LEGAL REGULATIONS AND POLICIES REGULATING AND IMPACTING YOUTH by cuiliqing

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									            CIDA PROJEKAT MLADI I ZDRAVLJE NA BALKANU
             CIDA BALKAN YOUTH AND HEALTH PROJECT




                       POLICY STUDY:




  LEGAL REGULATIONS AND POLICIES
 REGULATING AND IMPACTING YOUTH
 HEALTH IN BOSNIA AND HERZEGOVINA




Produced by the Center for Interdisciplinary Postgraduate Studies
               of the University of the Sarajevo




                    Sarajevo, January 2007




                                                                1
Table of contents:


Introduction

   1. International documents that provide direction for the development of laws
      and policies for youth health
      1.1. Global level
      1.1.1 International Human Rights Law and Youth Health
      1.1.2 World Program for Youth
      1.1.3 Other Global Instruments
      1.2. European level
      1.2.1 WHO-Regional Office for Europe
      1.2.2. Council of Europe and Youth Health
      1.2.3 European Union and Youth Health
      1.2.3.1. Health Determinants and Youth Health
      1.2.3.2. White Paper: „A new Impetus for Youth“
      1.2.3.3. EU Accession and Youth Health
      1.3. Conclusion

      2. Legal regulation of youth health in BiH
      2.1. Legal regulation of youth health on state level
      2.1.1. Constitutional framework
      2.1.2 Legal regulation, policies and strategies considering youth health at the
              state level
      2.1.2.1. Organization of health protection in Bosnia and Herzegovina
      2.1.2.2. Guidelines for development of the national legislation
      2.1.2.3. The legal regulations at the state level
      2.1.2.4. Recent changes related to legal regulation of youth health
      2.1.2.5.Youth policy on state level
      2.1.3 Concluding remark
      2.2. Legal regulation of youth health in the Federation of Bosnia and
              Herzegovina
      2.2.1. Constitutional framework of the Federation of BiH
      2.2.2. An overview of legal regulations which influence the health of youth in
               the Federation of BiH
      2.2.3. Recent changes related to legal regulation of youth health in the
               Federation of BiH


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2.2.4. Legal regulation of youth health in cantons

2.2.4.1. Bosansko-Podrinjski canton GORAŽDE

2.2.4.2. Zenica – Doboj canton

2.2.4.3. Canton Sarajevo

2.2.4.4. Tuzla canton

2.2.4.5. Una–Sana canton

2.2.4.6. Herzegovina–Neretva canton

2.2.5. Concluding remarks

2.3. Legal Regulation of Youth Health in Republika Srpska

2.3.1. Constitutional framework of Republika Srpska

2.3.2. Overview of legal regulations which influence youth health in Republika
         Srpska
2.3.3. Youth policy in Republika Srpska 2006 – 2010 (draft)– in procedure
2.3.4. Concluding remarks
2.5. Legal regulation of Youth Health in District Brcko
2.4.1. Statute of the Brcko District of Bosnia-Herzegovina
2.4.2. Overview of provisions of the law that concern the youth health in
Brcko
2.4.3. Law on youth – in procedure
2.4.4. Concluding remarks
2.5. Conclusion

3. Legal regulation of Youth Health in surrounding countries
3.1. Croatia
3.2. Slovenia
3.3. Conclusion

4. Conclusion and Recommendations


BIBLIOGRAPHY




                                                                                 3
Introduction

Youth are a significant portion of the world’s population. Since youth are being
understood as relatively healthy portion of society, their necessities in this field have been
very often overlooked except for reproductive health1.
Indeed, when we talk about the poor health of youth it is primarily the consequence of
involvement in accidents. According to the World Youth report, accidents and injuries
are the major cause of youth morbidity, mortality and disability. Poor health on the state
level is mostly the consequence of accidents, injuries caused by armed conflict, substance
abuse, HIV/AIDS and tuberculosis2. This means that young people suffer from poor
health as result of societal conditions, including harmful traditional practices, unhealthy
environments, lack of information, inadequate or inappropriate health services3.
This overview of the main health problems and their causes show us that the aspects that
we have to keep in mind during the process of creating the youth health policy are many
and we can say that each segment of nature and society could have an impact on youth
health. The range of elements that need to be taken into consideration is constantly
increasing and requires the action of many other social and economic sectors in addition
to health sector4. Accordingly, the World Programme of Action for Youth on Health
(A/RES/50/81) from 1995 reflects that this issue should be separately raised for this
population and obliges government to make some steps in different directions5.
This kind of document has become the most referral document for the youth health policy
on global level and certainly contributed a lot to the development of youth health policy
on many other levels. Additionally important provisions that refers to children and youth
health could be found in international human rights documents that posed the obligations
on governments that signed them, Governments commitments to ensure human right of
children and youth, as well as WHO strategic documents.
As regards European Union, the most comprehensive and systematic document
establishing priorities for youth health is White Paper “A new Impetus for European
Youth”, 2001 which presents a new framework for cooperation among Member States


1
  Youth at the United Nations. World Youth Report. http://www.un.org/esa/socdev/unyin/wpayhealth.htm
4/6 10/21/2006
2
  Youth at the United Nations. World Youth Report. http://www.un.org/esa/socdev/unyin/wpayhealth.htm
4/6 10/21/2006
3
  Youth at the United Nations. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 1/6 10/21/2006
4
  Declaration of Alma-Ata, International Conference on Primary Health Care, Alma-Ata, USSR, 6-12
September 1978. http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf 1/3 11/14/2006
5
  Youth at the United Nations. World Youth Report. http://www.un.org/esa/socdev/unyin/wpayhealth.htm
10/21/2006


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and other regions of Europe incorporating youth factor in inter sectoral policies6.
Legislation and policy at the EU level are recommendations towards its Member States,
not direction. Besides the White Paper, there is no other Act that specifically deals with
youth health, but we can within general health legislation identify provisions that refer to
youth health. Within EU accession process, which among other criteria means adjustment
of national legislation with legislation of EU, health legislation in general is a part of
legislation under the chapter 28 (Consumer and Health protection), while Acts impacting
youth health could be found under chapter 27 (Environment), 14 (Transport Policy), 19
(Social Policy and Employment)7 and certainly legislation that refer to economic issues.
The role of the Council of Europe as well as WHO Regional Office for Europe should not
be underestimated since they encompass more European countries then EU.
         Bosnia and Herzegovina does not have direct authority over the regulation of
youth health, although relevant legislation and policy could be found as a part of state
laws, entity laws on health, social care and other sectors. The factor that makes this
authority even more complicated is administrative organization of the country where the
majority of these sectors are highly decentralized. In December 2004 the Committee for
the coordination of youth issues in BiH was established. The Committee functions as the
permanent body of the Council of Ministers. One of seven activities of this Committee is
development of Youth Policy in BiH8.
         As a contribution to the overall youth policy, the goal of this study is to outline
the legal framework for the development of youth health policies and legislation in
Bosnia and Herzegovina. For this study youth are defined as between the ages of 10 to
26. The special focus during the analysis will be placed on vulnerable9 and especially
vulnerable youth10, as well as those provisions which provide or impact women and men
differently. In order to do that it will be necessary to outline provisions that refers to
youth health (both directly and indirectly) within laws, strategies, policies on state, entity
and cantonal level.
         The paper is composed of four main chapters, with a number of sub-chapters. The
first section elaborates global and European level of regulation of youth health as a basis
for further analysis. The second part presents the comprehensive analysis of legal and
other acts that regulate youth health or have impact on youth health. It consists of five
sections, where the first one deals with legal framework at the state level, second part
with laws in the Federation of BiH, third with the laws in Republika Srpska, fourth the
regulations in District Brcko, while the fifth part provides conclusion of the whole
chapter. The overview where legal regulation is different for men and women,
vulnerable and specifically vulnerable groups is part of all previous sections. Third

6
  Youth. http://europa.eu/scadplus/leg/en/s19003.htm. visited 11/08/06
7
  Enlargement. European Commission. Directory of Community legislation in force.
http://ec.europa.eu/enlargement/pdf/enlargement_process/accession_process/how_does_a_country_join_th
e_eu/negotiations_croatia_turkey/table_of_correspondence_2_2006_en.pdfr
8
  Komisija za koordinaciju pitanja mladih u BiH (Committee for the coordination of youth issues) set up by
decision of Council of Ministers of BiH from 16.12.2004 (“Official Gazette of BiH”, No. 33/05)
9
  Vulnerable youth are: IDPs, returnees, poor, young women and marginalized ethnic minorities. CIDA
Balkans Youth and Health Project
10
   Especially vulnerable youth are: young law violators, commercial sex workers, men who have sex with
other men, and drug abuser. CIDA Balkans Youth and Health Project



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chapter is dealing with the legal regulation of youth health in surrounding countries,
where two countries (Croatia and Slovenia) with the similar socio-political background to
BiH and the different status in relation to EU are briefly elaborated. In the last chapter the
overall conclusion is drawn and recommendations how to improve legal framework for
the better protection of youth health.
    The research methodology is mainly based on content-analysis method applied to
various pieces of legislation, communiqués, strategies, resolutions, human rights law,
Governments commitments, UN, EU and national reports etc. The major source of the
material on which this study is based is Internet, where the most of these documents have
been found. Besides Internet, library of WHO Office in Bosnia and Herzegovina, as well
as contacts to national coordinators on certain health issues, Cantonal Ministries of
Health were also taken.
    It is necessary to stress that the purpose of this study is to contribute to the creation of
BiH comprehensive youth policy and the part of health within it. The need for the review
of current legislation regulating youth health and affecting youth health was recognized
and as such initiated by the Canadian Society for International Health.




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   1. INTERNATIONAL DOCUMENTS THAT PROVIDE DIRECTION FOR
       THE DEVLEOPMENT OF LAWS AND POLICIES FOR YOUTH
       HEALTH
This chapter will explain the International documents that provide direction for the
development of laws and policies for youth health, both on the global (UN level) and
European level.

    1.1. Global level
Within this section it will be outlined what the International Human Rights Law says
regarding youth health, what are the priorities set up in the international strategy World
Program for Youth (1995), as well as what are the main priorities set up by World Health
Organization (WHO) in this respect.

1.1.1. Human Rights Law and Youth Health
The aim of this of section is to outline directions provided in the International Human
Rights Law regarding youth health as well as Governments commitments made on
certain World conferences regarding respect of human rights of youth.
International human rights documents where some directions for the protection of youth
health could be found are as follows: Universal Declaration of Human Rights, the
Convention on the Rights of the Child, the International Covenant on Economic, Social
and Cultural Rights, the International Covenant on Civil and Political Rights, the
Convention on the Elimination of All Forms of Discrimination Against Women, the
Convention against Discrimination in Education, and the ILO Minimum Age Convention
(No. 38)11.

- Universal Declaration of Human Rights (Adopted and proclaimed by General
Assembly resolution 217 A (III) of 10 December 1948)12 Articles 25

Right to a standard of living which would be adequate for the health and well-being of
himself/herself, including food, clothing, housing and medical care and necessary social

11
   PDHRE: Children. Goverments’ Commitments to ensuring the Human Rights of Children and Youth.
http://www.pdhre.org/rights/children.html, 11/15/2006
12
   United Nations. Universal Declaration of Human Rights (Adopted and proclaimed by General Assembly
resolution 217 A (III) of 10 December 1948). http://www.un.org/Overview/rights.html 11/27/2006


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services is one of the rights stipulated in the Universal Declaration of Human Rights. The
paragraph 2 out of the same article 25 refers to the same rights and social protection of
children either born in or out of wedlock.

