Kiri

ENOC SURVEY CONCERNING PROTECTION AND PROMOTION OF CHILDREN’S RIGHT TO PHYSICAL HEALTH
Dear ENOC members,
You are invited to participate in a survey with the aim of exploring the present state of children’s right to physical health across the ENOC membership, in order to support the elaboration of an ENOC policy position statement on the protection and promotion of children´s right to physical health.
The survey explores the level of availability, accessibility, acceptability and quality of the services and facilities of the healthcare systems, intended to ensure children's right to health across Europe, as well as the presence of the appropriate legislation, policies and practices for the prevention, treatment and care of health issues affecting children.
The survey is administered to the 44 ENOC member institutions based in 34 countries across the region. We kindly ask you to present your jurisdiction in this survey and answer the questions in your capacity as a Children’s Ombudsperson.
We would be very grateful if you could send your answers by March 30th, 2025.
The survey has been designed by the ENOC Working Group to map out the key areas affecting children’s right to health. It contains questions referring to existing national/regional policies and programs, the regulatory framework in force and good practices that are applied in ENOC countries in order to ensure all components that are part of the right to health, both education and prevention measures, as well as access to necessary treatments and care, including identification of the inequalities and discrimination on multiple grounds undermining children’s health, and other factors identified by the members in line with individual country/region’s patterns.
The survey consists of 4 parts, namely:
1. Statistical data regarding children's health
2. Ensuring disease prevention measures and protection of children's health, including health literacy and health promotion issues such as: nutrition, sports, hygiene, sexual and reproductive health, children's rest and other aspects which are key to a healthy lifestyle; mandatory vaccination schemes and development of the early intervention programs (for example, programs targeting child obesity, substance abuse, tobacco and alcohol consumption, sexually transmissible diseases, developmental disorders etc.); regulations ensuring road safety and safe environment for children.
3. Children's access to necessary services, treatments and care according to their health needs, including access to medicines and provision of services for children with specific health needs (children with rare diseases, in palliative care, with disabilities etc.) and those in vulnerable situation.
4. Place of the child in legislation on healthcare, including provisions that ensure respect for the child's rights to decide and to be informed, informed consent, respect for confidentiality and the right to complain and be protected.
The survey consists of 42 questions. Please prepare your answers in advance, as the survey needs to be completed at one go. Examples of best practices in your country are of particular interest.
The survey material is owned by ENOC. The data will be analyzed by Vasile Coroi in the Office of Ombudsman for Children, Republic of Moldova (e-mail: [email protected] ), together with an independent expert advisor, Associate Professor in health law and management, Rodica Gramma, Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova (e-mail: [email protected]).
Although some results will be presented in a country-specific way in the report, the names of the informants will not be presented. The data will be processed in accordance with data protection directions and good research ethics.
The last question of the survey provides a free text option for you to add additional information, clarifications, and any comments about the survey.
Name of the Office (country/region) ________________
Contact person ___________________
Contact details ___________________
PART I. STATISTIC OVERVIEW
1. How has the vaccination rate changed in your jurisdiction over the last 5 years? ______________________________________________________________________________
2. Is there evidence of the number of children with neurological and developmental disorders at the jurisdictional level? If so, what is the coverage rate with the necessary specific rehabilitation services at the country level?
_________________________________________________________________________________
3. How has changed over the last 5 years the number of children who died because of:

2019
2020
2021
2022
2023

Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
3.1. road accidents










3.2. drowning










3.3. substance overdose










4. Please provide how the indicators of children’s obesity and malnutrition has changed over the last 5 years in your jurisdiction.

2019
2020
2021
2022
2023

Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
4.1.malnutrition










4.2. obesity










5. Please provide the evolution of several indicators regarding the realization of sexual and reproductive rights of adolescents in your jurisdiction.

