Ulla Korpilahti

PW 1571 ‘Safety in all policies’ – perspective in implementation of the national target programme for the prevention of home and leisure injuries 2014−2020 in finland

Injuries are the fourth leading cause of death in Finland, leading to almost 2 500 premature deaths annually (5,5 million inhabitants). The Target Programme aims at 25 percent reduction in serious injuries and injury deaths by 2025. Aim of this study was to evaluate the implementation of the 92 actions of the programme in order to set the priorities. The implementation was studied using the policy analysis of Health in All Policies (HiAP) to clarify, what has led to success in implementation in some, but has been challenging in other actions. During the first half of the programme period, the reduction of injury deaths has been in line with the targets. Among the sets of actions, safety culture was improved and awareness of safety issues was increased through cooperation between organisations and communications on safety. Common vision, values, gains and outcomes lead to successful implementation, as well as scientific and financial ground, firm leadership and realistic timeframe. Working together without silo effect was a strengthened force. Implementation of some actions, especially including legislative changes, wasn’t not achieved due to the lack of political will. Prevention of injuries is a continuous effort and is everyone’s concern. The Target Programme was seen as a textbook example of ‘HiAP programme’: it deals with ‘wicked problem’ as for preventing a manifold range of injuries, there is no simple solution. Some actions are easier to tackle than others, which leads to different level of implementation. Acceptability, willingness to cooperate, and feasibility, resources and capacities to act, were at the core of an implementation process. Incompatible priorities, lack of resources or insecurity regarding effectiveness of policies were seen as a hindered factor in implementing actions. The concept of ‘Safety in All Policies’ (SiAP) fits for injury prevention work.

MULTI-SECTORAL MODEL FOR CHECKING HEALTH, SAFETY AND COMMUNITY WELL-BEING IN SCHOOLS

Background The Health Care Act (1326/2010, sections 16–17) prescribes that school and student health services must carry out triennial checks on the health and safety of school environments and well-being in learning communities in co-operation both with various authorities and with pupils, students and guardians. National follow-up data show, however, that checks have not been made comprehensively and that national guidance is needed. Objective In 2013 preparations were started for a handbook and a model for the checks in order to promote health, safety and community well-being as well as multi-sectoral co-operation in schools and educational institutions. The steering group had representatives from the Ministry of Social Affairs and Health, the National Institute for Health and Welfare, the Finnish National Board of Education, the Finnish Institute of Occupational Health, the Association of Finnish Local and Regional Authorities and the Trade Union of Education in Finland. During the process the group received valuable feedback from nearly 40 experts, and the handbook and the check forms were piloted in six schools. Results The handbook presents a new multi-sectoral model for checking the health, safety and community well-being in schools, covering the different stages of the checks: planning, implementation, monitoring, documentation, and communication of the results. It also includes the necessary forms for the checks and defines the roles of different actors. The handbook was published in autumn 2015. Conclusions Multi-sectoral co-operation increases the health, safety and community well-being in schools and educational institutions as well as improves effectiveness, bringing savings and benefits to all parties. The handbook is primarily intended for national authorities, but it can also be used by pupils and students, by teachers and educators in different educational institutions, as well as by employees and other stakeholders in the relevant sectors.

IMPROVING SAFETY CULTURE IN A MULTIPROFESSIONAL NETWORK - FROM POLICY TO PRACTICE

Background The Finnish safety culture in working life and in traffic has improved as well as the safety of children. A good safety culture needs to be extended to all environments and prevention belongs for everyone. The multi-sectoral coordination group in Finland has drawn up a National Target and Action Programme for the Prevention of Home and Leisure Accident Injuries 2014–2020. Description of the problem Young and middle-aged men are over-represented in the statistics on home and leisure accident injuries. The growing number of elderly people and independent living pose challenges the safety culture. The high levels of alcohol consumption and binge drinking increase the accident risk. Results Municipalities, National Institute for Health and Welfare, Finnish National Rescue Association, social and health care service providers and housing companies have increased safety assessments as a part of the structures, planning, management systems, decision-making and activities of organisations like schools, day-care centres and hospitals. Ministry of Social Affairs and Health (MSAH), Finnish Institute of Occupational Health and Centre for Occupational Safety have included the home and leisure accident prevention as a permanent part of safety work at workplaces. MSAH, Ministry of the Interior, Ministry of Transport and Communications and non-governmental organisations continue the efforts to intensify cooperation across the accident prevention sector. Finnish Defense Forces, Finnish Road Safety Council, sports clubs and leisure time organisations are engaged in the work to prevent accidents in various environments and activities into account in the preventive efforts. Conclusion Number of injury deaths in Finland show decreasing trends. The prevention activity has to be permanent and long lasting and targeted well for all age group and different environments. Non-governmental organisations are important in implementing actions in the practice.

939 Accidental injury prevention in comprehensive school in Finland

Background All pupils participating in education are entitled to a safe learning environment. The Health Care Act (1326/2010) obliges comprehensive schools to monitor health and safety of school environments and well-being in learning communities every three years. Methods Health and welfare promotion in schools and educational institutions has been monitored by the National Institute for Health and Welfare and the Board of Education since 2006. In 2013 data were collected nationally using a form addressed to headmasters of Finnish comprehensive schools (N = 2734). The response rate was 74% (N = 2022). The topics covered also accidental injuries at school, accidental injury prevention, and safety promotion. Results Inspection of health and safety of school environments and well-being in learning communities provides valuable information about the safety situation in the schools and their surroundings. One in four schools (24%) reported either that they did not know whether an accidental injury risk assessment indoors had been part of the inspection or that these issues had not been considered in the inspection. About three in four schools (76%) had taken into account indoors risk locations for accidental injuries. One in three schools (33%) did not know whether an accidental injury risk assessment outdoors had been included in the most recent inspection or not. Accidental injury risks had been assessed in 68 per cent of the schools, and outdoors safety was found deficient in 28 per cent of the schools. Conclusions Multiprofessional inspection provides valuable information about school indoors and outdoors conditions, school surroundings, and safety at school trips. Most schools had paid attention to accidental injury prevention and safety both indoors and outdoors. However, a significant part of the schools did not monitor the risk of accidental injuries indoors or in the school yard.