The Government of Estonia adopted a new National Health Plan 2020–2030 (NHP) on 6 February 2020. Several elements supported preparations for the NHP, including the results from the previous National Health Plan’s 2009–2020 evaluation, the recent trends in health and mortality rates, the practices of different countries, major studies and analyses, as well as strategic policy documents and discussions with stakeholders and representatives from different fields. A public discussion was also held.
The NHPs in Estonia are approved by the Government in the parliament (Riigikogu). In addition, pursuant to the State Budget (SB) Act, the sectoral development plan is submitted, prior to approval, also to the Riigikogu for deliberation. The Ministry of Social Affairs (MOSA) coordinates the application and implementation of the NHP, including the budget. Programmes including budget estimates cover at least one period of the SB strategy. The MOSA annually approves programmes with budgets after the adoption of the SB by the Riigikogu.
The vision of the NHP is the following: The people of Estonia live long and are as healthy as possible throughout their life cycle, and their health and well-being are maintained and supported through public, third and private sector cooperation for the development of the living environment and the health system.
The main objectives of the NHP are to:
- Increase the average life expectancy of Estonian people to 78.0 years for men and 84.0 years for women by 2030, and increase the number of healthy life years to 62.0 for men and 63.0 for women.
- Have faster growth in the number of healthy life years than in life expectancy, i.e. people will live most of their lives without any limitations caused by their health.
- Reduce health inequalities (between gender, regions and levels of education) by 2030. Specifically, life expectancy in any county should not be more than two years shorter than the Estonian average, and the average life expectancy of people with basic education should not fall behind the average life expectancy of people with higher education by more than eight years.
Achievement of the objectives of the NHP is planned through three sub-fields: healthy choices, health-supportive environment, and person-centred healthcare. Each sub-objective describes the desired result, the indicators reflecting changes in the sub-field as a whole as well as key problems and solutions.
The achievement of the objectives are monitored using defined indicators. In addition, to implement the NHP, a Steering Committee was set up by a directive of the Minister of Health. An annual report is prepared on the implementation of the NHP, to provide an overview of the achievement of the objectives set, the major progress made and the problems encountered. The reports are presented to stakeholders, experts and the local-authority-level working groups for discussion and joint annual workshops are held to present the outcomes.
The achievement of the objectives of the NHP, the fulfilment of the tasks and the efficiency of the measures will also be comprehensively assessed in 2025 in the framework of an interim evaluation.