General practitioners implementing innovative measures to tackle NCDs in Croatia

Triin Habicht

In Croatia, the probability of premature mortality from noncommunicable diseases is 18% and primarily affects males in their productive years. Noncommunicable diseases account for 90% of overall mortality. This has significant socioeconomic consequences and is a drain on the national economy. Status quo in the current levels of alcohol use, smoking, unhealthy diet and physical inactivity would result in an increased burden of noncommunicable diseases that would affect the sustainability of the health system. Despite clear governmental efforts to address these issues during the years previous to accessing the European Union, the Croatian health reforms have not specifically targeted noncommunicable diseases.

In order to contrast this trend, delegates of the Ministry of Health and Croatian Health Insurance Fund and experts of a WHO mission that took place from 1 to 5 December 2014, discussed the need to boost population-based actions to increase speed in fighting against noncommunicable diseases. In addition to strengthening multi-stakeholder response in Croatia’s public health programmes and to scaling up cost-effective population-based interventions, it was highlighted the need for establishing continuous quality improvement mechanisms and for aligning incentives to optimize models of care that tackle noncommunicable diseases. The harmonization of community health centres and family doctors practices also through the introduction cost-effective interventions for noncommunicable diseases prevention and the empowering of patients to take more responsibility for their health seem immediate actions to be considered. It is also envisaged that professional groups and patient organizations involved in the development of noncommunicable diseases clinical guidelines and training on noncommunicable diseases prevention would improve quality of care. Currently, Croatian family doctors are testing noncommunicable diseases panels that integrate people’s information in e-records allowing patients follow up over time.

These were the main conclusions of the WHO mission to the homeland of Andrija Stampar, president of the first World Health Assembly, after concluding a series of meetings with clinicians, NGOs, representatives of local and national public health authorities, academia, health professional groups, donors and several departments in the ministry of health and the health insurance fund. The WHO mission made field visits to hospitals, primary care clinics and several public health institutions where they conducted over 20 interviews and met with more than 55 individuals.

Croatia is the 8th country that undertakes this comprehensive assessment following Belarus, Estonia, Hungary, Kyrgyzstan, Moldova, Tajikistan, and Turkey. The purpose of these assessments is to produce pragmatic and actionable policy recommendations for health system strengthening and synthesize knowledge and experience related to good practices to accelerate gains in key noncommunicable diseases health outcomes.