service navigation

to quick search

main menu

jump to content

related content

jump to content

National Level Policies

The National Level Policies section of the portal provides an overview of
the actual situation concerning actions to tackle health inequalities in the
different European countries.

This part of the portal is currently being developed, the information for the remaining countries will continuously be completed.

In addition to the national level portraits of the individual countries the
overview analysis has been conducted and its initial results have been
published in EuroHealth magazine (EuroHealth, 11:2 p.24).

Download the final 'Closing the Gap' publication: Taking Action on Health Equity.

This publication contains summaries of what each of the 21 ´Closing the Gap´ partners are doing to address health inequalities in their countries, as well as the conclusions and recommendations of this 3-year initiative.

Results of the same country

List all good practice projects of the actual country.

You are here: > National Level Policies > Belgium > Policies, strategies and other documents > Driven by non-health sector

Policies and Strategies Driven by the Non-Health Sector

1. Addressing SDHI in education strategies
The Health Promotion Commission has begun a new strategy, with the intention of working on health promotion in education. This was signed by four Flemish Ministers: the Flemish Minister of Education, the Flemish Minister of Welfare and Public Health, the Flemish Minister of Youth and Sports and the Flemish Minister of Agriculture. In this declaration (2006), in order to work together to realize the health targets of the Flemish government, they committed themselves to these targets. As a result of this declaration, the Flemish Minister of Education and The Health Promotion Commission of the Flemish Education Council (Vlaamse Onderwijsraad or Vlor) signed a protocol in order to encourage all schools in the Flemish community to develop their own health policy.

The Vlor is the official advisory body on the education and training policy of the Flemish Community. Representatives of all the different stakeholders in education and training meet with the Vlor. Together, they look for ways to further improve education and training in Flanders. The task of the Vlor is threefold: advice, consultation and study. The Health Promotion Commission fits in the second task of the Vlor: to organize consultations between different educational and social partners. In this commission (and the working groups) partners from the field of education meet partners from the field of health in order to make arrangements for the development of education and training in the field of health promotion. The health coordinator (recruited to carry out the project together with the different health and educational partners) helps with the implementation of a health promotion policy in new educational initiatives. The commission developed a Strategic Plan ‘Op uw gezondheid!’ (‘On your Health’) as a guideline for the work to be done. For futher information, click here.

2. Addressing SDHI in employment strategies / Addressing SDHI in economic strategies
The most important tools of the Flemish policy to combat poverty are the Poverty Decree, the Permanent Poverty Consultation and the Flemish Action Plan (see documents section). As in the Federal government, a minister is responsible for the coordination of the poverty policy (the minister responsible for Welfare, Public Health and Family) and the participation of the people living in poverty is crucial. (See social inclusion strategies in Belgium for more detail).

3. Addressing SDHI in environment strategies
In Belgium, the regions are responsible for most areas of the environment, but the issues of environment and health policy are still handled at the federal level through the coordination and implementation of international environmental policy, the integrated products policy, and the policy on the marketing of chemicals and pesticides/biocides.

In any discussion of environment and health in Belgium, there are automatically federal, regional and community representatives sitting around the table. Given this institutional reality, Belgium must handle four major challenges in order to act effectively on environment and health:

1. Structuring measures into a coherent overall plan The Joint Inter-ministerial Conference on Environment and Health (JICEH) was set up to enable ongoing consultation on the measures to be taken. This conference brings together the competent ministers from the three levels of competence (federal, regional and community) and on 10 December 2003 it approved a cooperation agreement on the coordinated management of health and environmental policies.
2. Speaking with one voice at the international level, Belgium must be able to speak with one voice in international and European  forums. The cooperation agreement of 10 December 2003 therefore set up a national cell on environment and health in which the  competent administrations are represented; its mission is to prepare Belgian positions and drafts to be submitted to the JICEH.
3. Bringing the environmental and health players closer together. Even today, environmental and health specialists still tend to work separately from each other. Despite being complementary, these two sectors speak different languages and use approaches. There is therefore a need to foster ongoing cooperation and create a real synergy between them.
4. Establishing links with other sectors (transport, energy, economy, etc.) and taking account of sustainable development. The example of air pollution is illuminating. Effective environmental health measures can be taken only if the transport and energy policies are both involved and the costs and benefits of action or inaction are assessed on the economic, social and environmental levels.