2019
2020
2021
2022
2023

Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
5.1.abortion rate among - 10 to 14-year-olds  minors










5.2.abortion rate among - 15 to 19-year-olds 










5.3.incidence of sexually transmitted diseases










5.4.adolescent maternal mortality










PART II. HEALTH PROMOTION AND PREVENTION
POLICY DOCUMENTS - Children's health as a priority in policy documents
6. Is there a national/regional policy document (program, strategy, etc.) that directly relates to ensuring the protection of children’s health?
□ There is a separate policy document dedicated to child health protection at the jurisdiction level
□ The principle of “child health in all policies” is applied in all policy documents of our jurisdiction
□ Child health is included only as part of the policy documents related to the general population health
□ The “child health in all policies” strategy is not implemented in our jurisdiction
□ Other answer: _________________________________________________________________
7. Do you have national/regional public health programs focused on promoting children's healthy eating habits?
□ Yes □ No
If YES, please provide details ________________________________________________________
For example, are there any interventions or policies regarding limitation of children’s access to “fast foods” that are high in fat, sugar or salt, energy-dense and micronutrient-poor, and drinks containing high levels of caffeine or other potentially harmful substances.
8. How are breastfeeding (BF) practices promoted in your jurisdiction?

Yes
No
Partially
There is a comprehensive national policy / program on infant and young child feeding



There is a national coordinator and a multisectoral national breastfeeding committee



BF education sessions for pregnant women and in postnatal care



Mass or social media campaign



Limitation of promotion and marketing of food products that compete with breastfeeding (with monitoring mechanisms and deterrent sanctions for violators) – implementation of the provisions of the International Code of Marketing of Breast-milk Substitutes



Legal framework for promotion of community and workplace support to mothers in relation to pregnancy and lactation (such as breastfeeding facilities in the workplace, breastfeeding breaks etc.)



Support programs for good nutrition for pregnant and lactating women



Please provide details or comments __________________________________________________
9. Are there programs, plans or strategies to promote physical activities among children outside school hours?
□ Yes, this is a priority of the annual plans of the authorities, being under strict monitoring
□ There are only some activities that are carried out depending on the availability of funds
□ There are no such provisions
□ Other answer __________________________________________________________________
9.1. If YES, please, give examples of successful programs for the promotion of physical activity among children that are running in your jurisdiction__________________________
10. Are environmental factors (e.g., air quality, water pollution, climate change) considered in child health policies or programs in your jurisdiction? 
□ Yes □ No
10.1. If YES, please provide details __________________________________________________
11. Are there plans/strategies to prevent death or injury of children as a result of: (please tick)

Well-planned and financed strategic actions, with strict monitoring of implementation
Occasional, sporadic actions, insufficient funding
There are provisions in the policy documents, but no measures are taken
There are no strategic provisions and no actions in this area.
Road accidents




Domestic trauma (safety in the home environment)




Child drowning (unsupervised access to unsafe water pools)




Addictions with and without substances




Water quality and water-related diseases




11.1.  Please provide details and examples of good practices.  Please specify your country/region name. ____________________________________________________________

12. What harm reduction strategies to prevent addictions with and without substances are employed in your jurisdiction?
□ General plan addressing addiction with and without substances
□ General plan only addressing addiction with substances
□ Specific plans for different problems to address: tobacco, alcohol, illegal substances, games, screens, etc.
□ There are no such strategies or plans
□ Other answer __________________________________________________________________
12.1. Please, give examples of successful harm reduction strategies implemented in your jurisdiction.  Please specify your country/region name. _______________________________
13. Are there any public health programs implemented in your jurisdiction to prevent micronutrient deficiencies such as:
□ iron supplementation
□ folic acid supplementation
□ high dose vitamin A supplementation
□ iodized salt
□ other _______________________________________________________________________
□ there are no such programs
14. Are there any programs or plans to promote good quality of rest and sleep among children? □ Yes □ No
14.1. If YES, please provide details __________________________________________________
15. Give examples (if any) of good practice from your jurisdiction of an intersectoral approach to the problems of protecting children's health and promoting healthy lifestyle. _________________________________________________________________________________
Provisions regarding vaccination
16. Does your jurisdiction have a legal framework or specific legislation regarding mandatory vaccination? □ Yes □ No
16.1. If YES, please provide details _____________________________________________
17. What are the main determined causes in your jurisdiction that are influencing the vaccination rates of children?
□ Low availability of necessary vaccines
□ Limited geographic access
□ Lack of qualified personnel
□ Resistance to vaccination due to cultural/religious reasons
□ Strong influence of fake news and anti-vax movement
□ It's not a problem, we have a high vaccination rate
□ Other __________________________________________________________________________
17.1. Add if you have any comments on this issue.  Please specify your country/region name. __________________________________________________________________________________
18. What interventions are being developed in your jurisdiction to maintain high vaccination rates?