- Convention on the Rights of the Child (entered into force 2 September 1990 in
accordance with article 49)13, Articles 1, 2, 23, 24, 27, 32, and 34
At the beginning of the Convention is has been defined that “child means every human
being below the age of eighteen years unless under the law applicable to the child,
majority is attained earlier14” (Article 1). In this respect the Convention covers partly the
age group that is targeted in this study. It refers to each child without discrimination of
any kind (Article 2). Special focus to disabled children has been provided in the Article
23 where States Parties are invited to recognize right of disabled children to special care,
as access to education, training, health services, rehabilitation services, preparation for
employment etc. States parties are also invited to promote international cooperation
regarding activities in this field (Article 23). Article 24 invites State Parties to recognize
the right of the child to the enjoyment of the highest attainable standard of health and
facilities necessary for treatment of diseases and rehabilitation. In this respect the parties
are invited to undertake specific measures directed to the decrease of the leading
problems in the field of children’s health. Within regulation that deals with the provision
of adequate standard of living it is mentioned that it should be adequate to the child’s
physical, mental, spiritual, moral and social development (Article 27). Article 32 deals
with prevention of child economic exploitation at work or any work that could be
dangerous for the child, his/her physical, mental, spiritual, moral and social development.
In this respect State Parties need to take adequate legislation where among other things
the minimum age for admission to employment need to be set up, as well as regulation on
hours and conditions of employment. Protection from the all forms of sexual exploitation
and sexual abuse of children is regulated under the Article 34.

- International Covenant on Economic, Social and Cultural Rights (entered into force
3 January 1976, in accordance with the Article 27)15 Articles 10, 12
Similarly as article 32 of the Convention on the Rights of Child, the Article 10, Par. 3.
foreseen how special measures of protection should be taken regarding youth and
children. They should be protected from economic and social exploitation. Thus, the
particular attention should be placed on potential dangers that can arise from their work
engagements and age limits should be set by states below which child labor should be
prohibited. (Article 10. Par.3) Article 12 deals specifically with the health where State




13
   Office of the High Commission for Human Rights. “Convention on The Right of Child”, General
Assembly resolution 44/22. http://www.unhchr.ch/html/menu3/b/k2crc.htm
14
   Office of the High Commission for Human Rights. “Convention on The Right of Child”, General
Assembly resolution 44/22. http://www.unhchr.ch/html/menu3/b/k2crc.htm 2/19, 11/26/2006
15
   Office of the High Commission for Human Rights. “International Covenant on Economic, Social and
Cultural Rights”, General Assembly resolution 2200A (XXI)
http://www.unhchr.ch/html/menu3/b/a_cescr.htm 1/19, 11/26/2006


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Parties “recognize the right of everyone to the enjoyment of the highest attainable
standard of physical and mental health”16

- International Covenant on Civil and Political Rights (entry into force 23 March
1976, in accordance with Article 49)17, Articles 10, and 24
Within this Covenant the article 10 prescribes special measures for juvenile offenders
where they should be segregated from adults and they should have the treatment
appropriate to their age and legal status (article 10). Once again the special protection of
minors is mentioned in article 24 where every child without any discrimination should be
protected by his/her family, society and state on the basis of his/her status of minor (24).

- Convention on the Elimination of All Forms of Discrimination Against Women
(entry into force 3 September 1981, in accordance with article 27 (1)18, Articles 2, 5 and
12
Article 2 does not refer specifically to youth or health, but presents the basis that need to
taken into consideration during the development of youth policy. According to this article
the principle of equality between two sexes should be incorporated in the national
constitutions of State Parties, to take all necessary measure, both legal (modify existing
laws) and other to ensure elimination of discrimination of women by any person or other
bodies. This convention further obliged State Parties to modify social and cultural
patterns with the aim of achieving elimination of prejudices, and take all appropriate
measures that have for the aim sermonized roles of women and men. (Article 5). The
article that specifically deals with equal access to health services is Article 12. Apart of
calling states to eliminate discrimination in this field, within health services, the family
planning is underlined as well. Particularly to women appropriate services should be
assured in relation to pregnancy and post-natal period. (Article 12. par 2).

- Minimum Age Convention, 1973 (No. 138), (Entry into force: 19 June 1976, in
accordance with article 12)19, Articles 1, 2, and 3
This Convention urges all Member States to make national policy to ensure abolition of
child labor, and to determine minimum age limit for admission to employment in
accordance to the full mental and physical development of young person (Article 1).
Minimum age in relation to the Article 1 should not be less then age of completion of
compulsory schooling or 15 years (Article 2). These jobs that by it nature can put in
danger the health of youth persons should not be undertaken before 18 years (Article 3).

16
   Office of the High Commission for Human Rights. “International Covenant on Economic, Social and
Cultural Rights”, General Assembly resolution 2200A (XXI)
http://www.unhchr.ch/html/menu3/b/a_cescr.htm 1/19, 11/26/2006
17
   Office of the High Commission for Human Rights. “International Covenant on Civil and Political
Rights”, General Assembly resolution 2200A (XXI) of 16 December 1966.
http://www.ohchr.org/english/law/ccpr.htm#art23 11/26/2006
18
   Office of the High Commission for Human Rights. “Convention on the Elimination of All Forms of
Discrimination against Women”, General Assembly resolution 34/180 of 18 December 1979
http://www.unhchr.ch/html/menu3/b/e1cedaw.htm 1/13, 11/26/2006
19
   Office of the High Commission for Human Rights. “Minimum Age Convention”, 1973 (No. 138),
Adopted on 26 June 1973 by the General Conference of the International Labor Organization at
its fifty-eighth session. Entry into force: 19 June 1976, in accordance with article 12).
http://www.ohchr.org/english/law/ageconvention.htm 11/26/2006


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The commitments that governments undertaken to ensuring health of children and youth
are made at Earth Summit in Rio, the World Conference on Human Rights in Vienna, the
International Conference on Population and Development in Cairo, the World Summit for
Social Development in Copenhagen, the Habitat II conference in Istanbul., and excerpts
from the World Declaration on Education For All20. In this respect the respective
documents will be elaborated.

- Rio Declaration on Environment and Development21, 1992, Principle 21
In the Principle 21 the youth with its creativity, ideals and courage are invited to be
mobilized in order to achieve sustainable development and well being for all (Principle
21).

    - Agenda 2122, Chapter 25, paras 1, 8, and 12
Youth engagement in environment and development decision-making is also invited in
the Agenda 21 (Chapter 25, para 1). The countries are also obliged to combat human
rights abuses of youth providing them all necessary conditions for the full development
(Chapter 25, para 8). Paragraph 12 warns how children are highly vulnerable to
consequences of environmental degradation. Therefore, any action directed to the
improvement of the environment need to take into consideration special interests of
children (Chapter 25, paras 12).

- Vienna Declaration and Programme of Action (A/CONF.157/23, 12 July 1993)23,
 Part I, para. 18, 21, and Part II, paras. 47 and 48
The Article 18. (Part I) confirms how human rights of women and girl-child are the
consistent part of universal human rights. It additionally calls and underlines the need for
the elimination of the gender-based violence and all forms of sexual harassment which
are as such incompatible with the dignity of human person. This could be done by legal
measures and international cooperation in the many different fields (Aricle 18, Part I).
Referring and underlining the provisions of the Convention of the Rights of Child, the
article 21 urges universal ratification of that Convention and its effective implementation.
Different kinds of Program should particularly created for protection of children, “in
particular, the girl-child, abandoned children, street children, economically and sexually
exploited children , ... children victims of diseases..., refugee and displaced children,
children in detention, children in armed conflict, as well as children victims of famine
and drought and other emergencies”24 Implementation of the Convention should be taken

20
   PDHRE: Children. Goverments’ Commitments to ensuring the Human Rights of Children and Youth.
http://www.pdhre.org/rights/children.html, 11/15/2006
21
   United Nations Environment Program. “Rio Declaration on Environment and Development”, 1992.
http://www.unep.org/Documents.multilingual/Default.asp?DocumentID=78&ArticleID=1163&l=en
11/26/2006
22
   United Nations Department of Economic and Social Affairs. Division for Sustainable Development.
“Agenda 21”. http://www.un.org/esa/sustdev/documents/agenda21/english/agenda21toc.htm#pre
11/27/2006
23
   United Nations. General Assembly. “Vienna Declaration and Programme of Action” World Conference
on Human Rights, Vienna 14-25 June 1993. http://www.unhchr.ch/huridocda/huridoca.nsf/(Symbol)/A.
CONF.157.23.En?OpenDocu... 1/23, 11/15/2006
24
   PDHRE: Children. Goverments’ Commitments to ensuring the Human Rights of Children and Youth.
http://www.pdhre.org/rights/children.html 4/6, 11/15/2006


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as priority in the UN system wide action on human rights. (Article 21). Special attention
needs to be placed on equal enjoyment of human rights by disabled persons. (Article 22).
The calls for implementing Convention of the Rights of Child has been underline once
again in the articles 47 and 48 (Part II). The priority should be placed on reduce of infant
and maternal mortality rates, reduction of malnutrition and illiteracy rates, provision of
drinkable water and basic education. The following article warns that exploitation and
abuse of children should be stopped targeting their root causes. Thus, effective measures
are necessary “against female infanticide, harmful child labor, sale of children and
organs, child prostitution, child pornography, as well as other forms of sexual abuse."25
Articles 43 and 44 specifically referring to the forthcoming Fourth Conference on the
Rights of Women in the Beijing and calls governments, but also UN Secretariat to
strengthen their measures towards gender equality. (article 43, 44).


- Programme of Action of the International Conference on Population and
Development26, Cairo, 1994, Principle 11 and paras. 6.13

Within this Program it is once again underlined that “child has right to standards of living
adequate for its well-being and the right to the highest attainable standards of health, and
the right to education”27. In this respect the child needs to be cared and guided by parents,
families and societies and to be protected by adequate measures from specific threats to
children health and well being (Principle 11). Needs and aspirations of youth,
particularly in the areas of education, employment opportunities, housing and health
should be incorporated in all spheres of society (para. 6.13)

- Report of the World Summit for Social Development, Copenhagen, 6-12 March
1995)28, Commitment 6

Within this report it is again underlined the commitment to ensure enjoyment of rights of
children and exercise of those rights among other things adequate nutrition and accessible
health services.

- Fourth World Conference on Women Beijing Declaration29, paras. 9 and 23
Human rights of girl child are consistent part of the human rights and fundamental
freedoms (para 9). Therefore, it is necessary to undertake effective actions against
violations of these rights (para 23).


