Portugal’s National Health Plan for Sustainable Health: the implementation challenge

Abstract According to WHO, National Health Plans (NHP) play an essential role “in defining a country's policy directions and strategies for ensuring the health of its population”. There is growing evidence that NHPs’ success depends upon the process of implementation. Sustainable health (SH) creates an additional challenge to this process. Portugal's NHP 2030, with a focus on SH, under the Directorate General of Health (DGH), has developed a model to address this issue, using a strategic, population-based, “Planning for SH” framework, multilevel and multisector. The authors share the results of the first year monitoring of Portugal's NHP 2030 implementation process, mainly by addressing the following question: which are the enablers that ensure a successful NHP's implementation? Portugal's NHP is being implemented, at national level, mainly through a ‘Social Pact for SH’ (currently with 30 stakeholders and more than 40 initiatives) and by integrating an inter-ministerial network for policies coordination. At local level, through multistakeholder commitments (between health and the other sectors) under population-based local health plans and the guidance of public health services. A guide to support local planning for SH was produced. The project ‘NHP on the move’ has been touring the country, together with DGH's National Health Programs, involving ca. 1000 key subnational stakeholders, inside and outside the health sector, including 308 municipalities. Two health communication guides were developed to support implementation. Cooperation with UK and portuguese speaking countries was initiated. National and subnational investment in planning for SH, the quality of processes, strategic communication and public health teams behind it, and capacity building, have been critical to successful implementation. The early participation of a multilevel 120 Stakeholders’ Committee, in Portugal's NHP 2030 build-up process, was an enabler of their ongoing engagement during implementation. Key messages • National Health Plans success depends on national and subnational implementation. • Portugal’s NHP 2030 innovative model for sustainable health planning and implementation, has shown promising results.