1 M otovun je smješten u središtu Istre, na vrhu strma, 277 metara nad morem visoka brežuljka koji dominira dolinom rijeke Mirne, a razvio se na mjestu prapovijesne gradine. Od ranoga srednjeg vijeka utvrda mijenja feudalne gospodare, a od 1278. do 1779. u vlasništvu je Venecije. Najstarija, kružna jezgra naselja zaštićena je dobro očuvanim zidinama iz XIII./XIV. stoljeća, s četverokutnim obrambenim kulama. Unutrašnja gradska vrata imaju ranogotička obilježja. Među zgradama predgrađa nalazi se i hospicij iz 1622. godine. Gradska loža, iz XVII. stoljeća, smještena je poput vidikovca na platou bivše obrambene kule. Prepoznatljivi simbol Motovuna, romaničko-gotička zvonik-kula s nazubljenim prsobranom je, kao i zidine, iz XIII./XIV. stoljeća. Ispod cijeloga središnjeg trga nalazi se spremište javne cisterne. Od 1978. godine Motovun Group Association, međunarodno udruženje izdavača, sa sjedištem u švicarskom Lucernu, obnavlja i uređuje zgradu na središnjem motovunskom trgu i svake godine organizira susrete svjetske izdavačke elite. Početkom devedesetih u zgradi je Međunarodni centar hrvatskih sveučilišta u Istri, a od 1994. godine u toj se zgradi, i u drugim motovunskim prostorima, održava Ljetna škola unapređenja zdravlja. U Dubrovniku je od 6. do 12. lipnja 1994. godine održana Škola Zdravlje za sve – Zdravi gradovi: Umrežavanje za zdravlje – Udruge zdravlja, kao šesto događanje vezano uz projekt Zdravi grad, održano u Dubrovniku. Direktori Škole bili su Slobodan Lang, Sveučilište u Zagrebu, Knud Bragh Matzon, Horsens Healthy Cities Project, Alf Trojan, University of Hamburg, Agis Tsouros, WHO – Euro Healthy Cities Project Office i Selma Šogorić, Sveučilište u Zagrebu. A onda se dogodio Motovun. Prva je Ljetna škola unapređenja zdravlja održana u Motovunu od 1. do 15. srpnja 1994. godine, pod naslovom Intersektorska komunikacija i promocija zdravlja. Prvi su direktori Škole bili Slobodan Lang, Sveučilište u Zagrebu, John Middleton, Sandwell Health Authority, Selma Šogorić, Sveučilište u Zagrebu, Ante Bartolić, Sveučilište u Rijeci, Alf Trojan, University of Hamburg i Jay Sokolovsky, University of South Florida. Prva je koordinatorica Ljetne škole unapređenja zdravlja bila Ivana Eterović. Među voditeljima pojedinih tema su i Slavko Sakoman, KB Sestre milosrdnice, Zagreb, Flemming Holm i Lars Ebbesen, Health and Environment Group, Horsens, Gordana Pavleković, Sveučilište u Zagrebu, Hannes Schmidl, Vienna Healthy City Project, Zvonko Šošić, Sveučilište u Zagrebu... Središnja je tema bila Zloupotreba droga, o čemu su na petodnevnom tečaju raspravljali stručnjaci iz zemlje i inozemstva, liječnici specijalisti, socijalni radnici, sociolozi i profesionalni promotori zdravlja, a zajedno su posjetili i ured Fonda Motovun – Grad zdravlja