25
   United Nations. General Assembly. “Vienna Declaration and Programme of Action” World Conference
on Human Rights, Vienna 14-25 June 1993. http://www.unhchr.ch/huridocda/huridoca.nsf/(Symbol)/A.
CONF.157.23.En?OpenDocu... 17/23, 11/15/2006
26
   UNFPA. “Programme of Action of the International Conference on Population and Development”
http://www.unfpa.org/icpd/icpd_poa.htm#ch2 11/26/2006
27
   PDHRE: Children. Goverments’ Commitments to ensuring the Human Rights of Children and Youth.
http://www.pdhre.org/rights/children.html 5/6, 11/15/2006
28
   United Nations. “World Summit for Social Development” 19 April 1995.,
http://www.un.org/documents/ga/conf166/aconf166-9.htm 11/26/2006
29
   United Nations. “Fourth World Conference on Women Beijing Declaration”.
http://www.un.org/womenwatch/daw/beijing/platform/declar.htm 11/26/2006


                                                                                                 11
- The United Nations Fourth World Conference on Women. Platform for Action. 30,
paras. 80, 106, 175, and 230

Within para. 80 the State Parties are invited to set specific dates for elimination of all
forms of child labor (para 80), to put in force relevant legislation and to implement
Convention on the Rights of Child and ILO standards, providing protection of working
children (para 106), street children though provision of adequate health, education and
social services (para 175). It is also necessary to address acute children problems with the
aim of elimination of “female infanticide, harmful child labor, the sale of children and
their organs, child prostitution, child pornography and other forms of sexual abuse...."31
(para 230)32 This Platform for Action specifically deals with girl children and youth and
their specific needs the Governments need to take into consideration.


1.1.2. World Program for Youth
The most referent document that specifically deals with youth health as international
strategy is World Program for Youth (1995), and its respective part that refers to youth
health. The background for this strategy could be found in the fact that youth health is
threatened by many factors as harmful traditional practices, unhealthy environment, weak
health promotion systems, inadequate or inappropriate health services. The most frequent
problems are related to the „lack of a safe and sanitary living environment, malnutrition,
the risks of infectious, parasitic and water-borne diseases, the growing consumption of
tobacco, alcohol and drugs, unwarranted risk-taking and destructive activity, resulting in
unintentional injuries“33.
Accordingly, the World Programme of Action for Youth on Health (A/RES/50/81) from
1995 reflects that this issue for separately raised for this category of population obliged
government to make some steps in different directions. These directions are:
        Provision of basic health services
        Development of health education
        Promotion of health services
        HIV infection and AIDS among young people
        Promotion of good sanitation and hygiene practices
        Prevention of disease and illness among youth resulting from poor health
        practices
        Elimination of sexual abuse of young people
        Combating malnutrition among young people34


30
   United Nations. Department for Economic and Social Rights. Division for Advancement of Women. The
United Nations Fourth World Conference on Women. Platform for Action.
http://www.un.org/womenwatch/daw/beijing/platform/plat1.htm#objectives 11/26/2006
31
   United Nations. Department for Economic and Social Rights. Division for Advancement of Women. The
United Nations Fourth World Conference on Women. Platform for Action.
http://www.un.org/womenwatch/daw/beijing/platform/plat1.htm#objectives 11/26/2006
32
   PDHRE: Children. Goverments’ Commitments to ensuring the Human Rights of Children and Youth.
http://www.pdhre.org/rights/children.html 6/6, 11/15/2006
33
   Youth at the United Nations. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 1/6 10/21/2006
34
   Youth at the United Nations. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 1/6 10/21/2006


                                                                                                 12
Each of these areas comprises specific actions that government is obliged to undertake:

        Provision of basic health services
In order to provide access of youth to the health services each Government should
mobilize the necessary awareness, resources and channels. The activities should be
directed in order to fulfill the goals of national health-for-all strategies based on equity
and social justice35. This kind of request should be in line with Declaration of Alma Ata
which places the focus and necessity on governments expressing the need of all
governments, health workers and world community to protect and promote the health for
all the people of the world. This Declaration particularly emphasizes that realization of
this goal requires action of many social and economic sectors apart of health sector.
Primary health care is the crucial for this goal, and addition of health sector involves
“all related sectors and aspects of national and community development, in particular
agriculture, animal husbandry, food, industry, education, housing, public works,
communications and other sectors; and demands the coordinated efforts of all those
sectors”36. Apart of insisting on holistic approach to the organization of primary health
care and health for all, this Declaration particularly emphasize that comprehensive health
for all should give priority to those most in need37, without direct referral to the youth
population.
The Youth Action Plan particularly calls upon global actions against major diseases
which took lives of many people such as malaria, tuberculosis, cholera, typhoid fever and
HIV/AIDS, where further activities should continued under the Joint and Co-sponsored
United Nations Programme on HIV/AIDS38.
        Development of health education
In relation to health education, governments should include in the curricula for the
primary and secondary school the education of health and practices. The particular
emphasis should be placed on basic hygiene requirements and environmental protection.
Governments should further cooperate in the field of education and health sector in order
to encourage and promote personal responsibility for a healthy lifestyle.39.
        Promotion of health services
The particular emphasis within health education should be placed on sexual and
reproductive health and development of respective curricula. The document further
obliged governments and other relevant organizations and youth to ensure
implementation of commitments made in different before mentioned documents40.
The particular emphasis within documents have been placed on reproductive health, need
for education and information on this.

        HIV infection and AIDS among young people


35
   Youth at the United Nations. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 2/6 10/21/2006
36
    Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6-12
September 1978. http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf 2/2, 11/15/2006
37
   Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6-12
September 1978. http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf 2/2, 11/15/2006
38
   Youth at the United Nations. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 2/6
39
   Youth at the United Nations. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 2/6
40
   Youth at the United Nations. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 2/6


                                                                                              13
Available and affordable primary health care services should be provided by states.
Within these services sexual and reproductive health care and education programs, where
education on STDs, including HIV/AIDS should be included41.

       Promotion of good sanitation and hygiene practices
In cooperation with youth NGOs, governments should promote youth health
organizations that would work on promotion of this aim42.

         Prevention of disease and illness among youth resulting from poor health
         practices
Governments should work on the prevention of diseases among youth that are result of
poor health practices. In collaboration with youth organization, governments should work
on policies for discouraging drug, tobacco and alcohol abuse. Policies that forbidden
advertisement of tobacco and alcohol should be also taken into account. With the
assistance of UN bodies programs should be established to train young people on healthy
lifestyles43.

        Elimination of sexual abuse of young people
Having in mind that young women are specially vulnerable, the international cooperation
among governments should be established in order to take effective steps, mostly in the
field of prevention, “to protect children, adolescents and youth from neglect,
abandonment and all types of exploitation and abuse, such as abduction, rape and incest,
pornography, trafficking and acts of pedophilia, as well as from commercial sexual
exploitation resulting from pornography and prostitution”44. Prohibition of female genital
mutilation should be part of legislation in force45.
        Combating malnutrition among young people
Healthy eating practices should be promoted by post-primary school and out-of school
health project46.

        1.1.4 Other global instruments
The aim of this part is to outline just some international documents/initiatives that have
for the aim better youth health, either directly or indirectly.

WHO Framework Convention on Tobacco Control, 200347


41
   Youth at the United Nations. “The World Programme of Action for Youth on Health” (A/RES/50/81),
1995. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 1/6 10/21/2006
42
   Youth at the United Nations. “The World Programme of Action for Youth on Health” (A/RES/50/81),
1995. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 1/6 10/21/2006
43
   Youth at the United Nations. “The World Programme of Action for Youth on Health” (A/RES/50/81),
1995. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 1/6 10/21/2006
44
   Youth at the United Nations. “The World Programme of Action for Youth on Health” (A/RES/50/81),
1995. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 1/6 10/21/2006
45
   Youth at the United Nations. “The World Programme of Action for Youth on Health” (A/RES/50/81),
1995. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 1/6 10/21/2006
46
   Youth at the United Nations. http://www.un.org/esa/socdev/unyin/wpayhealth.htm 1/6 10/21/2006
47
   WHO Framework Convention on Tobacco Control, World Health Organization, 2003
http://www.who.int/tobacco/framework/WHO_FCTC_english.pdf 11/25/2006


                                                                                                     14
The concern from “escalation in smoking and other forms of tobacco consumption by
children and adolescents worldwide, particularly smoking at increasingly early ages”48
has been stated in the very beginning of this Convention (Preamble). The objective of the
Convention and its protocols is to protect present and future generations form all kinds of
consequences connected to tobacco consumption and expose to tobacco smoke. This will
be done providing a framework for tobacco control measures that are going to be
implemented by the Parties of this Convention on national, regional and international
level (Aricle 3). Among Guiding Principles the need to take such measures “to address
gender specific risks when developing tobacco control strategies” is underlined (Article
4). Within the part of the Convention where General obligations are listed, the first
obligation stipulates that each Party to the convention shall develop and implement
comprehensive multisectoral national tobacco control strategy, plans and protocols
according to this Convention and its protocols (Article 5). Within Article 6 it has been
said that reducing of tobacco consumption in general, and particularly of young persons
could be achieved by price and tax measures of tobacco products. (article 6). Within
Article 13, each Party will in accordance to its constitutional principles “undertake
comprehensive ban of all tobacco advertising, promotion and sponsorship”49. All these
measures need to be fully implemented within the period of five years after entry into
force of this Convention (Article 13). The State Parties should also regulate the age limit
for selling the tobacco products to minors. It will be regulated by domestic law, national
law, or minimum 18 years (Article 16).


Joint United Nations Program on HIV/AIDS - UNAIDS
This Program started in January 1996 as a response to the AIDS epidemic in the areas
ranging from health to economic development, and as a kind of global action on
HIV/AIDS. The member organization of UNAIDS are WHO, UNDP, UNICEF,
UNESCO, UNODC, UNPFA, ILO and the WORLD BANK50.
Although many of these organization started individually with their own activities in this
field much earlier, UN efforts to coordinate a response to pandemic started in 1988, when
WHO set up the Global Program on AIDS51.
During the Second ad hoc thematic meeting, New Delhi, 9-11 December 1998, “Young
people and HIV/AIDS: Background discussion paper on the elements of a global
strategy”52has been presented. More then 50% of new infections are of youth in the age 10 –
24. At the one hand they are responsive to the prevention programs and good promoters of
prevention programs. On the basis of this fact seven sets of action have been set up:


48
   WHO Framework Convention on Tobacco Control, World Health Organization, 2003
http://www.who.int/tobacco/framework/WHO_FCTC_english.pdf 11/25/2006
49
   WHO Framework Convention on Tobacco Control, World Health Organization, 2003
http://www.who.int/tobacco/framework/WHO_FCTC_english.pdf 11/25/2006
50
   Joint United Nations Program on HIV/AIDS – UNAIDS. Uniting the World against AIDS.
http://www.unaids.org/en/
51
   “Joint United Nations Program on HIV/AIDS”. UNOG and the UN Specialized Agencies, pp. 20
52
   UNAIDS. UNAIDS Policy Position: Young People. “Young people and HIV/AIDS: Background
discussion paper on the elements of a global strategy”; Second ad hoc thematic meeting, New Delhi, 9-11
December 1998. http://data.unaids.org/Governance/PCB02/PCB_07_98_03_en.pdf 11/26/2006


                                                                                                      15
“1. establishing or reviewing national policies to reduce the vulnerability of young people to
HIV/AIDS and ensuring that their rights are respected, protected and fulfilled.
2. promoting young people’s genuine participation in expanding national responses to
HIV/AIDS
3. supporting peer and youth groups in the community to contribute to local and national
responses to HIV/AIDS
4. mobilizing parents, policy-makers, media, and religious organizations to influence public
opinions and policies with regard to HIV/AIDS and young people
5. improving the quality and coverage of school programmes that include HIV/AIDS and
related issues
6. expanding access to youth-friendly health services including HIV/STD prevention, testing
and counseling, care and support services
7. ensuring care and support of orphans and young people living with HIV/AIDS”53.
In this program of action, UNAIDS, Governments, Secretariat, non-governmental
organizations are invited to take a part. All of them have a role to play in these strategic
actions. This discussion paper describes those role s and proposes the development of
specific indicators to monitor programmatic responses to HIV/AIDS and young people54.