YES
NO
Partially
Free access to vaccination is ensured through a national program



Vaccination requirements for school attendance



Extensive and frequent information campaigns



Community-based and parent-focused interventions



Centralized reminder/recall



Informational vaccine websites with interactive social media components



No specific interventions



18.1.  Please provide details on this subject (good practicies, succesfull interventions).  Please specify your country/region name. _________________________________________________________________________________

Health promotion and prevention in educational institutions
19. To what extent is health education part of the school curriculum?
□ There are special programs adapted to the specific age for each year of study
□ There are dedicated hours included only once in the general curriculum
□ There are no such provisions
□ Other answer ______________________________________________________________
19.1  Please provide details or comments  on this subject.  Please specify your country/region name. _____________________________________________________
20. What does health education include in the curriculum at different levels of education? (please tick)

pre-school
primary
secondary
High school level
Nutrition




Physical activity




Road security




Addictions




Sexual and reproductive health




Sleep and rest




21. Is there a ”health agent” or similar figure in the schools in your jurisdiction who would be in charge of detection and prevention programs ?
□ Full-time presence of a medical worker (doctor, nurse or public health specialists) in schools is mandatory
□ Part-time attendance of a medical worker in the school
□ It remains at the school administration's decision
□ There are no such provisions for schools in our jurisdiction
□ Other answer ______________________________________________________________
21.1 Do you have  any comments  on this subject? ___________________________________________
22. Are there any normative provisions and programs in your jurisdiction to ensure accessible nutrition for children in schools?
□ School meals are fully covered by the state budget or by local authorities for all ages
□ School meals are covered by the public budget only for primary classes
□ There are public programs that only partially cover children's meals
□ Only children from vulnerable families are provided with meals from public funds
□ There are no such programs
□ Other answer __________________________________________________________________
22.1. Please add if you have any comments on this subject.  Please specify your country/region name. _________________________________________________________
23. Is there strict monitoring of the nutritional value of the menus offered in the educational institutions?
□ The menus are strictly monitored by nutrition specialists and are approved in strict accordance with the regulations in force regarding children's nutrition
□ The menus are adjusted to the nutritional needs of children's age only in some institutions
□ The menus are composed based on the financial capabilities of the educational institutions, according to the funding they receive
□ Other answer __________________________________________________________________
23.1.  Please add if you have any comments on this subject.  Please specify your country/region name. __________________________________________________________
PART III. HEALTH SERVICES
24. Are health services universal for children under 18 years of age in your jurisdiction?
□ YES □ NO
24.1. If NO, please specify:
What group of children is not covered?
Those not covered by general health services, how do they get health related attention?
25. Please indicate from what sources and to what extent children's health expenses are covered.
□ The public budget covers in full volume all expenses for healthcare provided to children
□ The public budget partially covers the necessary expenses for children's treatment
□ Child health services are covered only through special programs
□ Children's access to health services depends on their parents' insurance
□ Other answer ______________________________________________________________


26. Which services are provided free of charge to children in your jurisdiction.
□ prevention and prophylaxis services, including vaccination and periodic health checks
□ hospital treatment for all illnesses
□ hospital treatment only for emergencies and life-threatening situations
□ hospital treatment is not covered by public funds
□ outpatient treatment at the family doctor
□ outpatient treatment at the pediatrician
□ outpatient treatment is not covered by public funds
□ full dental services, including prosthetics
□ only some dental services
□ dental services are not covered
Other ______________________________________________________________________

27. Providing children with free essential medicines (those that satisfy the priority healthcare needs of the pediatric population) and prosthetic items

YES, fully according to needs
Partially
NO
The pediatric formulations are accessible and affordable in your jurisdiction



The expenses for children's medications are covered by public funds



Providing free hearing aid



Providing glasses



Providing wheelchairs and other items necessary for children with locomotor disabilities



27.1. Please provide details ____________________________________________________
28. Are health services adjusted to the age of children?

yes
no
partially
Do all medical specialties have pediatric specialty?



