By Ingrid Stegeman
Slovenia has one of the highest life-expectancies in the EU. The population is ageing at a rapid rate: In 1995, 12.5% of the population was older than 65, in 2008 this increased to 20%, and the figure is projected to increase to 35% in 2060. At the same time Slovenia has one of the lowest employment rates of older workers (aged 55-64) in the EU. In 2014 the rate was 35.4%, while the EU average was 51.8% (highest in Sweden 74%, lowest in Greece, 34%). Public expenditures for pensions in Slovenia are projected to increase from 12.06% of GDP to 15.45% in 2060. At the same time birth rates are declining, while increases in healthy life years are lagging behind growth in life expectancy.
These big challenges for Slovenian society can only be addressed through comprehensive, multi-sectoral approaches. Despite evidence that good quality work contributes to well-being by e.g. giving people a sense of purpose and keeping them socially engaged, there is much resistance among the general public to rising pension ages. This apprehension may be founded for those who do not have the physical condition to work longer or who face discrimination in the workplace. Ageing societies will inevitably make more demands upon health and social care systems, making it necessary to ensure that these systems join up to work more efficiently and effectively.
In light of the challenges, the EU has recommended under the European Semester process [1] that Slovenia strengthen the long-term sustainability of its pension system and improve the efficiency, cost effectiveness and quality of the long-term care sector [2]. The European Social Investment Package (SIP) provides Member States with guidance on how they can achieve more efficient and effective social policies. The EU programme for employment and social innovation (EASI) in turn provides incentives for Member States to implement measures in the SIP. It was in this context that the National Institute of Health in Slovenia (NIJZ) and the Ministry of Health explored the possibilities of implementing measures included in the SIP in Slovenia, with a focus on Active and Healthy Ageing.
Since the initiative started, the existing collaboration between the Ministry of Health and Ministry of Labour, Family, Social Affairs and Equal Opportunities (MLFSA), was strengthened and attracted the involvement of the Ministry of Education, Science and Sport (MESS). Multi-sectoral and collaborative approaches were established. When the opportunity arose through a call under the EASI programme, the Slovene consortium of partners, led by NIJZ, designed the Active and Healthy Ageing project.
A new comprehensive strategy on Active and Healthy Ageing
The Active and Healthy Ageing in Slovenia project (AHA-SI) was a two year initiative (2014-2016) involving the NIJZ and five other Slovenian organisations: the Institute for Economic Research, Social Protection Institute, Association of Social Institutions of Sovenia, Emonicum Institute (and NGO focusing on active and healthy lifestyles), Slovenian Federation of Pensioners’ Organisations. EuroHealthNet also took part as evaluator of the action, to provide input on relevant EU processes, and to help disseminate information about the process across the EU.
The overall aim of AHA-SI was to support the development of a new comprehensive AHA Strategy which promoted the employment of older people, health in old age and pre-retirement programmes as well as it highlighted the need for new models of Long-Term Care (LTC). Main activities included creating a sustainable network of relevant sectors and stakeholders in the area of AHA; conducting a comprehensive analysis of the situation in the three areas of focus, providing an overview of possible solutions, identifying good practice and developing recommendations; generating greater awareness among target groups on the urgent need to adopt an AHA Strategy.
Engaging with partners to succeed
Though the process of implementation confirmed how hard it is to get different sectors engaged and collaborating, progress was evidenced by the active participation of health and social ministry officials, senior ministers and state secretaries at project events and the more active engagement of the business sector towards the end of the project. The media were another important stakeholder and despite the immense competition for media attention, AHA-SI was able to get good coverage.
AHA-SI also built project partners’ capacities through workshops and good practice exchange, and informed and engaged regional and local actors. The impact of the project can already be noted. For example, many organisations and actors that were working on falls prevention independently are now working together. Work in the area of Long Term Care led to the development of a tool to help municipalities analyse what they are doing to care for older people, which will be further applied and developed. In addition, NIJZ and other partner organisations are now considering implementing pre-retirement activities for their own employers.
The project’s real impact will depend on the political will to act on the recommendations that were developed and to implement the necessary reforms. The Slovenian government indicated in early 2016 that it will develop three national strategies to respond to the challenge of longevity in Slovenia, and that it will draw on the project’s recommendations, which are already being used by the governmental working group. The project has therefore managed to bring evidenced based solutions to the table that address real social issues and have a broad basis of support.
To read more on AHA-SI, click here
[1] The European Semester is the process whereby the EU assesses Member State’s economic and fiscal policies, including social protection policies. See:
[2] http://ec.europa.eu/europe2020/pdf/csr2014/csr2014_slovenia_en.pdf
Ingrid Stegeman
Ingrid Stegeman is Programme Manager with almost 20 years of experience in the field of EU health and social policies, and in managing EU co-funded projects. She works across EuroHealthNet’s Policy, Practice and Research Platforms, and is responsible for overseeing and ensuring the quality of EuroHealthNet’s wide-ranging activities to reduce health inequalities through underlying determinants of health. She is currently managing EuroHealthNet’s Schools4Health project and our contributions to the FEAST research consortium, that focuses on transforming food systems, as policy lead.