Health Promotion and Child Friendly Schools
Health- Promoting School presents the concept which WHO promotes, through its Global
School Initiative. It could be described as school that constantly strengthening itself as
healthy place for living, learning and working. UNICEF developed “a framework of
rights-based child-friendly educational setting”55 and schools that are multifunctional for
children. Studies conducted regarding this concept show the following results:
    - influences behavior of students
    - a positive psycho-social setting has positive impact of mental health of students
    - a supportative school improves students learning outcomes56.


Conclusion
Reviewed international documents clearly emphasize increasing need for specific
regulation aimed at improving the health of youth. There are international guidelines for
developing policy and regulation to promote youth health that exist. These refer directly
to youth, vulnerable youth and especially vulnerable youth, while some policy and
regulation is less direct. Having in mind that most of European countries ratified
previously elaborated documents they obliged themselves to incorporate their provisions

53
   UNAIDS. UNAIDS Policy Position: Young People. “Young people and HIV/AIDS: Background
discussion paper on the elements of a global strategy”; Second ad hoc thematic meeting, New Delhi, 9-11
December 1998. http://data.unaids.org/Governance/PCB02/PCB_07_98_03_en.pdf 11/26/2006
54
   UNAIDS. UNAIDS Policy Position: Young People. “Young people and HIV/AIDS: Background
discussion paper on the elements of a global strategy”; Second ad hoc thematic meeting, New Delhi, 9-11
December 1998. http://data.unaids.org/Governance/PCB02/PCB_07_98_03_en.pdf 11/26/2006
55
   “Creating an Environment for Emotional and Social Well-Being. An Important Responsibility of a
Health Promoting and Child Friendly School”. The World Health Organization. Information Series on
School Health Document 10, 2003
56
   “Creating an Environment for Emotional and Social Well-Being. An Important Responsibility of a
Health Promoting and Child Friendly School”. The World Health Organization. Information Series on
School Health Document 10, 2003


                                                                                                      16
within national legislations. This demands a multisectoral approach to this issue, which is
very often lacking in the creation of laws.

    1.2. European level
The legal regulation of youth health on European level will be elaborated through three
main levels: WHO acts referring to European Region; Council of Europe activities in this
field and the largest part of this chapter will refer to EU legislation that refer to youth
health. It has to be said that policies on all three levels are quite compatible with each
other.

    1.2.1. WHO Regional Office for Europe
Within this section some WHO documents/initiatives that refer to Europe region will be
presented.

Health for All in XXI century, World Health Organization, Regional Office for
Europe57
Among 26 aims set up for the improvement of health situation in the European Region,
the following are directly related to this study:
Objective 3: Health of Young People
The concrete aims to be achieved would be:
    - “increase the level of self-respect among young people for 20%
    - decrease of at least 20% of cases of injuries an deaths among young people
    - increase for at least 20% the number of young people who do not to start to smoke
    - decrease for at least 20% the number of young people who are involved in risky
        behavior, as alcohol and drug consumption
    - decrease for at least 20% the number of unplanned pregnancies among teenagers
    - decrease for at least 20% the number of suicides among youths
    - decrease of at least 20% of differences under variable among socio-economic
        groups”58

This could be done if:
   - “member states set up the appropriate measures and structure of children
       protection as sensitive (vulnerable) members of population, as has been defined in
       UN conventions on children rights
   - the countries need to create such general politics to facilitate creation of
       supportive and safe environment, making healthy choices the best choice
   - health sector, education sector and social services should function together in
       order to strengthen positive self esteem of young people


57
   “Health for All in XXI century”, World Health Organization, Regional Office for Europe in Strateski
Plan za reformu i rekonstrukciju zdravstvenog sistema 1997-2000 (Strategic Plan for reform and
reconstruction of health system 1997-2000), Republika Srpska, May 1997
http://www.pcuhealth.org/dokumenti/sp972000.pdf 11/29/2006
58
   “Health for All in XXI century”, World Health Organization, Regional Office for Europe in Strateski
Plan za reformu i rekonstrukciju zdravstvenog sistema 1997-2000 (Strategic Plan for reform and
reconstruction of health system 1997-2000), Republika Srpska, May 1997
http://www.pcuhealth.org/dokumenti/sp972000.pdf 11/29/2006


                                                                                                         17
     -   state parties should ensure access to the measures which lead towards avoidance
         of unplanned pregnancies including information and support to youth”59

Objective 6: Health and gender
The concrete aims to be achieved would be:
   - “decrease of deaths at giving birth so that any country in the region does not have
       percentage higher then 20 on 1000 inhabitants, while minimum 20% of countries
       would not have the percentage of 20 on 1000 inhabitants.
   - Decrease of at least 20% of cases of abortion as the way of regulating fertility
   - Decrease of at least 20% of cervical cancer and breast cancer
   - Increase life of men in their 20s through significant decrease of deaths as result
       of injuries and risky behavior
   - By 2005 elimination of dangerous customs as genital mutilation
   - By 2005 decrease of at least 20% of cases and consequences of rapes and other
       violence based on gender
   - decrease of at least 20% of differences under variable among socioeconomic
       groups”60
   This could be achieved by:
   - “To give higher priority to the health of women in the development of health
       policy on all levels
   - The access to the quality of reproductive services in order to provide effective
       contraceptive methods, suitable technologies and basic medicines
   - Inter-sectoral collaboration among employees, providers of health care, policy
       makers in order to improve the general overburden of women
   - Violence based on gender is marked as public health issue, and preventive,
       service and rehabilitation structures are provided for that services
   - Messages and advertisement which promote risky behavior are contra
       productive”61;
   Objective 11 – Decreasing intentional and unintentional injuries
   This specifically means:
   - “decreasing of at least 20% of deaths and disabilities caused by car accidents
   - decreasing of at least 20% deaths and disabilities caused by injuries at work
   - decreasing of at least 20% deaths and disabilities caused by injuries at home, sport
       related injuries and leisure activities
   - decreasing of at least 20% of cases and consequences of injuries caused by
       domestic violence and violence related to gender and organized violence”62


59
   “Health for All in XXI century”, World Health Organization, Regional Office for Europe in Strateski
Plan za reformu i rekonstrukciju zdravstvenog sistema 1997-20002000 (Strategic Plan for reform and
reconstruction of health system 1997-2000) , Republika Srpska, May 1997
http://www.pcuhealth.org/dokumenti/sp972000.pdf 11/29/2006
60
   “Health for All in XXI century”, World Health Organization, Regional Office for Europe in Strateski
Plan za reformu i rekonstrukciju zdravstvenog sistema 1997-2000, Republika Srpska, May 1997
http://www.pcuhealth.org/dokumenti/sp972000.pdf 11/29/2006
61
   “Health for All in XXI century”, World Health Organization, Regional Office for Europe in Strateski
Plan za reformu i rekonstrukciju zdravstvenog sistema 1997-2000, Republika Srpska, May 1997
http://www.pcuhealth.org/dokumenti/sp972000.pdf 11/29/2006


                                                                                                         18
     This could be achieved if:
     - “policy development should give high priority to the issues that relate to safety in
        life and working environments
     - all sectors should collaborate in actions to prevent accidents and violence
        wherever it is possible, and help in supporting consequences and costs to victims
        and their families
     - countries should maintain better records of incidents and effects of all types of
        violence”63

WHO European Ministerial Conference on Mental Health, Helsinki, 12-15 January
200564

    The aims of the Conference were:
    - to explore the status of mental ill health in Europe and the policies that are in
        force regarding this
    - to explore the settings which could have the impact on mental health of different
        age groups as schools, workplaces, health services etc.
    - to suggest solutions that could framed in common and sustainable policies65
This Ministerial Conference was a kind of introduction into the creation of Green Paper
“Promoting the mental health of the population. Towards a strategy on mental health for
the EU” (COM(2005)484 final of 14 October 2005), where European Commission is
invited as a partner to contribute to creation of this Green Paper.66

Life without Injuries and Violence in Europe (LIVE)
Newsletter of the WHO/Europe programme on violence and injury prevention67
The European Conference has been held on Injuries prevention (Vienna and Graz). The
forthcoming launch of UN Secretary General Study on Violence against Children as well

62
   “Health for All in XXI century”, World Health Organization, Regional Office for Europe in Strateski
Plan za reformu i rekonstrukciju zdravstvenog sistema 1997-2000, Republika Srpska, May 1997
http://www.pcuhealth.org/dokumenti/sp972000.pdf 11/29/2006
63
   “Health for All in XXI century”, World Health Organization, Regional Office for Europe in Strateski
Plan za reformu i rekonstrukciju zdravstvenog sistema 1997-2000, Republika Srpska, May 1997
http://www.pcuhealth.org/dokumenti/sp972000.pdf 11/29/2006
64
   The World Bank. “WHO European Ministerial Conference on Mental Health. Facing Challenges,
Building Solutions”, Helsinki 12-15 January 2005.
http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTHEALTHNUTRITIONANDPOPULATIO
N/EXTMH/0,,contentMDK:20330307~pagePK:148956~piPK:216618~theSitePK:384012,00.html
11/26/2006
65
   The World Bank. “WHO European Ministerial Conference on Mental Health. Facing Challenges,
Building Solutions”, Helsinki 12-15 January 2005.
http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTHEALTHNUTRITIONANDPOPULATIO
N/EXTMH/0,,contentMDK:20330307~pagePK:148956~piPK:216618~theSitePK:384012,00.html
11/26/2006
66
   European Commission. Health and Consumer Protection. Green Paper “Promoting the mental health of
the population. Towards a strategy on mental health for the EU” (COM(2005)484 final of 14 October
2005). http://ec.europa.eu/health/ph_determinants/life_style/mental/green_paper/mental_gp_en.pdf
67
   World Health Organization. Regional Office for Europe. “Life without Injuries and Violence in Europe
(LIVE)” Newsletter of the WHO/Europe programme on violence and injury prevention.
http://www.euro.who.int/Document/VIP/VIP_News_Sep06.pdf 11/26/2006


                                                                                                     19
as preparation of UN Global Week on road safety (23-29 April 2007) showed the
increasing interest in injury prevention and the significant threat to health in general, and
particularly young people68. It has to be outline that injuries are leading cause of death
and illness among youth within the region of Europe.

1.2.2. Council of Europe
Among numerous activities and documents that CoE conducts in the field of health,
youth and many other fields for the purpose of this analysis it will be mentioned
Pompidou Group. Pompidou Group Ministerial Conference is organized once every three
years. Currently, Pompidou Group adopted “six platform anti-drug abuse Program, with
focus on youth involvement”69. This Group within CoE is created in 1971 to combat drug
abuse and illicit Drug trafficking. On the last Strasbourg Conference on the Pompidou
Group, it has been emphasized that special attention should be placed on women in
relation to drug abuse since they are vulnerable for a number of social, economic and
biological reasons70. In this respect, it particularly target vulnerable groups, as women,
minorities etc71.