Pediatrician services are equally accessible to the entire population of the jurisdiction



Health monitoring and periodically check of children according to their age (neonates, up to 5 years, school age, adolescents)



28.1. Please provide details _______________________________________________________________
29. How is ensured the right to sexual and reproductive health (SRH) of adolescents?

yes
no
partially
Free accessible adolescent-friendly health services in conditions of confidentiality and anonymity



Accessible SRH services in remote rural regions



Accessible SRH services adapted to ethnic communities



SRH services adjusted to the needs of adolescents with disabilities



Free access of adolescents to contraceptives



There is a regulatory framework ensuring safe abortion services and post-abortion care, especially for adolescents



30. Are there publicly funded programs for

NO
YES,
fully accessible
YES, but does not cover the high number of requests
YES, but are underfunded
Other
Children with locomotor disabilities requiring rehabilitation services





Children with neurological and developmental disorders requiring rehabilitation services





Children with incurable diseases requiring palliative care





Children with HIV/AIDS at all levels of prevention, treatment, care and support





Children with tuberculosis and from families with tuberculosis





Children suffering from rare diseases





Children with diabetes





Children with intolerances






30.1.Please provide details _________________________________________________________

31. What barriers do minors encounter when accessing health services?
□ Low availability of services
□ Limited geographic access
□ Lack of qualified personnel
□ Financial barriers
□ Social barriers
□ Racism/discrimination
□ There are no barriers in access to health services
31.1. Please provide details ______________________________________________________

32. Are there specific policies to ensure equitable access to healthcare services for all children, regardless of their socio-economic background, ethnicity, or disability?
☐ Yes
☐ No
☐ Some Policies
Please provide details______________________________________________________

33. How well do healthcare services cater to children from vulnerable groups (e.g., refugees, minorities, children with disabilities)?
☐ Excellent
☐ Good
☐ Fair
☐ Poor
33.1. Please provide details_____________________________________________________

PART IV. PLACE OF THE CHILD IN LEGISLATION ON HEALTH CARE
34. Does the healthcare system ensure that children’s rights are respected in terms of privacy, confidentiality, and informed consent?
☐ Yes
☐ No
☐ Partially
34.1. Please provide details ______________________________________________________
35. Are there legal requirements regarding the obligation of healthcare workers to provide medical information to caregivers and children in a language they understand?
□ Yes, the healthcare institution must ensure that communication with the child and the family is done in a language they understand
□ The medical institution does not assume the translation, this must be provided by the family
□ Other answer ________________________________________________________________
36. Are there laws or policies that guarantee children’s right to participate in decisions regarding their treatment or care?
☐ Yes ☐ No
36.1. Please provide details ________________________________________________________

37. According to your legislation, at what age are children allowed to make decisions about their own health?
□ less than 16 years old
□ from 16 years old
□ from 17 years old
□ only from 18 years old
□ Other answer ________________________________________________________________

38. Are there any particularities regarding decisions in certain specific conditions, such as pregnancy, HIV testing, etc.?
☐ Yes ☐ No
38.1. Please provide details: ______________________________________________________
39. Is there a mechanism in place for children or their guardians to file complaints or report violations of healthcare rights?
☐ Yes ☐ No ☐ Limited Mechanisms
39.1. Describe the available options: _____________________________________________________________________________________________
40. Is there an independent body or agency that monitors the implementation of children’s rights in healthcare?
☐ Yes
☐ No
☐ Partially
40.1. If yes or partially, describe the role of this body: _________________________________________________________________________________________________
41. What are the priority areas for the work of your office in relation to ensuring children’s right to health? __________________________________________________________
42. Please propose three priority issues which your office advises should be addressed in ENOC's statement on children's right to physical health. __________________________

