of the CCM 2014 program “Equity audit in PRP in Italy” which involved 6 Regions (Piedmont, Lombardy, Emilia Romagna, Veneto, Tuscany, Puglia), that had the task of experimenting in specific areas concrete actions of “Health Equity Audit” (HEA).

The proposal. In continuity with the previous one, the elaboration of the new PNP (2020-2025) also envisages the reduction of health inequalities as a transversal priority to all the objectives of the PNP. The following proposal has the general objective of improving the introduction of “equity lenses” in prevention and health promotion programs regulated by the new PNP. To this end, based on the experience gained and the results produced by the 6 Regions participating in the CCM 2014 project, all Italian Regions should use a common and validated methodology, namely the HEA, and guarantee at least a minimum common base achievement.

Objectives

Develop or improve the competence of PRP coordination groups with regard to the introduction or further development of the equity principle in their PRPs by adequately applying the lenses of equity in the planning of their interventions.
Develop or improve the competence of the Regions that had not participated in the CCM 2014 project, in a specific field of action through the transfer of the HEA package tested by the pilot Regions.
Support the collection and updating of available data on health inequalities and the impact of interventions in order to allow policy-makers to make more informed decisions about targets and categories of actions to be recommended.
Improve the knowledge on the use of “good practices” capable of impacting in an effective and sustainable way on health inequalities through the production of recommendations based on scientific evidence obtained through already existing databases or through the results deriving from WP6 activities (“Healthy living environment”) within JAHEE. This result will make information available through the PROSA documentation system available to operators and prevention services.

Type of study

Training and technical assistance to the PRP coordination groups of all the Regions.
Assistance to the Ministry-Regions group, planning the new PNP 2020-2025

Expected results

Transforming equity in prevention from an inspiring principle to an operational method of orienting actions.

Responsible of the project: Raffaella Bucciardini (raffaella.bucciardini@iss.it), Benedetta Mattioli (benedetta.mattioli@iss.it)

Department/Center: National Center for Global Health