Health Promotion Centres (HPCs) – Slovenia

PHC centres are well established in Slovenia, representing the first point of contact for patients, providing access to curative and preventive services. Given their gatekeeping role, PHC centres have a wide range of practitioners including general practitioners (GPs), paediatricians, gynaecologists, community nurses, midwives, dentists for adults and children, pharmacists, physical therapists, psychologists and others. Every PHC centre in the country has a Health Promotion Centre (HPC) within its structure. These centres were introduced in 2002 alongside the National programme for prevention of cardiovascular diseases, theoretically and conceptually based on a bio-psyco-social model of care. HPCs provide fee-free lifestyle intervention programmes on healthy nutrition, physical activity, mental health, smoking and alcohol drinking. An upgrade to the HPCs was established in 2013 with interventions focused on vulnerable populations. Twenty-five Health Care Centres across Slovenia implemented the upgrade project from the period of 2018-2019 lead by the National Institute of Public Health of Slovenia. An important component of this project has been in linking different stakeholders in the local communities with the health services, identifying the needs and accessing vulnerable groups. New professionals, such as dieticians and kinesiologists, have been added to multidisciplinary teams previously composed of nurses, physiotherapists and psychologists. Nurses are recommended to lead the multidisciplinary teams as well as providing services and interventions. The HPCs are integrated with primary health services which provide preventive check-ups to detect individuals at risk of non-communicable diseases (NCDs). HPCs provide information, counselling, motivation, practical lessons, skills training and follow up of users to change life-style habits due to increased risk for or early stage of chronic NCDs. In over 15 years of NCDs preventive programme and operating HPCs, more than half of the adult population has been screened for lifestyle risk factors. There have been trends in reduced premature mortality due to cardiovascular disease by 19% between 2007 and 2015. However, disparities still exist between regions and income categories. The lessons learnt with this practice include: 1) multidisciplinary teams in HPCs have a broad spectrum of competencies and skills to provide health promotion and disease prevention programmes, 2) Primary health care services together with public health services reaching out to communities have proved to be a powerful vehicle to reaching vulnerable groups.

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