The national cooperation on environment and health started with the National Action Plan on Environment and Health (NEHAP), adopted April 2003. This is a mutual plan from both the regions and the federal governments, for the period 2003-2008 and is the reference for all actions on health and environment in Belgium. The NEHAP takes stock of the scientific data currently available on environmental health issues. It inventories the measures taken at community, regional and federal levels and reports on the general situation of the links between the environment and health in Belgium. Finally, it proposes priorities for action and a general framework applicable to all the players.

A number of measures have already been introduced using NEHAP’s recommended priorities including: the joint funding of a study on environmental health indicators applicable to the whole of Belgium; the introduction, in Flanders, of a large-scale campaign of measures aimed at evaluating the contamination of the population (Milieu en gezondheid); the setting-up, in Wallonia, of an environmental health platform responsible for studying specific problems (Milieugezondheidszorg); the setting-up by the Brussels-Capital Region of the Regional Indoor Pollution Intervention Unit (CRIPI), focusing on forms of pollution in the home that can lead to health problems (see Bruxelles Environment - in French and Dutch only); the introduction by the French-speaking community of medical supervision for residents around the Mellery landfill site (Direction générale de la santé (FR)); the introduction of environmental aspects into the “health” measures of the Federal Authority’s Federal Plan for Sustainable Development (2004-2008) (see Commission Interdépartementale du Développement Durable - in French only). For further information, click here.

4. Addressing SDHI in tourism
Since 2001, a new policy on social tourism has been developed by the Flemish Minister for Tourism. Under the motto “Tourism for All”, legislation was established that focused on new target groups. The successful results are not only evaluated by the users and holiday centers, but experiences are also exchanged with other organizations in the UK and France.

In the policy document Toerisme (Tourism) 2004-2009, the Flemish Minister of Policy Affairs, Foreign Affairs, Media and Tourism stated that the fourth strategic target is to make tourism in Flanders accessible to everyone. Research shows that a holiday (even a very short or modest one) is not affordable for more than 300.000 people in Flanders. The importance of well-being can be supported by a vacation experience, which can have a clear influence on physical and mental health. It was noted that some people do not have the option to enjoy a holiday, and that it is important to give these people the opportunity to participate in touristic activities. This might be done by giving financial aide, and physical or mental obstacles much be tackled. This policy must be an inclusive policy, with cooperation with the welfare and youth sector.

In the Planning Document of 2008, the Support Centre for Holiday Participation (Plannota 2008 van het Steunpunt Vakantieparticipatie) explicitly discusses health. It states that although a holiday will not make poverty disappear, it brings people together which encourages self-confidence and empowerment. The positive effects of a holiday can include well-being and the reduction of stress. The support centre negotiates with travel agencies and service industries to create low cost offers for people with lower incomes.
A holiday experience does however not solve structural social problems. This needs a cooperation of political powers, development and implementation of long term solutions. The Flemish Government approved the Flemish Action Plan on poverty reduction 2005-2009 in November 2005. The global policy lines are: participation, prevention and an inclusive policy. The ‘Steunpunt Vakantieparticipatie’ fits in these global policy lines (chapter Culture and Leisure time).

The initiatives proposed by the “Tourism for All” plan include making financial resources available to ensure holidays for the impoverished, and to create a framework for the support of organizations that are involved in working with the impoverished. The Flemish government has provided several initiatives. They have created a support and advice centre (Steunpunt Vakantieparticipatie) for the intermediary organizations that inform them on numerous issues. Since 2001, this advice centre has served as a driving force for advocacy and awareness, has been a database to support the intermediary organizations, as a consultation platform involved in guiding and evaluating the implemented initiatives.

By July 2007, 834 social organizations were member of the Support Centre. The holiday support consisted of 73 tourist attractions, 200 group accommodations and 62 individual or family accommodations. 17 organizations offered more than 100 holidays. 50,980  tourists enjoyed an holiday that year.

