104 / 188
Health systems in transition
Portugal
104
5.1 Public health
Public health services in Portugal include the surveillance of health status and
identification of its determinants, health promotion and disease prevention at
community level and health impact assessment. The organization of public
health services at national level is the responsibility of the DGH. The DGH is in
charge of designing the programmes, defining strategies and approving national
plans. These plans are approved as needed, according to the National Health
Plan. For example, the DGH is responsible for coordinating all priority health
programmes established since 2012: diabetes, cerebro-cardiovascular diseases,
oncological diseases, mental health, tobacco control, respiratory diseases,
healthy nutrition, physical activity, prevention and control of antimicrobial
resistance and infections, viral hepatitis, and HIV/AIDS.
As a great deal of the population’s time is spent at school, at work and in
leisure locations, public health interventions require a multisectoral approach.
To strengthen this approach, the Ministry of Health cooperates with other
ministries, such as the Ministry of Labour, Solidarity and Social Security (for
workplaces), the Sports State Secretary (for sports spaces), the Youth State
Secretary (for public leisure locations), the Ministry of Education (for primary
and high schools) and the Ministry of Justice (for prisons).
Some of the health education initiatives are run as vertical programmes
by separate bodies within the Ministry of Health. The Directorate-General
for Intervention on Addictive Behaviours and Dependencies (
Serviço de
Intervenção nos Comportamanetos Aditivos e nas Dependências
) coordinates
the prevention and treatment of drug and alcohol addiction.
The NHS is responsible for implementing the National Immunization
Programme (
Programa Nacional de Vacinação
), which includes the most
important vaccines as set by the DGH (e.g. according to the epidemiology of
disease in Portugal) for protecting population health. Vaccination is strongly
advised but not mandatory. These vaccines can be altered from one year to the
next in order to adapt the programme to the population’s epidemiological profile,
usually by combining existing vaccines, or introducing new ones. People can
be vaccinated in local primary care units and vaccines that are included in the
national programme are free for all NHS users. High levels of immunization
are achieved in Portugal (see section 1.4).
At regional and local levels, the main entities involved in the delivery of
public health services are: