Public Health in Estonia 2008: An analysis of public health operations, services and activities

Since the end of the twentieth century, both public health as a discipline and public health services in Europe have faced unprecedented challenges. Estonian public health services (PHS) have undergone extensive reform since 1990, as part of broader health sector reforms. Following European Union accession, the landscape of public health has been reshaped in many areas, most importantly through the new National Health Plan 2009–2020, which sets out the basis of further improvements. This has coincided with the evaluation of PHS undertaken by a team of the WHO Regional Office for Europe, at the invitation of the Ministry of Social Affairs and its Public Health Department. The growing challenges to the health system in Estonia are mainly public health challenges: addressing the high incidence (which peaked in 2001) and prevalence of HIV, and addressing and reversing lifestyle and behavioural factors that contribute to ill health, such as tobacco use, alcohol consumption, low levels of physical activity and obesity.