8.C. Workshop: Networking for life: How European regions develop/strengthen cross-border health

Abstract   The WHO European Programme of Work (2020-2025) emphasizes the importance of “supporting local living environments that enable health and well-being”. Through engaging with regulatory arrangements that support an environment that responds to citizens’ concerns for safer, healthier and better living, the EPW intertwines with the aims of the EPH Conference to promote population health and to strengthen health systems. The Covid-19 pandemic shows that health threats do not stop at national borders. Different responses amongst cross-border regions, based on national policies in terms of Public Health and Social Measures (PHSM), may even weaken their effectiveness. The importance of cooperation across border is not only relevant in the framework of pandemic preparedness and responses, but in many other fields: healthcare cooperation, emergency medical care, medico-social cooperation and health promotion. All have shown to be beneficial to population health when developed at the subnational level across border regions. Consequently, cross-border health (care) gained importance in recent years and there are various border regions who showcase successful cross-border cooperation in the field of health. Projects are being implemented along neighbouring European regions, translating into improved access to healthcare for the border populations, promoting prevention and health education as well as increasing healthcare availability and equity. Via various health networks, border regions can learn to engage with neighbours and build up tailor-made health services for their citizens. More so, through active participation in various well-established public health networks, the exchange of ideas, knowledge and solutions to strengthen cross-border health becomes part of region's daily work. Through strong networks and partnerships, joint solutions for a strengthened citizens’ health in rural areas could be found. Creating synergies between the healthcare capacities of the two sides of the border, collaboration between border area medical teams, access to equipment located one or other side of the border can make a positive impact on the users of health services and facilities. In this round table workshop, the role and impact of health networks on a sub-national level (regional) will be further examined. Based on selected well-established health networks, their work and value will be outlined. The Keynote speech will be given by the Coordinator of the WHO Europe Regions for Health Network, Dr. Bettina Menne. Subsequently, 3-4 well-established health networks will take the floor with a short presentation (5 min) in order to present their ‘business case’ and value. The presentations will be followed by a short round table discussion in order to highlight the role and strengths European health networks can bring to regions in order to improve cross-border healthcare (WHO RHN, Healthacross /Lower Austria, euPrevent, AEBR, EUREGHA). Key messages • Role and impact of health networking for cross-border health on a sub-national level. • Outlining the benefits and challenges for border regions to participate in health networks in order to strengthen cross-border health (also during Covid-19).


Introduction:
Like in many other countries, the COVID-19 pandemic and the government restrictions introduced to contain the spread of the virus had major consequences for the health and wellbeing of the population in the Netherlands. To monitor the short and long-term public health impact, a nationally coordinated research program was initiated with the intention to guide decision-making by local and national public health authorities. This contribution presents the process to establish a continuous dialogue with end-users of information to add focus to the monitor, make sense of the findings and formulate policy recommendation and practical guidance, both at the national and regional level.

Methods:
To facilitate the translation and dissemination of research results among policy makers, practitioners and scientists, an ongoing series of dialogue sessions is organized during the monitoring program. Apart from the objective of evidenceinformed public health decision-making, the dialectic process seeks to ensure multi-sectoral learning and co-creation and contribute to a broad sense of ownership among stakeholders. National and regional health participants serve as hub coordinators. New stakeholders are invited and will be actively approached wherever considered relevant.

Results:
At the EUPHA conference experiences with organizing the dialogue in app. the first two years of the program will be presented together with preliminary results and a reflection on factors that helped or hindered the implementation and uptake of findings.