1.2.3. European Union and Youth Health
Due to EU expansion there are 75 million young people of the age between 15 and 25 in
Europe. The legal basis for cooperation at the European level is the article 149 of the
Treaty establishing European Community. According to this various kinds of activities
are allowed which are directly or indirectly related to young people.
In general youth sector is excluded from any harmonization of the legislative and
regulatory provisions of the Member States. Council texts are mainly recommendations,
with the only exception of these Programmes that refer to youth and their organizations72.
The overview of EU legislation referring to youth health will go through lines: health
determinants set up by the European Commission, White Paper “A new Impetus for
Youth, and EU accession and Youth Health.

1.2.3.1 Health determinants and youth health
Youth are “part of the strategy laid down in the Community Action Programme on Public
Health”73. Due to the process of enlargement and threat of new diseases and Community
has come into situation to develop new strategy. Two main new features of this strategy
are: a new framework for action plan in public health (2001 – 2006), and the

68
   World Health Organization. Regional Office for Europe. “Life without Injuries and Violence in Europe
(LIVE)” Newsletter of the WHO/Europe programme on violence and injury prevention.
http://www.euro.who.int/Document/VIP/VIP_News_Sep06.pdf 11/26/2006
69
   Council of Europe. Pompidou Group. http://www.coe.int/T/dg3/Pompidou/default_en.asp visited
11/28/06
70
   Council of Europe. Pompidou Group. http://www.coe.int/T/dg3/Pompidou/default_en.asp visited
11/28/06
71
   For more information about Council of Europe activities please see http://www.coe.int
72
   Youth. http://europa.eu/scadplus/leg/en/s19003.htm. visited 08/11/06

73
  PH Strategy of 2000 + Action Program in PH 2001-2006. http://europa.eu/scadplus/leg/en/s03001.htm
visited 08/11/2006



                                                                                                      20
development of an integrated health strategy, which contains specific measures to
incorporate health protection into all Community policies. In mentioned
programs/strategies, as well in the following ones (EU Public Health Program 2003-
2008) that refers generally to public health there is no direct referral to youth health74.
The following section has for the aim to explore legislation that refers to the specific
health determinants as tobacco, alcohol, nutrition and physical activity, mental health,
HIV/AIDS.

Prevention of Smoking
According to the Council Recommendations 2003/54/EC of 2 December 2002 on the
prevention of smoking and on initiatives to improve tobacco control (Official Journal L22
of 25.01.2003), one of recommendations urges Member States to adopt such legislative
framework which will prevent the sale of tobacco to children and adolescents by:

     •   “requiring vendors of tobacco products to establish that purchasers are old
         enough, according to the age limit set by national law;
     •   removing tobacco products from self-service displays;
     •   restricting access to vending machines;
     •   restricting distance sales, e.g. via the Internet;
     •   prohibiting the sale of sweets and toys intended for children and manufactured
         with the intention that the product and/or packaging has the appearance of a
         tobacco product;
     •   prohibiting the sale of cigarettes individually or in packets of fewer than 19
         cigarettes”75.

The measures that these Recommendations advocate are actually additional to the
provisions of two Directives: Directive on tobacco products (2001), and Directive on
advertising and sponsorship of tobacco products (2003). The measures are further in line
to WHO Framework on Tobacco Control that at the time of adoption of two previous
Directives was still in the process of negotiations76.
As a background for the Council Resolution of 26 November 1996 on reduction of
smoking in the European Union the evidences are presented that more and more young
women taking up smoking habit. Moreover, young people do not take seriously harmful
effects of tobacco, and therefore there is important rise in proportion of smokers of young
and school age. In this respect the various options are presented for future action at
Community level, among which the studies to improve understanding on reasons for
youth smoking are highly encouraged77.

74
   PH Strategy of 2000 + Action Program in PH 2001-2006. http://europa.eu/scadplus/leg/en/s03001.htm
visited 08/11/2006
75
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH
HEALTH DETERMINANTS: LIFESTYLE. TOBACCO.
http://www.europa.eu/scadplus/leg/en/s03003.htm
76
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH HEALTH
DETERMINANTS: LIFESTYLE. TOBACCO. http://www.europa.eu/scadplus/leg/en/s03003.htm
77
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH HEALTH
DETERMINANTS: LIFESTYLE. TOBACCO. http://www.europa.eu/scadplus/leg/en/s03003.htm


                                                                                                       21
It should be also mentioned that previously mentioned WHO Framework Convention on
Tobacco Control from 15 June 2004 was approved by the Council of the European Union
on 2 June 2004 (2004/513/EC). The Convention was signed by EC on 16 June 2005, and
ratified on 30 June 2005)78.

Drinking of alcohol by young people
As background for the Council Recommendation 2001/458/EC of 5 June 2001 on the
drinking of alcohol by young people, in particular children and adolescents (Official
Journal L161 of 16.06.2001) there is statistical evidence of changes in drinking patterns
among adolescents which are of particular concern. The purpose of the recommendations
is to raise awareness on dangers of alcohol abuse among young people, parents and
manufacturers. Youth as such are separately mentioned as those to which health
promotion the special emphasis needs to be placed in the strategies of the Member States.
In that respect the key features of the strategies, where all specifically relate to youth are:

     •   “promote research into all the different aspects of problems associated with
         alcohol consumption by young people with a view to identifying and evaluating
         measures to deal with them;
     •   ensure that general health promotion policies targeted at all the groups concerned
         (children, adolescents, parents, teachers, etc.) should include the alcohol issue;
     •   foster a multisectoral approach to educating young people about alcohol
         involving, as appropriate, the education, health and youth services, law
         enforcement agencies, non-governmental organizations, the media, etc.;
     •   encourage the production of advisory materials for children, adolescents and
         parents;
     •   increase young people's involvement in youth health-related policies and actions;
     •   develop specific initiatives addressed to young people on the dangers of drinking
         and driving;
     •   take action as a matter of priority against the illegal sale of alcohol to under-age
         consumers”79.

Accordingly, Member States should establish effective mechanisms in cooperation with
producers and retailers of alcoholic beverages and civil society sector in order to:

     •   “to ensure that producers do not produce alcoholic beverages specifically targeted
         at children and adolescents;
     •   to ensure that alcoholic beverages are not designed or promoted to appeal to
         children and adolescents. Particular attention should be paid to the use of styles
         (motifs, colors, etc.) associated with "youth culture" , the images used, the
         promotion of ideas associated with alcohol consumption (implications of social
         success, sexual or athletic prowess, featuring of children in drink promotion


78
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH HEALTH
DETERMINANTS: LIFESTYLE. TOBACCO. http://www.europa.eu/scadplus/leg/en/s03003.htm
79
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH HEALTH
DETERMINANTS: LIFESTYLE. ALCOHOL. http://www.europa.eu/scadplus/leg/en/s03003.htm


                                                                                            22
         campaigns and sponsoring of alcoholic drinks (sponsoring of sporting or musical
         events, sport merchandising, etc.);
     •   to ensure the possibility of examining and recalling products which do not respect
         the principles mentioned above;
     •   to develop, as appropriate, specific training for servers and sales persons;
     •   allow manufacturers, promoters, etc. to get pre-launch advice”80

In the Conclusions of the Council of 5 June 2001 on a Community strategy to reduce
alcohol-related harm (Official Journal C 175 of 20.060.2001), the Council calls the
development of a comprehensive Community strategy.
Priority themes related to the protection of young people, children and unborn child
within EU Strategy to support Member States in reducing alcohol related harm are:

“Aim 1: To curb under-age drinking, reduce hazardous and harmful drinking among
young people, in cooperation with all stakeholders.

Aim 2: To reduce the harm suffered by children in families with alcohol problems.

Aim 3: To reduce exposure to alcohol during pregnancy, thereby reducing the
number of children born with Foetal Alcohol Disorders.
Aim 4: To contribute to reducing alcohol-related road fatalities and injuries”81.

The rationale for action is seen in the fact that youth are unfairly seen more as
perpetrators of alcohol problems rather then victims. However, alcohol is estimated to be
causal factor in 16% of cases of child abuse. It has been considered that harmful alcohol
consumption among youth has negative impact not only on health and social wellbeing,
but also on educational results82.
Moreover, approximately one accident in four is related to alcohol consumption. Young
people in the age 18-24 are particularly exposed to this danger. For young people,
actually, car accidents are the most common cause of death (according to several sources
47%). Regarding drinking and driving accidents, two thirds of people involved were
youth in the age 15 – 34, and 96% were male83.

Drugs and Substances

The Directorate General of Health and Consumer Protection deals with the public aspect
of drug abuse, particularly prevention, education, risk/harm reduction, treatment and



80
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH HEALTH
DETERMINANTS: LIFESTYLE. ALCOHOL. http://www.europa.eu/scadplus/leg/en/s03003.htm
81
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH HEALTH
DETERMINANTS: LIFESTYLE. ALCOHOL. http://www.europa.eu/scadplus/leg/en/s03003.htm
82
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH HEALTH
DETERMINANTS: LIFESTYLE. ALCOHOL. http://www.europa.eu/scadplus/leg/en/s03003.htm
83
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH HEALTH
DETERMINANTS: LIFESTYLE. ALCOHOL. http://www.europa.eu/scadplus/leg/en/s03003.htm


                                                                                          23
rising of the awareness. It cooperates with many agencies, among which are WHO and
Pompidou Group of Council of Europe84.

Council Recommendation of 18 June 2003 on the prevention and reduction of health-
related harm associated with drug dependence
Official Journal L 165 , 03/07/2003 P. 0031 – 0033
(2003/488/EC)85
The Council Recommendation refers to all previous measures that European Union
conducted in relation to the problem of drug dependence and drug abuse. Having in mind
the dangerous consequences of drug abuse and its connection to communicable diseases,
it calls multi-sectoral approach to this issue proposing lot of preventative and educational
measure that need to be undertaken within Member States, but without clear referral to
youth. Each of Member states needs to adopt its own Program for the prevention of drug
dependence and drug abuse86.

Healthy diets and physical activity
Unhealthy diets and lack of physical activity are main causes of illness and premature
death in Europe. The Green Paper of 8 December 2005 “Promoting healthy diets and
physical activity: a European dimension for the prevention of overweight, obesity and
chronic diseases” (COM(2005) 637 final – Not published in the Official Journal) is
response to the described problem. This paper invites contributions on range of topics
which are related to nutrition and physical activities. The aim is through collection of
information, give a European dimension to the battle against consequences of this
problem and coordinates existing national measures. In that respect there are number of
instruments for combating obesity at European level87.
One of the areas of action specifically requests focusing on children and youth. This
specifically outlines how eating habits which are developed during the period of
childhood and adolescence play significant role in potential health problems that occur
during adulthood. In this respect schools could be seen as place where healthy habits
should be promoted and behavioral patterns. Although it is up to the state which measure
will apply within school, the Community poses some recommendations on the basis of
the best practices:

     •   “improvement of the nutritional value of school meals and ways of informing
         parents about how to improve the nutritional value of meals at home;

84
   Activities of the European Union, Summaries of the legislation. Public Health. Health Determinants.
Drugs and Substances. http://ec.europa.eu/health/ph_determinants/life_style/drug_en.htm 11/30/2006
84
   Activities of the European Union, Summaries of the legislation. Public Health. Health Determinants.
Drugs and Substances. http://eur-
lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:32003H0488:EN:HTML 11/30/2006
85
   Activities of the European Union, Summaries of the legislation. Public Health. Health Determinants.
Drugs and Substances. http://ec.europa.eu/health/ph_determinants/life_style/drug_en.htm 11/30/2006
86
   Activities of the European Union, Summaries of the legislation. Public Health. Health Determinants.
Drugs and Substances. http://eur-
lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:32003H0488:EN:HTML 11/30/2006
87
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH HEALTH
DETERMINANTS: LIFESTYLE. NUTRITION. http://www.europa.eu/scadplus/leg/en/s03003.htm


                                                                                                         24
     •   good practice regarding the provision of regular physical activity in schools;
     •   good practice in encouraging school pupils to make healthy dietary choices;
     •   the role of the media, health services, civil society and sectors of industry in
         supporting health education efforts made by schools”88.