ENOC SURVEY CONCERNING PROTECTION AND PROMOTION OF CHILDREN’S RIGHT TO PHYSICAL HEALTH
Dear ENOC members,
You are invited to participate in a survey with the aim of exploring the present state of children’s right to physical health across the ENOC membership, in order to support the elaboration of an ENOC policy position statement on the protection and promotion of children´s right to physical health.
The survey explores the level of availability, accessibility, acceptability and quality of the services and facilities of the healthcare systems, intended to ensure children's right to health across Europe, as well as the presence of the appropriate legislation, policies and practices for the prevention, treatment and care of health issues affecting children.
The survey is administered to the 44 ENOC member institutions based in 34 countries across the region. We kindly ask you to present your jurisdiction in this survey and answer the questions in your capacity as a Children’s Ombudsperson.
We would be very grateful if you could send your answers by March 30th, 2025.
The survey has been designed by the ENOC Working Group to map out the key areas affecting children’s right to health. It contains questions referring to existing national/regional policies and programs, the regulatory framework in force and good practices that are applied in ENOC countries in order to ensure all components that are part of the right to health, both education and prevention measures, as well as access to necessary treatments and care, including identification of the inequalities and discrimination on multiple grounds undermining children’s health, and other factors identified by the members in line with individual country/region’s patterns.
The survey consists of 4 parts, namely:
1. Statistical data regarding children's health
2. Ensuring disease prevention measures and protection of children's health, including health literacy and health promotion issues such as: nutrition, sports, hygiene, sexual and reproductive health, children's rest and other aspects which are key to a healthy lifestyle; mandatory vaccination schemes and development of the early intervention programs (for example, programs targeting child obesity, substance abuse, tobacco and alcohol consumption, sexually transmissible diseases, developmental disorders etc.); regulations ensuring road safety and safe environment for children.
3. Children's access to necessary services, treatments and care according to their health needs, including access to medicines and provision of services for children with specific health needs (children with rare diseases, in palliative care, with disabilities etc.) and those in vulnerable situation.
4. Place of the child in legislation on healthcare, including provisions that ensure respect for the child's rights to decide and to be informed, informed consent, respect for confidentiality and the right to complain and be protected.
The survey consists of 42 questions. Please prepare your answers in advance, as the survey needs to be completed at one go. Examples of best practices in your country are of particular interest.
The survey material is owned by ENOC. The data will be analyzed by Vasile Coroi in the Office of Ombudsman for Children, Republic of Moldova (e-mail: [email protected] ), together with an independent expert advisor, Associate Professor in health law and management, Rodica Gramma, Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova (e-mail: [email protected]).
Although some results will be presented in a country-specific way in the report, the names of the informants will not be presented. The data will be processed in accordance with data protection directions and good research ethics.
The last question of the survey provides a free text option for you to add additional information, clarifications, and any comments about the survey.
Name of the Office (country/region) ________________
Contact person ___________________
Contact details ___________________
PART I. STATISTIC OVERVIEW
1. How has the vaccination rate changed in your jurisdiction over the last 5 years? ______________________________________________________________________________
2. Is there evidence of the number of children with neurological and developmental disorders at the jurisdictional level? If so, what is the coverage rate with the necessary specific rehabilitation services at the country level?
_________________________________________________________________________________
3. How has changed over the last 5 years the number of children who died because of:

2019
2020
2021
2022
2023

Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
3.1. road accidents










3.2. drowning










3.3. substance overdose










4. Please provide how the indicators of children’s obesity and malnutrition has changed over the last 5 years in your jurisdiction.

2019
2020
2021
2022
2023

Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
4.1.malnutrition










4.2. obesity










5. Please provide the evolution of several indicators regarding the realization of sexual and reproductive rights of adolescents in your jurisdiction.