Discussion:
Monitoring data collected using robust methods and analyzed in such a way that vulnerability factors are carefully considered, is invaluable for decision-making. However, in order to effectively serve as guidance to public health policy, whether in the context of the COVID-19 pandemic or in noncrisis situations, a constructive, ongoing exchange between end-users of the information needs to be facilitated. environment that responds to citizens' concerns for safer, healthier and better living, the EPW intertwines with the aims of the EPH Conference to promote population health and to strengthen health systems. The Covid-19 pandemic shows that health threats do not stop at national borders. Different responses amongst cross-border regions, based on national policies in terms of Public Health and Social Measures (PHSM), may even weaken their effectiveness. The importance of cooperation across border is not only relevant in the framework of pandemic preparedness and responses, but in many other fields: healthcare cooperation, emergency medical care, medico-social cooperation and health promotion. All have shown to be beneficial to population health when developed at the subnational level across border regions. Consequently, cross-border health (care) gained importance in recent years and there are various border regions who showcase successful cross-border cooperation in the field of health. Projects are being implemented along neighbouring European regions, translating into improved access to healthcare for the border populations, promoting prevention and health education as well as increasing healthcare availability and equity. Via various health networks, border regions can learn to engage with neighbours and build up tailor-made health services for their citizens. More so, through active participation in various well-established public health networks, the exchange of ideas, knowledge and solutions to strengthen cross-border health becomes part of region's daily work. Through strong networks and partnerships, joint solutions for a strengthened citizens' health in rural areas could be found. Creating synergies between the healthcare capacities of the two sides of the border, collaboration between border area medical teams, access to equipment located one or other side of the border can make a positive impact on the users of health services and facilities. In this round table workshop, the role and impact of health networks on a subnational level (regional) will be further examined. Based on selected well-established health networks, their work and value will be outlined. The Keynote speech will be given by the Coordinator of the WHO Europe Regions for Health Network, Dr. Bettina Menne. Subsequently, 3-4 well-established health networks will take the floor with a short presentation (5 min) in order to present their 'business case' and value. The presentations will be followed by a short round table discussion in order to highlight the role and strengths European health networks can bring to regions in order to improve cross-border healthcare (WHO RHN, Healthacross /Lower Austria, euPrevent, AEBR, EUREGHA).

Key messages:
Role and impact of health networking for cross-border health on a sub-national level.
Outlining the benefits and challenges for border regions to participate in health networks in order to strengthen crossborder health (also during Covid-19).  (RHN) works to place health and well-being high on the key political agendas, and advocates the needs of local and subnational authorities at the regional and international levels. RHN has been launched in 1993 to help regions to accelerate the delivery of improved population health, and currently has 34 members. It has developed over the decades into a forum that creates synergies between regions and stakeholders in the field of health (mutual learning); strengthens cooperation/collaboration between regional and local actors and international health institutions; increases understanding of the functioning of regional and local health systems; promotes the exchange of experience, and mutual learning. RHN positions itself at the forefront of innovative approaches and aims at becoming a cutting-edge network ready to capture and disseminate effective approaches, policies and strategies that improve population health at the regional level of governance. In past years, RHN has spearheaded collaborative efforts amongst cross-border regions, on different topics, and with technical guidance from WHO. These efforts have led to joint initiatives, publications, study trips, project collaboration and periodic and structured exchanges of experiences. Lower Austria is by size the biggest province of Austria and located in the heart of Europe with a 414 km long border to the Czech Republic and Slovakia, and in close proximity to Hungary. Not only through its geographic location but also through its understanding to be a connected region as part of a strong European Union, cross-border health care plays an important issue at the provincial level. Led by the European spirit, all international and cross-border health activities are bundled under the umbrella of the 'Healthacross initiative''. The initiative is part of the Health Agency of Lower Austria (N&Ouml; Landesgesundheitsagentur), which operates and manages all 27 public hospitals and around 50 care/nursing homes in the region. Via the ''Healthacross initiative'', Lower Austria is participating in four transnational networks and since 2008, conducted eight EU co-funded projects in crossborder healthcare, four of them currently running. Healthacross is the coordinator of this session, with support of WHO RHN network. Active networking in various European and international networks is part of the regional strategy of Lower Austria in order to gain excellence to improve the health and quality of life for citizens living in border regions. The premise is to enable equal access to health care services for citizens, regardless of their place of residence. The current epidemiological situation with the COVID-19 pandemic has not only impact on cross-border healthcare, but also on the life, health and well-being of citizens. With the closure of national borders, the exchange of healthcare services came to an interim halt; solely dialog remained -which was incredibly valuable for both commuters and citizens living in the border regions. Lower Austria will take care of the moderation of the session and will be represented by Julia Winkler.