As in other areas of health, the Community calls for a consistent and comprehensive
approach, which would take in consideration all aspects towards this problem creating a
supportive environment89.

Mental Health

The Green Paper “Promoting the mental health of the population. Towards a strategy on
mental health for the EU” (COM(2005)484 final of 14 October 2005) was adopted on 14
October 2005 by the Commission. This paper aims to promote a public consultation on
how to improve way of dealing with mental illness and how to improve mental well
being in the EU. This initiative should lead towards Commission proposal for an EU
strategy on mental health in late 200690.

The current instrument for action in the field of mental health is EU Public Health
Programme 2003-2008, which is based on Article 152 of the Treaty establishing
European Community”91.

The Green Paper presents the first response to the invitation made in January 2005 during
WHO European Ministerial Conference on Mental Health, where the European
Commission was invited as a partner to contribute in implementing framework of action
made during that conference. The purpose of this Paper is to initiate debate with the
European institutions, Government, health professionals and all other stakeholders, the
need for a strategy at EU level, and possible priorities within it92.

The Commission proposes that EU strategy should concentrate on the following:

             o   “Promote the mental health of all;
             o   Address mental ill health through preventive action;
             o   Improve the quality of life of people with mental ill health or disability
                 through social inclusion and the protection of their rights and dignity; and


88
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH HEALTH
DETERMINANTS: LIFESTYLE. NUTRITION. http://www.europa.eu/scadplus/leg/en/s03003.htm
89
   Activities of the European Union, Summaries of the legislation, PUBLIC HEALTH HEALTH
DETERMINANTS: LIFESTYLE. NUTRITION. http://www.europa.eu/scadplus/leg/en/s03003.htm
90
   Public Health. Mental Health.
http://ec.europa.eu/health/ph_determinants/life_style/mental_health_en.htm 11/26/2006 1/3
91
   Public Health. Mental Health. http://ec.europa.eu/health/ph_determinants/life_style/mental_health_en.htm
11/26/2006 2/3
92
   European Commission. Health and Consumer Protection. Green Paper “Promoting the mental health of
the population. Towards a strategy on mental health for the EU” (COM(2005)484 final of 14 October
2005). http://ec.europa.eu/health/ph_determinants/life_style/mental/green_paper/mental_gp_en.pdf , pp. 3


                                                                                                        25
             o   Develop a mental health information, research and knowledge system for
                 the EU.” 93

Within options for actions it has been particularly emphasized the need for building
mental health in infants, children and adolescents. It could be achieved by " conducive
school environment and ethos; resource packs on mental health for students, parents and
teachers”94. Targeting and supporting of vulnerable groups in society is also identified as
one of necessities, due to the fact that their low social and economic status increases
vulnerability for mental ill health95. Among EC events that relate to mental health
between 1999 and 2005 within Annex 5 of this document is listed WHO Ministerial
conference on Young people and alcohol96.

We can say that now there is strong political commitment for action in this field. This
document presents the relevance of mental health for some of the most important policy
objectives as prosperity, solidarity, social justice etc. For consultations around proposed
questions related to this paper, the deadline for contributions was 31 May 200697.

Sexual Health and HIV/AIDS

The purpose of sexual health aspect as Health Determinant Strand is to encourage and
develop health promotion strategies and identify best practices regarding teenage
pregnancies, family planning, prevention of STDs, among which the most burning issue
is prevention of HIV/AIDS. The Commission has had the HIV/AIDS issue as high
priority since the start of epidemic. In the current Public Health Action Program (2003-
2008), HIV/AIDS is addressed as a part of sexual health and drug prevention strategies98.

Action programme to prevent AIDS and certain communicable diseases 1996-200299

European Parliament and Council Decision 96/647/EC of 29 March 1996 adopting a
programme of Community action on the prevention of AIDS and certain other

93
   European Commission. Health and Consumer Protection. Green Paper “Promoting the mental health of
the population. Towards a strategy on mental health for the EU” (COM(2005)484 final of 14 October
2005). http://ec.europa.eu/health/ph_determinants/life_style/mental/green_paper/mental_gp_en.pdf , pp. 8
94
   European Commission. Health and Consumer Protection. Green Paper “Promoting the mental health of
the population. Towards a strategy on mental health for the EU” (COM(2005)484 final of 14 October
2005). http://ec.europa.eu/health/ph_determinants/life_style/mental/green_paper/mental_gp_en.pdf, pp. 8
95
   European Commission. Health and Consumer Protection. Green Paper “Promoting the mental health of
the population. Towards a strategy on mental health for the EU” (COM(2005)484 final of 14 October
2005). http://ec.europa.eu/health/ph_determinants/life_style/mental/green_paper/mental_gp_en.pdf, pp. 9
96
   European Commission. Health and Consumer Protection. Green Paper “Promoting the mental health of
the population. Towards a strategy on mental health for the EU” (COM(2005)484 final of 14 October
2005). http://ec.europa.eu/health/ph_determinants/life_style/mental/green_paper/mental_gp_en.pdf, pp. 19
97
   European Commission. Health and Consumer Protection. Green Paper “Promoting the mental health of
the population. Towards a strategy on mental health for the EU” (COM(2005)484 final of 14 October
2005). http://ec.europa.eu/health/ph_determinants/life_style/mental/green_paper/mental_gp_en.pdf
98
   European Commission. Public Health. Sexual Health and HIV/AIDS.
http://ec.europa.eu/health/ph_determinants/sexual_health_en.htm 11/26/2006
99
   Besides this, there are Action Programs to prevent AIDS 2004 and 2006


                                                                                                      26
communicable diseases within the framework for action in the field of public health
(1996-2000) [Official Journal L 95, 16.04.1996]100.

Decision No 521/2001/EC of the European Parliament and of the Council of 26 February
2001 extending certain programmes of Community action in the field of public health
[Official Journal L 79, 17.03.2001]101.

The Commission action is in that to help Member States to achieve in complete their
objectives in eh combat against AIDS and some communicable diseases. The
Commission prepared the work program setting up priorities for 1999. The measures are
foreseen in four areas (surveillance and control of communicable diseases, preventing
transmission; information, education and training, and support to persons living with
HIV/AIDS), where two specifically refer to youth:

      -   preventing transmission: the work program should be specifically focus on
          vulnerable groups and groups whose behavior put them on risk (prostitution,
          young homosexuals, disadvantages women, migrants), where the measure would
          be to foster exchange of experience among State Members
      -   information education and training: information and education of youth is sees as
          one of programme's priorities. These measures are also planned for vulnerable
          groups listed above102

Decision 647/96/EC provides basis for the participation of the countries that applied for
membership to European Union to take the active part in Community programs in this
field103.

The threat of HIV/AIDS in Europe and its neighboring countries underlined the need for
adoption of specific strategies in these regions. This preceded the adoption of document
“Combating HIV/AIDS within the European Union and in the neighboring
countries, 2006-2009” on 15 December 2005, based on the orientations set out in the
Commission’s working paper “Coordinated and integrated approach to combat
HIV/AIDS within the EU and in its Neighborhood”. “Within this strategy, the
Commission provides for political leadership and advocacy by pushing HIV/AIDS to the
top of the political agenda, and helps combating stigma and discrimination, promoting the
provision of universal access to prevention services, ARV (anti-retroviral) treatment and

100
    Activities of European Union. Summaries of Legislation. “Action programme to prevent AIDS and
certain communicable diseases 1996-2002”. http://www.europa.eu/scadplus/leg/en/cha/c11533.htm
11/25/2006
101
    Activities of European Union. Summaries of Legislation. “Action programme to prevent AIDS and
certain communicable diseases 1996-2002”. http://www.europa.eu/scadplus/leg/en/cha/c11533.htm
11/25/2006
102
    Activities of European Union. Summaries of Legislation. “Action programme to prevent AIDS and
certain communicable diseases 1996-2002”. http://www.europa.eu/scadplus/leg/en/cha/c11533.htm
11/25/2006
103
    Activities of European Union. Summaries of Legislation. “Action programme to prevent AIDS and
certain communicable diseases 1996-2002”. http://www.europa.eu/scadplus/leg/en/cha/c11533.htm
11/25/2006


                                                                                                    27
harm-reduction services for injecting drug users. A particular attention has been, and
continues to be, devoted to addressing the challenges faced by vulnerable groups, such as
migrants, sex workers, inmates and young people. The Commission also focuses on best
practice in HIV/AIDS prevention and sex education”104.

Injuries

Injuries are leading cause of death among European population. There is difference
between intentional and unintentional injuries. A number of initiatives have been
undertaken in order to reduce frequency of injuries. The major direction for injury related
actions under Public Health Program are determined by Commission Communication
on “Actions for Safer Europe”, 23.06.2006105, and Council Recommendation on the
Prevention of Injury and Promotion of Safety, 23.06.2006106. Within seven priority
areas posed in latter document, the first priority theme is safety of children and
adolescents. Therefore the Member states are invited to develop a national injury
surveillance and reporting system, set up national plans for preventing accidents; ensure
that injury prevention and safety promotion is introduced in a systematic way in training
of health care professionals. Separate recommendations have been created for European
Commission.107

1.2.3.2. White Paper “A new Impetus for Youth”
The purpose of this part is to outline the youth policy within European Union, or so
called White Paper and the place of health within it.
As a response to the dissatisfaction with traditional ways of involvement in public life,
the White Paper “A new impetus for European youth” was published in November
2001108 It was preceded by intensive consultations on national and European levels,
among which it is inevitable to mention the Resolution of the Council and of the
representative of the governments of the Member States from 2000 on the social
inclusion of the young people (Official Journal C 374 of 28.12.2000). The Resolution
follows the strategic goal established at Lisbon Council from March 2000 which aims to
unite social and economic progress and sees the fight against social exclusion as the
major aspect of it. This Resolution calls Commission and the Member States to ensure
that youth are included in all aspects of the society. Concerning youth health issues the



