Alexandra Cucu, Adriana Galan

1
Challenges to Build a Modern Environmental Health
Indicators System in Romania

• Alexandra Cucu, Adriana Galan
• Institute of Public Health Bucharest
• Romania

2
Environmental Health in ROMANIA (1)

• At present, Romania is implementing the National
  Environmental Health Action Plan (designed in
  1997).
• The ministers of environment and health were
  signing the Declaration of the Third Ministerial
  Conference on Environment and Health (London,
  June 1999).
• It was ratified and adopted the Law 86/2000
  concerning the Aarhus Convention on access to
  information.

3
Environmental Health in ROMANIA (2)

• Romania was involved from the very beginning in
  The Design of Environment and Health Information
  System for the use with NEHAPs project launched
  by the WHO-ECEH, Bilthoven Division, at the
  beginning of 2000. After completing the
  feasibility study, Romania continued to be
  involved in the implementation phase of this
  project.
• The design and implementation of a common set of
  standardized indicators and the creation of a
  network for data exchange represent a high
  priority of policy making.

4
Paper Objective
Methods
5
Results (1)
Strengths

• Awareness Most of the decision-makers are
  recognising
• that there is a strong need for better
  information on
• environmental health in order to develop
  adequate policies

• Competence The level of competence in Public
  Health has
• considerably increased in Romania after 1990.

• An interministerial responsible team was
  established
• At the beginning of 2002, the Deputy Minister
  of Health
• invited 10 potential partner institutions to
  nominate a
• responsible person to be part of the
  interministerial team
• for the development of a new information system
  
• concerning environmental health. An
  Interministerial
• Committee was established for project
  coordination.

6
Results (2)
Weaknesses (1)

• Poor coordination There were big difficulties to
  bring
• together so many institutions with apparently
  different
• goals. The partner institutions didnt
  understand easily the
• usefulness of such a multisectorial approach.

• Too many information sources It was very
  difficult to
• obtain the data from many holders, having
  different
• interests. There are also missing data
  necessary to build
• some core indicators.

7
Results (2)
Weaknesses (2)

• Lack of quality assurance Generally, the quality
  assurance
• process for data collection is not secured in
  most of our
• institutions.

• Poor use of data for decision making Evidence
  based
• policy is a new concept in Romania, so that the
  
• decision-makers are still reluctant to develop
  policies based
• on updated and valid information.

8
Results (3)
Opportunities (1)

• New requirements for complying with EU
  regulations within
• the accession process

• Participation in European projects The Design
  of
• Environment and Health Information System for
  the use
• with NEHAPsabove-mentioned. Romania was
• involved from the very beginning, by active
  participation of
• the specialists from the Institute of Public
  Health Bucharest.
• After completing the feasibility study, the
  specialists from
• IPHB continued to test and use EuroIndy
  application,
• creating a national and sub-national database,
  producing
• a set of Fact Sheets based on calculated
  indicators.

9
Results (3)
Opportunities (2)

• There are some other international projects
  related to further
• improvements of Environment and Environmental
  Health,
• like for instance a big PHARE Project
  concerning
• The assurance of Water quality in Romania.

• It is for the first time when existing data at
  national and local
• level will be gathered together in a valid,
  standardised and
• comparable information system, representing the
  basis for
• the adequate implementation of the National
  Environmental
• Health Action Plan.

10
Results (4)
Threats

• Frequent changes of ministerial structures and
  responsible
• persons.

• Competing stakeholders. Many of them would like
  to keep
• the information for their own interests.

• Reluctance to change

• Insufficient financial resources to guarantee
  continuity of
• the system (e.g. cost for Internet access,
  maintenance, etc.)

11
Conclusions
Despite the difficulties encountered during
the implementation of such an ambitious,
multidisciplinary approach in the field of
environmental health, we consider the
establishment of environmental health indicator
system a very useful managerial tool, able to
meet real needs of communication and transparency
in this field.
This core set of indicators will fill the gaps in
environmental field of activity, providing useful
information for policy making at local and
national level, and facilitating international
comparability and data exchange.