2019
2020
2021
2022
2023

Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
Abs. figures
per 100 000 inhab.
5.1.abortion rate among - 10 to 14-year-olds  minors










5.2.abortion rate among - 15 to 19-year-olds 










5.3.incidence of sexually transmitted diseases










5.4.adolescent maternal mortality










PART II. HEALTH PROMOTION AND PREVENTION
POLICY DOCUMENTS - Children's health as a priority in policy documents
6. Is there a national/regional policy document (program, strategy, etc.) that directly relates to ensuring the protection of children’s health?
□ There is a separate policy document dedicated to child health protection at the jurisdiction level
□ The principle of “child health in all policies” is applied in all policy documents of our jurisdiction
□ Child health is included only as part of the policy documents related to the general population health
□ The “child health in all policies” strategy is not implemented in our jurisdiction
□ Other answer: _________________________________________________________________
7. Do you have national/regional public health programs focused on promoting children's healthy eating habits?
□ Yes □ No
If YES, please provide details ________________________________________________________
For example, are there any interventions or policies regarding limitation of children’s access to “fast foods” that are high in fat, sugar or salt, energy-dense and micronutrient-poor, and drinks containing high levels of caffeine or other potentially harmful substances.
8. How are breastfeeding (BF) practices promoted in your jurisdiction?

Yes
No
Partially
There is a comprehensive national policy / program on infant and young child feeding



There is a national coordinator and a multisectoral national breastfeeding committee



BF education sessions for pregnant women and in postnatal care



Mass or social media campaign



Limitation of promotion and marketing of food products that compete with breastfeeding (with monitoring mechanisms and deterrent sanctions for violators) – implementation of the provisions of the International Code of Marketing of Breast-milk Substitutes



Legal framework for promotion of community and workplace support to mothers in relation to pregnancy and lactation (such as breastfeeding facilities in the workplace, breastfeeding breaks etc.)



Support programs for good nutrition for pregnant and lactating women



Please provide details or comments __________________________________________________
9. Are there programs, plans or strategies to promote physical activities among children outside school hours?
□ Yes, this is a priority of the annual plans of the authorities, being under strict monitoring
□ There are only some activities that are carried out depending on the availability of funds
□ There are no such provisions
□ Other answer __________________________________________________________________
9.1. If YES, please, give examples of successful programs for the promotion of physical activity among children that are running in your jurisdiction__________________________
10. Are environmental factors (e.g., air quality, water pollution, climate change) considered in child health policies or programs in your jurisdiction? 
□ Yes □ No
10.1. If YES, please provide details __________________________________________________
11. Are there plans/strategies to prevent death or injury of children as a result of: (please tick)

Well-planned and financed strategic actions, with strict monitoring of implementation
Occasional, sporadic actions, insufficient funding
There are provisions in the policy documents, but no measures are taken
There are no strategic provisions and no actions in this area.
Road accidents




Domestic trauma (safety in the home environment)




Child drowning (unsupervised access to unsafe water pools)




Addictions with and without substances




Water quality and water-related diseases




11.1.  Please provide details and examples of good practices.  Please specify your country/region name. ____________________________________________________________

12. What harm reduction strategies to prevent addictions with and without substances are employed in your jurisdiction?
□ General plan addressing addiction with and without substances
□ General plan only addressing addiction with substances
□ Specific plans for different problems to address: tobacco, alcohol, illegal substances, games, screens, etc.
□ There are no such strategies or plans
□ Other answer __________________________________________________________________
12.1. Please, give examples of successful harm reduction strategies implemented in your jurisdiction.  Please specify your country/region name. _______________________________
13. Are there any public health programs implemented in your jurisdiction to prevent micronutrient deficiencies such as:
□ iron supplementation
□ folic acid supplementation
□ high dose vitamin A supplementation
□ iodized salt
□ other _______________________________________________________________________
□ there are no such programs
14. Are there any programs or plans to promote good quality of rest and sleep among children? □ Yes □ No
14.1. If YES, please provide details __________________________________________________
15. Give examples (if any) of good practice from your jurisdiction of an intersectoral approach to the problems of protecting children's health and promoting healthy lifestyle. _________________________________________________________________________________
Provisions regarding vaccination
16. Does your jurisdiction have a legal framework or specific legislation regarding mandatory vaccination? □ Yes □ No
16.1. If YES, please provide details _____________________________________________
17. What are the main determined causes in your jurisdiction that are influencing the vaccination rates of children?
□ Low availability of necessary vaccines
□ Limited geographic access
□ Lack of qualified personnel
□ Resistance to vaccination due to cultural/religious reasons
□ Strong influence of fake news and anti-vax movement
□ It's not a problem, we have a high vaccination rate
□ Other __________________________________________________________________________
17.1. Add if you have any comments on this issue.  Please specify your country/region name. __________________________________________________________________________________
18. What interventions are being developed in your jurisdiction to maintain high vaccination rates?