The target group itself and the ‘associations in which the poor have a say’ appreciate the opportunity to enjoy a holiday. Nevertheless the Flemish Action Plan notices: “The initiatives of the Steunpunt Vakantieparticipatie are very positive but reach of course only a small part of the more than 300.000 Flemish people that can’t afford a holiday.”

In 2008, the Support centre wants to develop their holiday support in order to reach more people. The centre depends on the goodwill of the tourist sector, but will actively lobby to involve potential new businesses offering holidays. The aim is to perform personal visits, to organise at least three regional information sessions and to develop new information materials.
The work of the centre is evaluated annually by a consultation and discussion forum in January with suppliers and clients (tourists who have enjoyed one of the holidays). Although very few people dispute the positive effects on health and well-being, there is very little research that shows the effects of social tourism. In 2007, the support centre started a cooperation with the University of Westminster (Dr. Lynn Minnaert) for the first extended research, based on qualitative interviews with participants and their coaches.

For further information:
- het Steunpunt Vakantieparticipatie
- Decreet Toerisme voor Allen
- beleidsnota Toerisme 2004-2009

5) Social Inclusion strategies

Coordination of the federal and Flemish policy to combat poverty:
Both the federal and regional policies to combat poverty are aimed at tackling inequalities and reaching more equal opportunities for everyone in the different domains of society. Designing holistic policies is a particular challenge in the Belgian constitutional framework where a federal state, three economic regions and three cultural communities have autonomous power in different policy areas and in territorial entities that partly overlap. The coordination of the Belgian poverty policy is achieved in three ways:

1. The Federal Minister of Social Integration is responsible for the coordination of the poverty policy;
2. The Inter-ministerial Conference on Integration in Society brings together ministers of the federal, community and regional governments to design and evaluate coordinated strategies and measures at different levels;
3. The “Service for the fight against poverty, insecurity, and social exclusion” (founded in 1998) is a public body entrusted with the  permanent monitoring and dialogue between public authorities (across all levels of government), civil society and associations of people experiencing poverty and exclusion

The Service for the fight against poverty, insecurity, and social exclusion:
A Partnership Agreement, concluded between the federal and regional authorities and subsequently enshrined in laws and decrees, has determined the main tasks of the centre. One task is to include the collection of information regarding poverty, social insecurity and access to rights. This information must be inventoried, systematized and analyzed. The Centre formulates policy recommendations helping to fight poverty and improving social integration. Every two years, the Centre draws up a report on the state of affairs regarding poverty, giving advice and writing interim reports on issues regarding the vast domain of poverty. The Centre ensures a structural consultation of the poor, which implies the structural involvement of the ‘associations of the poor’.

The fact that the Centre has been created through a cooperation agreement, ratified by the laws of six mutually autonomous authorities, obviously limits its vulnerability in the event of political conflicts. Criticism of government policies will not result in political or financial ‘retaliation measures’. This also means that civil society can use the Centre to voice their evaluation of policies without fear. As an active listener, the Centre tries to congregate the opinions and complaints of a diversity of partners and to communicate these from the field to the policy makers and vice versa. A specific ‘dialogue method’ has been developed in attempting to ensure a genuine partnership between people experiencing poverty and social exclusion on the one hand, and other stakeholders on the other hand.

In Belgium, the National Action Plan on Social Inclusion demonstrates the ‘open method of coordination’ in the field of social inclusion. For the development and follow up of the Action Plan, a complex institutional framework was set up to engage the different policy levels, stakeholders and target groups. The Flemish Community produces and updates yearly its own Flemish Action Plan on Combating Poverty . Given the smaller scale and more limited scope of policy fields involved, as well as the absence of space constraints in its presentation, the Plan gives a very detailed and interesting account of achievements and new measures envisaged for the future. The most recent Plan contains all planned actions from the Flemish government in the period 2005 to 2009 to combat poverty. A new feature is that the “associations in which the poor have a say” were involved in the development of this Plan. The updating and monitoring of the Flemish Action Plan on Combating Poverty is carried out by a “Permanent Poverty Consultation”, where a distinction is made between vertical and horizontal consultation. Two updates have already made: in 2007 and 2008.