AIM:Based on the results of the first phase of the County Public Health Capacity Building Program named Health-Plan for It, implemented in the Republic of Croatia during the 2002-2008 period, this article analyzes the relationship between training of the county teams and their ability to develop health policy. Our hypothesis was that decentralized model of health planning and management would not occur just by changing legislation alone. Counties in Croatia needed educational support (learning-by-doing training) in order to improve public health practices at the county level.SAMPLE AND METHODS:During the 2002-2005 period, the first 15 county teams (so-called first cycle counties) completed their training. The teams consisted of 12 to 15 members, representatives of political and executive component, technical component (public health professionals, representatives of health and social welfare institutions) and community members (non-government sector and media). Teams were trained in cohorts. Three counties passed together through the six-month process of modular training (four education modules, with four days of intensive training and "homework" between modules) at the time. The remaining 5 counties (second-cycle counties) completed the same kind of training in 2007-2008. The Public Health Performance Matrix (the Local Public Health Practice Performance Measures instrument developed by the US CDC Public Health Practice Program Office) was used as an evaluation instrument. Each county team had to fill it out at the beginning of education.RESULTS:Comparison of the Public Health Performance Matrices of first cycle counties (training in 2002-2005) with those of the second cycle counties (trained several years later) yielded no differences. Although training materials were publicly available (accessible through the Croatian Healthy Cities web pages) for years, the second cycle counties did not spontaneously (without training) increase their county-level capacities for participative health needs assessment, health planning, and provision of health services tailored to the local needs.CONCLUSION:Results of this study showed that decentralized model of health planning and management in Croatia could not be developed without educational support given to the lower level of administration. Only through the training process (the Health-Plan for It County Public Health Capacity Building Program), county teams had managed to develop policy function and create County Health Profiles and Strategic Framework of the County Health Plan

Zalaganje za zdravlje jedno je od podrucja najvece odgovornosti svakog hrvatskog covjeka, zdravstvenog radnika, civilnih udruga, politike i države. Kroz cijelu povijest, hrvatski je narod cuvao i brani zdravlje, okoline, stanovnistva, gradova, sela, obitelji i pojedinca. Zalaganje, ocuvanje, obnova, suradnja, znanje, ucenje, organizacija, i solidarnost za zdravlje su kljucne za razumijevanje hrvatskih vrijednosti, morala i vjekovnog nastojanja u stvaranju drustva a težnje za vlastitom državoma. U tim ostvarenjima istaknuo se stari Dubrovnik, katolicka crkva i posebno red franjevaca u Bosni i Hercegovini, nacionalni pokret 19. stoljeca, braca Radic i HSS, dr. Andrija Stampar i drugi. Od osnivanja Republike Hrvatske, neprekidno i uporno u svim djelovima Hrvatske, bez obzira na rat i mir djeluje pokret „Zdravog grada“ i Zdravih županija, koji je pokrenuo ljetnu skolu u Motovunu, obisao i potakao zalaganje za zdravlje u svim županijama, osnovao sajam zdravlja u Vinkovcima, uveo priznanje gradovima za zdravlje, predstavljao Hrvatsku u Europi i svijetu i obuhvatio sve građane do Predsjednika Republike. U 21. stoljecu održan je I. hrvatski kongres preventivne medicine i unapređenja zdravlja, osnovan Hrvatski casopis za javno zdravstvo i obnovljeno Drustvo za javno zdravstvo. Hrvatska je dobila državnog tajnika za javno zdravstvo i uvela savjete za zdravlje u županijama. Zdravlje je nerazdvojno od hrvatske slobode. U danasnjem vremenu i vremenu koje je pred nama stalno cemo se susretati sa novim znanjima i mogucnostima unapređenja zdravlja, ali i preprekama i opasnostima za zdravlje – prirodnim i drustvenim. Na temelju iskustva iz dalje i bliže proslosti, odgovrni za sadasnjost i pripremajuci se za buducnost, odlucili smo osnovati hrvatski Savjet za zdravlje. Hrvatska danas i sutra treba savjet za zdravlje, koji ce pratiti i poticati koristenje svjetskog znanja, djelovanje nacina života, gospodarstva, medija, zakonodavstva, organizacije, financiranja, zdravstvene slžbe, edukacije, istraživanja i međunarodne suradnje u ostvarivanju prava i odgovornosti svakog i svih zajedno za zdravlje. Hrvatsko drustvo je odlucno, strucnjaci i civilno drustvo spremni, a organizacija spremna za osnivanje nacionalnog savjeta za zdravlje Drugi hrvatski kongres ce u plenarnom sastavu prihvatiti predložene kandidate i među njima izabrati clanove savjeta. Molimo da razmotrite dosadasnji rad, postignute rezultate, ljubav za Hrvatsku, osobnu hrabrost, upornost i odlucnost i predložite kandidate za clanove Savjeta. Prijedlozi trebaju biti izneseni na jednoj kartici teksta, sa navedenim rezultatima i iskustvima iz proslosti, sa ocjenom sposobnosti za doprinos danas i sutra. Pojedinacni prijedlozi trebaju biti izneseni na do jedne kartice teksta. Predlagac treba biti naveden. Za clanove Savjeta mogu se predlagati i prijatelji iz svijeta koji su doprinijeli i doprinose hrvatskom zdravlju. Clanovi savjeta mogu biti svi građani, bez obzira na dob, spol, nacionalnost, vjeru, struku, zdravstveno stanje, socijalni položaj ili politicko uvjerenje. Bitno je vjerovanje i odgovornost za zdravlje. Predložite kandidate Odboru kongresa.