104
    European Commission. Press release. Questions and answers on EU action on fighting HIV/AIDS.
http://europa.eu.int/rapid/pressReleasesAction.do?reference=MEMO/06/428&format=HTML&aged=0&la
nguage=EN
105
    European Union. Public Health. Injuries Prevention. “Commission Communication on “Actions for
Safer Europe” 23.06.2006
http://ec.europa.eu/health/ph_determinants/environment/IPP/documents/com_328_en.pdf 11/27/2006
106
    European Union. Public Health. Injuries Prevention. Council Recommendation on the Prevention of
Injury and Promotion of Safety http://ec.europa.eu/health/ph_determinants/environment/IPP/ipp_en.htm
11/28/2006
107
    European Union. Public Health. Injuries Prevention. Council Recommendation on the Prevention of
Injury and Promotion of Safety
http://ec.europa.eu/health/ph_determinants/environment/IPP/documents/com_329_en.pdf 11/26/2006
108
    Youth. http://europa.eu/scadplus/leg/en/s19003.htm. visited 08/11/06


                                                                                                  28
Resolution urges Member states to “seek a high level of health protection for young
people and develop preventative health care measures suited to their needs109.
White Paper presents a new framework for cooperation among Member states and
regions of Europe. It consists of two components: “increasing cooperation between
Member States and better incorporating the youth factor into sectoral policies110.
The White Paper presents the basis for action in a wide range of fields-sectors that
directly or indirectly influence youth: “discrimination, European citizenship,
employment, social exclusion, education, vocational training, culture, health, consumer
protection, freedom of movement, environmental protection, mobility for young
researches, development cooperation and poverty”111. All these sectors require close
coordination at both national and European level112
Regarding provisions directly or indirectly deals with youth health is the one related to
the need of young people for special social protection. It is actually related to the
perception of young people that more has to be done regarding social legislation at
European level. It particularly focuses on young people specific needs which are not
harmonized with growing pressure from labor market. In this respect the focus has been
placed on ethnic minorities, women, disabled young people that face discrimination and
therefore there is a call for more “social Europe”113
One of the additional sections refers to improvement of mental and physical health and
avoiding drugs. The main consultations conclusion is about commonly need for
“preventative health information and education for all, as part of the school curricula and
within the context of youth work”114. In the process of personal development of youth,
youth work has a supportative element. Health prevention programs should concentrate
on positive healthy lifestyles. In schools, in youth work, counseling services and media
should be provided information on health, personal development, consumer goods and
environmental questions. These areas are actually those seen by youth as important to be
addressed through before mentioned media. In this respect access to health should be free
and without discrimination. Moreover, there is a request for youth specific health care
facilities are seen as necessary. Public health policies should take care more on health
problems that are specific for youth and that affect youth specifically. As major problems
has been perceived smoking, drinking, abuse of legal medical substances, but also quite


109
   Social inclusion of young people / RESOLUTION on the social inclusion of young people of
14.12.2000. http://europa.eu/scadplus/leg/en/cha/c11605.htm

110
    Youth. http://europa.eu/scadplus/leg/en/s19003.htm. visited 08/11/06
111
    COMMISSION OF THE EUROPEAN COMMUNITIES Brussels, 21.11.2001 COM(2001) 681 final
EUROPEAN COMMISSION WHITE PAPER. A NEW IMPETUS FOR EUROPEAN YOUTH. http://eur-
lex.europa.eu/
112
    COMMISSION OF THE EUROPEAN COMMUNITIES Brussels, 21.11.2001 COM(2001) 681 final
EUROPEAN COMMISSION WHITE PAPER. A NEW IMPETUS FOR EUROPEAN YOUTH. http://eur-
lex.europa.eu/
113
    COMMISSION OF THE EUROPEAN COMMUNITIES Brussels, 21.11.2001 COM(2001) 681 final
EUROPEAN COMMISSION WHITE PAPER. A NEW IMPETUS FOR EUROPEAN YOUTH. http://eur-
lex.europa.eu/
114
    COMMISSION OF THE EUROPEAN COMMUNITIES Brussels, 21.11.2001 COM(2001) 681 final
EUROPEAN COMMISSION WHITE PAPER. A NEW IMPETUS FOR EUROPEAN YOUTH. http://eur-
lex.europa.eu/


                                                                                              29
high percentage of suicide rates among European youth. Youth are of opinion that drug
addiction should be perceived and treated as illness, and not as crime. In this respect the
prevention programs should be fostered115.
Accordingly, there is a need for more openness on sexuality. It is perceived by youth
people as an important aspect of the well being. In that respect they see school, non-
formal learning environments as places of providing more information on sexuality,
contraception, sexual diseases. All youth should have the access to these information, as
well as contraception. Abortion should be legalized, while it is necessary to create
tolerant environment for all sexual orientations. They propose peer education as a way of
overcoming difficulties that arise talking about sexuality within families. Particular focus
should be placed on ethnic minorities and particularly those groups where maternity
presents the major way of social disintegration116
Having in mind that youth heath is heavily threatened by car accidents, safety in inner-
city areas and prevention of road accidents is seen as special concern. Moreover, there is
a problem of safety risks at work. All demands higher standards and better regulatory
mechanisms117
The great impact on living conditions of youth has environmental issues. In order to
achieve more knowledge on healthy environment, the Sixth Environment Action program
should be used, which foreseen environmental education and raising awareness on
environmental issues. According to this environmental issues should be integrated as a
part of educational curricula promoting greener lifestyles118.
The results of the consultations are the following proposals:
• In the area of health and drugs policy:
– “non-discriminatory access to health services;
– general improvement in health care facilities;
– promotion of health education (including consumer-related issues);
– stronger support for information and prevention programmes;
– improved communication and awareness building in the media;
– peer group information and counseling;
– parental information;
– better treatment for drug addiction, preferably in special centres;
– more support for health research and statistical data”119.
• ”Other issues (mental health, sexuality, family, gender issues, personal safety):

115
    COMMISSION OF THE EUROPEAN COMMUNITIES Brussels, 21.11.2001 COM(2001) 681 final
EUROPEAN COMMISSION WHITE PAPER. A NEW IMPETUS FOR EUROPEAN YOUTH. http://eur-
lex.europa.eu/
116
    COMMISSION OF THE EUROPEAN COMMUNITIES Brussels, 21.11.2001 COM(2001) 681 final
EUROPEAN COMMISSION WHITE PAPER. A NEW IMPETUS FOR EUROPEAN YOUTH. http://eur-
lex.europa.eu/
117
    COMMISSION OF THE EUROPEAN COMMUNITIES Brussels, 21.11.2001 COM(2001) 681 final
EUROPEAN COMMISSION WHITE PAPER. A NEW IMPETUS FOR EUROPEAN YOUTH. http://eur-
lex.europa.eu/
118
    COMMISSION OF THE EUROPEAN COMMUNITIES Brussels, 21.11.2001 COM(2001) 681 final
EUROPEAN COMMISSION WHITE PAPER. A NEW IMPETUS FOR EUROPEAN YOUTH. http://eur-
lex.europa.eu/
119
    European Commission. Youth. White Paper on Youth. “EUROPEAN COMMISSION WHITE PAPER
A NEW IMPETUS FOR EUROPEAN YOUTH”. 21.11.2005
http://ec.europa.eu/youth/whitepaper/download/whitepaper_en.pdf 11/26/2006


                                                                                         30
– improved medical coverage in the field of psychological and
psychosomatic diseases;
– better counseling at an earlier age and the creation of special mental
health care facilities;
– better re-integration programmes for young people suffering from mental
diseases;
– better access to information and counselling in the field of sexuality;
– more support for contraception and family-planning programmes;
– improved/expanded therapy facilities for the victims of sexual
exploitation and violence;
– better material and organizational support for families, especially
regarding affordable child-care facilities;
– equal and free access to sexual and parenthood health services for all
women;
– stricter criteria and enforcement of safety at the workplace;
– special training facilities for young drivers;
– attractive public transport services, even at unusual hours;
– raising awareness of environmental issues and supporting environmental
education in formal and non-formal learning”120.

It is expected from European Union to concentrate of two lines of action: to establish
certain standards and to promote such policies and programs that are more in accordance
to the needs of youth.
In this respect four standards were suggested:
“– standards for adequate social security coverage for all young people, free
of discrimination and based on the principle of intergenerational justice;
– standards for health care for all young people, free of discrimination,
emphasising the role of prevention and flexible enough to take full
account of the special needs of certain groups of young people;
– standards for a European policy on substance abuse, which takes account
of today’s realities, which covers the entire range of legal and illegal
substances and which treats drug dependence as an illness and not as a
crime;
- EU standards for child care facilities”121

1.2.3.3. EU Accession Process and Youth Health

Within criteria for accession which are determined by European Council in Copenhagen
in 1993, the one of the criteria refers to the adoption of the acquis communautaire (the


120
    European Commission. Youth. White Paper on Youth. “EUROPEAN COMMISSION WHITE PAPER
A NEW IMPETUS FOR EUROPEAN YOUTH”. 21.11.2005
http://ec.europa.eu/youth/whitepaper/download/whitepaper_en.pdf 11/26/2006
121
    COMMISSION OF THE EUROPEAN COMMUNITIES Brussels, 21.11.2001 COM(2001) 681 final
EUROPEAN COMMISSION WHITE PAPER. A NEW IMPETUS FOR EUROPEAN YOUTH. http://eur-
lex.europa.eu/


                                                                                       31
entire European legislation) and its effective implementation through appropriate
administrative and judicial structures122. The aquis communitarie includes:

      •   “the content, principles and political objectives of the Treaties on which the
          Union is founded;
      •   legislation and decisions adopted pursuant to the Treaties, and the case law of the
          Court of Justice;
      •   other acts, legally binding or not, adopted within the Union framework, such as
          interinstitutional agreements, resolutions, statements, recommendations,
          guidelines;
      •   joint actions, common positions, declarations, conclusions and other acts within
          the framework of the common foreign and security policy;
      •   joint actions, joint positions, conventions signed, resolutions, statements and other
          acts agreed within the framework of justice and home affairs;
      •   international agreements concluded by the Communities, the Communities jointly
          with their Member States, the Union, and those concluded by the Member States
          among themselves with regard to Union activities”123.

In all areas of acquis the candidate country should adjust its administrative and judicial
systems, management capacities and institutions in line to EU standards. On the basis of
the screening regarding acquis conducted by EU, the negotiations are opened whose
subject are divided in 35 chapters which presents the directory of Community legislation
in force124.

It practically means that all previously elaborated documents that directly or indirectly
deals with youth health needs to be adjusted with national legislation during the process
of accession towards European Union. Youth Health as such does not present the separate
chapter within directory of the Community legislation. Health legislation in general is a
part of legislation under the chapter 28 (Consumer and Health protection), while probably
some documents regulating youth health could be found under chapter 27 (Environment),
14 (Transport Policy), 19 (Social Policy and Employment)125, as well as those chapters
referring to Economic issues.

A could be seen, almost all regulations within European Union are of recommendation
nature, what means that their enforcement is left to member states to decide upon.

122
    Enlargement. European Commission. Accession Criteria.
http://ec.europa.eu/enlargement/enlargement_process/accession_process/index_en.htm
123
    Enlargement. European Commission. The Content of the Aquis.
http://ec.europa.eu/enlargement/enlargement_process/accession_process/how_does_a_country_join_the_eu
/negotiations_croatia_turkey/index_en.htm#acquis
124
    Enlargement. European Commission. Negotiations with Croatia and Turkey.
http://ec.europa.eu/enlargement/enlargement_process/accession_process/how_does_a_country_join_the_eu
/negotiations_croatia_turkey/index_en.htm
125
    Enlargement. European Commission. Directory of Community legislation in force.
http://ec.europa.eu/enlargement/pdf/enlargement_process/accession_process/how_does_a_country_join_th
e_eu/negotiations_croatia_turkey/table_of_correspondence_2_2006_en.pdf



                                                                                                 32
However, the scope and quality of recommendations is quite extensive, and the principle
of intersectoral collaboration in order to achieve youth health is highly emphasized. The
regulation/initiatives on the level of the whole European region (WHO activities) as well
as those on the level of Council of Europe are also quite comprehensive and compatible
to those of European Union.



