Framework for Assessing Health Prevention Policies and Investment in Europe: +Prevention Project

Background

Health prevention remains underfunded and unevenly implemented across Europe, with OECD countries allocating less than 3% of health expenditure to prevention. The +Prevention Project aims to develop a systematic data-driven approach to assess, compare and propose strategies for strengthening prevention policies and investment in Europe. Its objectives are to identify priority prevention policies, assess their implementation across ten European countries, develop a European Health Prevention Index (EHPI), and propose an economic framework to improve measurement of prevention investment in Portugal.

Methods

A literature review identified priority health areas and public health policy domains, forming the project conceptual framework. Based on this, a set of prevention policies was selected. Their implementation levels are being assessed in ten European countries through a quantitative survey disseminated to national public health schools, with ASPHER’s institutional support. In parallel, a national Delphi expert panel is being conducted to evaluate the completeness of preventive healthcare expenditure data, followed by a focused panel assessing feasibility of Portuguese data access, standardization and reporting.

Results

Six priority health areas were identified: cancer; cerebro-cardiovascular and metabolic diseases; mental health; chronic respiratory diseases; infectious diseases; and antimicrobial resistance. Six public health policy domains were identified: health education and literacy; screening; immunization; behaviors and consumption; environment; and data and artificial intelligence. A total of 22 primary and secondary prevention policies were selected for cross-country assessment. EHPI and expert panel results are being collected.

Conclusions

The +Prevention Project provides a structured framework that might contribute to advance prevention policy assessment and investment in Europe by supporting evidence-based decision-making in public health.

Key messages

• The +Prevention Project enables cross-country benchmarking of 22 prevention policy implementation across Europe, strengthening evidence-informed public health investment decisions.

• By informing the economic framework for prevention investment in Portugal, with potential for cross-country replication, this project contributes to more resilient health systems.