Objective: To determine the progress in the development and implementation of health policies on a county level resulting from the learning-by-doing training provided through the County Public Health Capacity Building Program started in 2001 in Croatia.Methods: Modular training using management tools, public health theory and practice, and SMDP's Healthy Plan-it (TM) tool, followed by the self-evaluation of the progress made by county teams in health needs assessment and health policy development. implementation, and assurance. Fifteen county teams consisting of politicians, executive officers, public health professionals, and community members.Results: Twelve of 15 county teams completed the program. The teams made progress in the evaluated areas, although to a different extent, which did not depend on the amount of time they had or the governance experience. The differences in improvement depended on the differences in the strength of political, executive, and professional components of the teams. Teams with a strong political and/or executive component, but weak public health professional and community components made major improvements in policy development and/or assurance function, but performed less well in the health needs assessment and constituency building. The reversed was also true.Conclusion: Learning-by-doing training program improved public health practices on a county level in Croatia. (c) 2008 Elsevier Ireland Ltd. All rights reserved.

Napad na Vukovar bio je i izravna bitka između JNA i cetnika s jedne, i dr. Njavre s druge strane. Oni su sa svih strana i svim oružjima napali ljude i grad, ubijajuci, ranjavajuci i razarajuci - cineci zlo, a on se zatvorio u svoju bolnicu, u kirursku salu i cinio dobro. Sto je bilo vise napada i stradanja, to je on duže operirao i pomagao. Juraj Njavro bio je dobar covjek u nasem kratkom životu ispunjenom nasim slabostima, grijehom i propustima. U tome smo vremenu branili i obranili hrvatski narod i ostvarili hrvatsku državu. Dr. Njavro bio je hrvatski ministar, zastupnik i imao visoki cin Hrvatske vojske. Sve to je obavljao odgovorno i strucno. Međutim, Hrvatska ima i imat ce mnogo visokih dužnosnika o kojima se puno i govori i pise. Kako govoriti o dobrom covjeku, o dobroti, o hrvatskoj dobroti? Juraj Njavro ostavlja kljucna pitanja Hrvatskoj 21. stoljeca. Zna li danasnja Hrvatska sto je dobar covjek? Trebaju li Hrvatskoj dobri ljudi? Tko su danas dobri ljudi Hrvatske? Jesu li Hrvatsku branili i stvarali dobri ljudi? Treba li se sjecati dobrih ljudi? Ako da, zasto? Cijeni li danasnja Hrvatska, podržava li i stvara li dobre ljude? Znate li navesti nekoliko dobrih ljudi? Jeste li i želite li biti dobar covjek? Želite li da Hrvatska bude zemlja Dobra? U ovom kratkom tekstu želim, slijedeci život Dr. Njavre, zajedno s Vama razmisljati, vise razgovarati nego pisati o dobroti u obrani i stvaranju Hrvatske, i dobroti u Hrvatskoj danas i sutra.