YES
NO
Partially
Free access to vaccination is ensured through a national program



Vaccination requirements for school attendance



Extensive and frequent information campaigns



Community-based and parent-focused interventions



Centralized reminder/recall



Informational vaccine websites with interactive social media components



No specific interventions



18.1.  Please provide details on this subject (good practicies, succesfull interventions).  Please specify your country/region name. _________________________________________________________________________________

Health promotion and prevention in educational institutions
19. To what extent is health education part of the school curriculum?
□ There are special programs adapted to the specific age for each year of study
□ There are dedicated hours included only once in the general curriculum
□ There are no such provisions
□ Other answer ______________________________________________________________
19.1  Please provide details or comments  on this subject.  Please specify your country/region name. _____________________________________________________
20. What does health education include in the curriculum at different levels of education? (please tick)

pre-school
primary
secondary
High school level
Nutrition




Physical activity




Road security




Addictions




Sexual and reproductive health




Sleep and rest




21. Is there a ”health agent” or similar figure in the schools in your jurisdiction who would be in charge of detection and prevention programs ?
□ Full-time presence of a medical worker (doctor, nurse or public health specialists) in schools is mandatory
□ Part-time attendance of a medical worker in the school
□ It remains at the school administration's decision
□ There are no such provisions for schools in our jurisdiction
□ Other answer ______________________________________________________________
21.1 Do you have  any comments  on this subject? ___________________________________________
22. Are there any normative provisions and programs in your jurisdiction to ensure accessible nutrition for children in schools?
□ School meals are fully covered by the state budget or by local authorities for all ages
□ School meals are covered by the public budget only for primary classes
□ There are public programs that only partially cover children's meals
□ Only children from vulnerable families are provided with meals from public funds
□ There are no such programs
□ Other answer __________________________________________________________________
22.1. Please add if you have any comments on this subject.  Please specify your country/region name. _________________________________________________________
23. Is there strict monitoring of the nutritional value of the menus offered in the educational institutions?
□ The menus are strictly monitored by nutrition specialists and are approved in strict accordance with the regulations in force regarding children's nutrition
□ The menus are adjusted to the nutritional needs of children's age only in some institutions
□ The menus are composed based on the financial capabilities of the educational institutions, according to the funding they receive
□ Other answer __________________________________________________________________
23.1.  Please add if you have any comments on this subject.  Please specify your country/region name. __________________________________________________________
PART III. HEALTH SERVICES
24. Are health services universal for children under 18 years of age in your jurisdiction?
□ YES □ NO
24.1. If NO, please specify:
What group of children is not covered?
Those not covered by general health services, how do they get health related attention?
25. Please indicate from what sources and to what extent children's health expenses are covered.
□ The public budget covers in full volume all expenses for healthcare provided to children
□ The public budget partially covers the necessary expenses for children's treatment
□ Child health services are covered only through special programs
□ Children's access to health services depends on their parents' insurance
□ Other answer ______________________________________________________________


26. Which services are provided free of charge to children in your jurisdiction.
□ prevention and prophylaxis services, including vaccination and periodic health checks
□ hospital treatment for all illnesses
□ hospital treatment only for emergencies and life-threatening situations
□ hospital treatment is not covered by public funds
□ outpatient treatment at the family doctor
□ outpatient treatment at the pediatrician
□ outpatient treatment is not covered by public funds
□ full dental services, including prosthetics
□ only some dental services
□ dental services are not covered
Other ______________________________________________________________________

27. Providing children with free essential medicines (those that satisfy the priority healthcare needs of the pediatric population) and prosthetic items

YES, fully according to needs
Partially
NO
The pediatric formulations are accessible and affordable in your jurisdiction



The expenses for children's medications are covered by public funds



Providing free hearing aid



Providing glasses



Providing wheelchairs and other items necessary for children with locomotor disabilities



27.1. Please provide details ____________________________________________________
28. Are health services adjusted to the age of children?

yes
no
partially
Do all medical specialties have pediatric specialty?



Pediatrician services are equally accessible to the entire population of the jurisdiction



Health monitoring and periodically check of children according to their age (neonates, up to 5 years, school age, adolescents)



28.1. Please provide details _______________________________________________________________
29. How is ensured the right to sexual and reproductive health (SRH) of adolescents?

yes
no
partially
Free accessible adolescent-friendly health services in conditions of confidentiality and anonymity



Accessible SRH services in remote rural regions



Accessible SRH services adapted to ethnic communities



SRH services adjusted to the needs of adolescents with disabilities



Free access of adolescents to contraceptives



There is a regulatory framework ensuring safe abortion services and post-abortion care, especially for adolescents



30. Are there publicly funded programs for

NO
YES,
fully accessible
YES, but does not cover the high number of requests
YES, but are underfunded
Other
Children with locomotor disabilities requiring rehabilitation services





Children with neurological and developmental disorders requiring rehabilitation services





Children with incurable diseases requiring palliative care





Children with HIV/AIDS at all levels of prevention, treatment, care and support





Children with tuberculosis and from families with tuberculosis





Children suffering from rare diseases





Children with diabetes





Children with intolerances






30.1.Please provide details _________________________________________________________

31. What barriers do minors encounter when accessing health services?
□ Low availability of services
□ Limited geographic access
□ Lack of qualified personnel
□ Financial barriers
□ Social barriers
□ Racism/discrimination
□ There are no barriers in access to health services
31.1. Please provide details ______________________________________________________

32. Are there specific policies to ensure equitable access to healthcare services for all children, regardless of their socio-economic background, ethnicity, or disability?
☐ Yes
☐ No
☐ Some Policies
Please provide details______________________________________________________

33. How well do healthcare services cater to children from vulnerable groups (e.g., refugees, minorities, children with disabilities)?
☐ Excellent
☐ Good
☐ Fair
☐ Poor
33.1. Please provide details_____________________________________________________

PART IV. PLACE OF THE CHILD IN LEGISLATION ON HEALTH CARE
34. Does the healthcare system ensure that children’s rights are respected in terms of privacy, confidentiality, and informed consent?
☐ Yes
☐ No
☐ Partially
34.1. Please provide details ______________________________________________________
35. Are there legal requirements regarding the obligation of healthcare workers to provide medical information to caregivers and children in a language they understand?
□ Yes, the healthcare institution must ensure that communication with the child and the family is done in a language they understand
□ The medical institution does not assume the translation, this must be provided by the family
□ Other answer ________________________________________________________________
36. Are there laws or policies that guarantee children’s right to participate in decisions regarding their treatment or care?
☐ Yes ☐ No
36.1. Please provide details ________________________________________________________

37. According to your legislation, at what age are children allowed to make decisions about their own health?
□ less than 16 years old
□ from 16 years old
□ from 17 years old
□ only from 18 years old
□ Other answer ________________________________________________________________

38. Are there any particularities regarding decisions in certain specific conditions, such as pregnancy, HIV testing, etc.?
☐ Yes ☐ No
38.1. Please provide details: ______________________________________________________
39. Is there a mechanism in place for children or their guardians to file complaints or report violations of healthcare rights?
☐ Yes ☐ No ☐ Limited Mechanisms
39.1. Describe the available options: _____________________________________________________________________________________________
40. Is there an independent body or agency that monitors the implementation of children’s rights in healthcare?
☐ Yes
☐ No
☐ Partially
40.1. If yes or partially, describe the role of this body: _________________________________________________________________________________________________
41. What are the priority areas for the work of your office in relation to ensuring children’s right to health? __________________________________________________________
42. Please propose three priority issues which your office advises should be addressed in ENOC's statement on children's right to physical health. __________________________