Sa ovom 2007. godinom pocinje jubilej hrvatskog zdravlja, 120 godina od rođenja Andrije Stampara i 60 godina od osnutka Svjetske Zdravstvene Organizacije. Ovo se događa u samostalnoj Hrvatskoj državi, u vrijeme ujedinjavanja Europe, novih odnosa u svijetu i ogromnih potreba jacanja mira, nenasilja, ljudskih prava i zdravlja. Hrvatska sloboda i obrana su ostvarene ujedinjenjem ljubavi i znanja cijelog naroda i svakog covjeka u svakom gradu, selu i domu Hrvatske, bez obzira na dob, spol, vjeru, nacionalnost ili struku.

Dubrovnik je bio svojevrsni kulturni centar na hrvatskim prostorima i uvijek je bio grad koji je nastojao prihvatiti svjetska strujanja. Njegov jedinstveni geografski položaj na razmeđu istocnog i zapadnog mediteranskog svijeta ucinio ga je prijemljivim za razne kulturne tradicije te razna znanstvena i drustvena postignuca. Dubrovnik i njegovo stanovnistvo uvijek su mislili na boljitak svoga grada i željeli ga sto vise povezati sa svijetom. Zato su cesto odlazili u strane krajeve radi skolovanja ili trgovine te se vracali u svoj grad i nastojali ga oplemeniti novim stvarima i ljudima koje su dovodili iz udaljenih krajeva vodeci uvijek racuna o vlastitoj kulturnoj posebnosti. Dubrovnik je tako postao i ostao svojevrstan svijet u malome na dubrovacki nacin koji i danas iznova zacuđuje one koji se bave njegovom prosloscu i sadasnjoscu.

The goal of this study is to identify and describe variables contributing to the efficiency of health promotion interventions, and to assess whether these variables can serve as reliable and early indicators of the success of such interventions. The study sample includes 44 interventions selected through a network of key informants from five cities--Liverpool, Sandwell, Vienna, Pula, and Rijeka--by using a chain technique. Data on each intervention are collected through an in-depth interview with a program leader, the collection of project-related documents, and on-site observation. Qualitative analysis of data performed with content analysis and computer-assisted free-text analysis reveals different characteristics of interventions depending on whether they are initiated by the city government sector, health-care system, or citizens sector (independent of the city or country). The assessment of the efficiency of these three groups of interventions also differs because of varying features, scope (activity potentials) and impact they are able to accomplish. We have identified ways in which the efficiency of all three groups of interventions can be improved. The efficiency of the interventions within the city sector can be increased through an improved process of delegation to other sectors, higher involvement of user groups, and higher receptivity and organizational flexibility. The efficiency of the interventions within the citizens sector can be improved through professional, organizational, and financial support. Support from the professional community is important for citizens sector interventions in confirming the importance of the problem they address and legitimizing the actions they propose and undertake.

Ivan Sarac, Ivan Bagaric, Stjepan Oreskovic, Jack Reamy, Vladimir J. Simunovic, Slobodan Lang Public Health Institute, Mostar, Bosnia and Herzegovina; Andrija Stampar School of Public Health, Zagreb University School of Medicine, Zagreb, Croatia; Graduate Program in Health Services Administration, Xavier University, Cincinnati, OH, USA; and Mostar University Hospital, Mostar, Bosnia and Herzegovina

The aim of this article was to make reader more familiar with the shift in health and society thinking which occurred during the last fifteen years. Authors are describing changes in macro environment and their impact on health and health needs in Croatia. The notion that behavior is greatly influenced by social context in which people lead their lives is demanding a new approach to health and health system policy development. The key questions they elaborate are: How to make health system aware of these changed health needs and How to make health system more capable to respond to these unmet needs? Authors are discussing two alternatives--Health system reform and health system reorientation advocating the second one as the way to go.

Using moral and empirical analysis, we analyzed and discussed the role of public health in prevention of war as well as its function during and after the war. The idea is to develop a theory and new strategy in the spirit of public health to improve practices in preserving and strengthening peace, to be prepared for the future. The experiences from the last four wars in South Eastern Europe were ethical challenges to public health. We identified and described four models of public health practice in the past wars and conflicts. Based on the recent wars, the two new models, Professional Model and Peace Model, were developed and suggested as a new public health strategy in prevention and alleviation of the health burden of war.

Grad Dubrovnik je poznat u cijelome svijetu po svojoj arhitekturi i ljepoti. Dubrovacki arhiv sadrži niz dokumenata povezanih s prosloscu ovoga prekrasnoga grada i regije od srednjeg vijeka do danas. Među tim dokumentima nalazi se i ekstenzivna zbirka dokumenata vezanih uz socijalnu politiku i zdravstvo Dubrovnika. Cilj ovom radu bio je izvrsiti svojevrsnu sintezu do sada pronađene građe vezane uz proslost socijalne i zdravstvene politike Dubrovnika. Tekst je napisan u obliku vodica . On pokusava dati pregled osnovnih podataka vezanih uz ove teme te povijest Dubrovnika. Iz teksta je vidljivo da je Dubrovnik posjedovao visoku razinu organizacije zdravstvene i socijalne zastite (nahodiste, staracki dom, razni zdravstveni propisi). Jedinstvenost i naprednost dubrovackoga socijalnog i medicinskog sustava ocituje se i u cinjenici da je bas u Dubrovniku prvi puta u povijesti uvedena karantena.

This paper presents improvements of the humanitarian proposals of the Challenge of Goodness project published earlier (1). In 1999 Kosovo crisis, these proposals were checked in practice. The priority was again on the practical intervention - helping people directly - to prevent, stop, and ease suffering. Kosovo experience also prompted us to modify the concept of the Challenge of Goodness. It should include research and education (1. redefinition of health, 2. confronting genocide, 3. university studies and education, and 4. collecting experience); evaluation (1. Red Cross forum, 2. organization and technology assessment, 3. Open Hand - Experience of Good People); activities in different stages of war or conflict in: 1. prevention (right to a home, Hate Watch, early warning), 2. duration (refugee camps, prisoners-of-war camps, global hospital, minorities), 3. end of conflict (planned, organized, and evaluated protection), 4. post conflict (remaining and abandoned populations, prisoners of war and missing persons, civilian participation return, and renewal). Effectiveness of humanitarian intervention may be performed by politicians, soldiers, humanitarian workers, and volunteers, but the responsibility lies on science. Science must objectively collect data, develop hypotheses, check them in practice, allow education, and be the force of good, upon which everybody can rely. Never since the World War II has anybody in Europe suffered in war and conflict so much as peoples in Croatia, Bosnia and Herzegovina, and Kosovo. We should search for the meaning of their suffering, and develop new knowledge and technology of peace.

In Croatia, as in Yugoslavia as a whole, the immense economic progress achieved since the Second World War has been accompanied by a marked decline in the prevalence of infectious and parasitic diseases. On the other hand there has been an upsurge in chronic diseases, attributable to changes in life-styles. Third World countries now undergoing rapid development should see this as a timely warning.

The tale of poor countries squandering resources on high-technology medicine is by now too familiar: the hospital in the capital city consuming 90 percent of the health budget while the countryside lacks safe water; the CT scanner perched virtually atop a malarious swamp. The explanations of this recurring problem are also commonplace: doctors like to play with exotic and expensive toys; the self-interested local elite dominates decisions about medical spending; a few spectacular cures are more easily comprehended (and publicized) than a host of public health problems.But such pronouncements treat only half the issue — the consumption of medical . . .