1.3. Conclusion

Regulations that refer to youth health, both on global and European level provide the
guidelines to the Member States how to regulate this issue. Having in mind the wide
diapason of sectors that influence youth health, the need to inter-sectoral approach to this
issue has been strongly emphasized on all levels.




                                                                                          33
2. LEGAL REGULATION ON YOUTH HEALTH IN BOSNIA AND
   HERZEGOVINA


        Referring to the youth health, this subject is percept in frame of health and social
protection. Although considering the fact that on youth health is influenced by numerous
factors, and according to previous documents this subject demand multisectoral and
integral approach, subject of analyses are not necessarily only health legislative
regulations. During selection of legal regulations we are going to have in mind areas of
priority which are affecting youth health in this part of the world, as well as with socio -
historical specifics of Bosnia and Herzegovina, referring to consequences of the recent
war.

        There is no law in Bosnia and Herzegovina, strategy or other document regarding
youth policy in general, youth health in particular. There fore aside to the global
guidelines and guidelines on the level of European Union additional guidelines are
reports created in BiH by various expert groups, referring the subject of this study.

        The legislative authority within the health sector is within responsibility of
entities in Bosnia and Herzegovina. Moreover, according the Constitution of Bosnia and
Herzegovina, in the Federation of Bosnia and Herzegovina, it is within responsibility of
the Federation and cantons. Therefore, the regulations about health of young people and
other spheres that influence the youth health, we can find in the legal acts of entities,
District Brcko and cantons of the Federation of Bosnia and Herzegovina.
The overview of regulations will be presented separately for each entity and District
Brcko, in order to be able within each legal system to encompass entirety.
Regarding regulations on cantonal level, due to the extent of the subject, the overview
will not encompass all ten cantons. Having in mind that cantons’ legislations follow the
principles of federal law, we will offer the overview of concrete activities regarding
youth health and youth policy that take place in cantons.

       During elaboration of various legal acts and regulation, particular emphasis will
be placed eventual regulations regarding vulnerable and specifically vulnerable groups.

       In relation to the previous chapter, it is necessary to stress that Bosnia and
Herzegovina is UN member state, and in that respect the member of WHO. Moreover,
Bosnia and Herzegovina is the member of Council of Europe. Although still not the EU
candidate country, Bosnia and Herzegovina is on its way towards European Union,
conducting extensive reforms needed for this status.

2.1. Legal regulation of youth health on state level




                                                                                         34
        The aim of this part is to outline the constitutional framework of Bosnia and
Herzegovina; legal regulations, policies and strategies considering youth health at the
state level and concluding remark regarding this section.


2.1.1. Constitutional framework

        According to Constitution of Bosnia and Herzegovina126 area of health and social
protection is not quoted in jurisdiction of BiH institutions (Article 3) it belongs to
Entities. However, parts of Constitution are, and relevant for this subject, international
agreements sign by BiH and cited in Annex I of the Constitution and in Chapter 1. of his
document, and that Bosnia and Herzegovina is obliged to coordinate its legislature with
those and to insure their implementation. This are:

      1. Universal Declaration on Human Rights, 1948.
      2. International Covenant on Civil and Political Rights, 1966 and additional
         Optional protocols, 1989.
      3. International Covenant on Economical, Social and Cultural rights, 1966.
      4. International Convention on Elimination all kinds of Discrimination Against
         Women, 1979.
      5. Convention of the Rights of Child, 1989.127

2.1.2. Legal regulation, policies and strategies considering youth health at the state
          level

        This section aims to elaborate administrative responsibility division within the
field of health care; guidelines for development of the national legislation; legal
regulations at the state level; recent changes related to youth regulation of youth health,
and state of the youth policy on the state level.

2.1.2.1. Organization of health protection in Bosnia and Herzegovina

      According to the Law on Ministry’s and the Other Government Agencies of Bosnia
and Herzegovina128 health and social protection in BiH is under jurisdiction of Ministry
for Civil Affairs, but it belongs in narrow frame of Ministry of Civil Affairs which is in
charge of “managing affairs and execution of tasks which are in jurisdiction of BiH and
which refer on establishment of basic principals of activity coordination, planning
coordination of entity institutions and defining of strategy on international level in
areas:…”129 were health and social protection are.




126
    http://www.parlament.ba/bos/ustav/index.php 11/28/2006
127
    See: Constitution of BiH Annex I
128
    “Official Gazzette of BiH”, No 5/03
129
    See: “Law on ministry’s and the other government agencies of Bosnia and Herzegovina” Article 15.


                                                                                                       35
      According to above, health sector in Bosnia and Herzegovina is primarily in
jurisdiction of Entities. There for health protection is a realized trough different
legislative system in each entity and in District Brčko.

      Legal frame for implementation of health protection in Entities are Entities Laws:
Law on Health protection130 and Law on Health insurance131. In Brčko District legal
basic is consisted from Law on Health Protection of Brčko District132 and Law on Health
Insurance of Brčko District.133 The quoted Laws regulate jurisdiction for their
implementation.

      The legislative and appliance of the social policy are exclusively under entities
jurisdiction and Brčko District.


2.1.2.2. Guidelines for development of the national legislation


      All activities related to the health issues at the state level are based at the Resolution
on Policy “Health for all citizens of Bosnia and Herzegovina”134.
Beside that, according to the “Functional survey of health sector in Bosnia and
Herzegovina”135 the essential documents of strategy or those that stimulate any of related
activities at the state level are as follows:

„BiH Midterm Development Strategy“ for the period of time from 2004 until 2007136

      The general plan of the midterm development strategy for BiH (PRSP) 2004-2007
contains developed activities, deadlines and measures directed to the improvement of:
social policy, protection of the war invalids and families of died soldiers, social
protection, protection of the persons with disability, civil victims of the war, protection of
the family and children, the status of refugees and displaced persons and returnees.

Recommendations from the World Health Organisation “Health for All”137

130
    Law on Health Protection of the Federation of BiH „Official Gazzette of the Federation of BiH“, No
29/97
  Law on Health Protection of Republika Srpska, „Official Gazzette of Republika Srpska “, No 18/99
131
    Low on Health Inssurance of the Federation of Bosnia and Herzegovina, „Official Gazzette of the
Federation of BiH“, No 30/97
  Low on Health Insurance of Republika Srpska, „Official Gazzette of Republika Srpska “, No 18/99
132
    “Official Gazzette of Brčko District”, No 2/01
133
    “Official Gazzette of Brčko District”, No 1/02
134
    Resolution has been adopted at the 17th Meeteng of House of people of parliamentary Assembly of BiH on
29.04.2002. http://www.parlament.ba/bos/zakonodavstvo/zakonarh. 11/28/2006
135
    “Functional review of health sector in Bosnia and Herzegovina – Tools for functional review”, 30 August
2004. - The European Union’s CARDS Programme for Bosnia and Herzegovina
136
    http://www.parlament.ba/bos/zakonodavstvo/zakonarh.php?id=544 11/28/2006



                                                                                                              36
          Goals of priorities that have been identified by entities of BiH from the declaration
    of the WHO “Health for all in 21 century” are as follows: health of youth; improvement
    of the mental health; reducing the number of injures provoked by the violence and
    incidents; health and safe physical environment; healthy way of living; to prevent
    alcohol-related harm, drug use and smoking; health environment, etc.

    Health recommendations of Council of Europe138

           The European Commission Committee for health creates recommendations in
    order to establish common framework in health sector in Europe and the goal is to
    improve health of the citizens.

    The Conference about the health determinations in Dubrovnik139

           Dubrovnik declaration is directed on the improvement of the health in South-
    Eastern European states.


            Although the strategy at the state level will not take off the health under entities
    jurisdiction, it is necessary that state designs framework of the health system. Framed by
    that principle, the common values and principles will be the foundation for the
    complementarities of heath systems between the regions in BiH.
    .

    2.1.2.3 The legal regulations at the state level

            According to the fact that the subject of our research is the youth140 health that
    requires multisectoral approach, it has to be emphasized that although generally speaking
    there is no legal regulations in BiH that directly takes care of the youth health, there are
    relevant articles in a few state laws and entity’s laws on health, social protection, labor,
    education, criminal law etc, that will be described in next chapter.
.
             When it comes to the legislative (formal) regulation of the health, at the BiH level

    137
        See: „Functional review of health sector in Bosnia and Herzegovina – Tools for functional review”, 30
    August 2004. page 7 -The European Union’s CARDS Programme for Bosnia and Herzegovina.
    138
         See: „Functional review of health sector in Bosnia and Herzegovina – Tools for functional review”, 30
    August 2004. page 8 -The European Union’s CARDS Programme for Bosnia and Herzegovina.
    139
         See: „Functional review of health sector in Bosnia and Herzegovina – Tools for functional review”, 30
    August 2004. page 9 -The European Union’s CARDS Programme for Bosnia and Herzegovina.
    .
    140
       Our research is about the group of youth aged from 10 to 26 years. A focus within this population will be on
    vulnerable groups of youth .
    The vulnerable groups of youth (VGs): internal displaced persons, returnees, very poor population, young
    women and marginalized ethnic groups (Roma people, for example).
    Especial vulnerable groups of youth (EVGs): youth that break a law; commercial sex workers, men that have a
    sex with man and those who abuse matter. See: „Projekat za mlade i zdravlje mladih za područje Balkana, Plan
    implementacije projekta – Bosna i Hercegovina“, august 2006. str.1.


                                                                                                                37
there are only four laws that contain provisions that influence youth health. Beside that,
although according to its legislative power it is not a law, Strategy of prevention and
combating against HIV/AIDS in Bosnia and Herzegovina, 2004-2009, is a very important
document, so it deserves to be processed in this chapter.

(1) Framework Law on Primary and Secondary Education in Bosnia and Herzegovina141

       As one of general goals of education Law states provision of optimal development
for each person, including persons with special needs, and in accordance with their age,
mental and physical abilities. (Article 3 b).

        Regulating that primary education is obligatory while the secondary education is
attainable to all according to individual abilities and interests, the Law in foresee, in
Article 19, particularly individually adopted programs for children and youth with special
needs.

             In Article 34, the Law regulates role and obligations of school:

“Its role school realize in environment which develop motivation for getting of knowledge, which
support individuality of each pupil, as well as his cultural and national identity, language,
religion, which is safe and does not have any kind of frightening, molesting, physical insulting,
humiliation or degradation or damage to health, including the damage caused by smoking or use
of narcotics and prohibited substances”.

         In Article 37, it is predicted joint action of school, parents, children and local
community on implementation of prevention actions focused on protection of citizens
and health of children, and in Article 43 e) implementation of curriculum’s and programs
with focus on promotion of healthy stile of life.
         Regarding the Law on High Education on state level, which initially has been in
parliamentary procedure in spring of year 2004, discussions have still been ongoing.


(2) Law on Prevention of Drugs Abuse

        Law on Prevention of Drugs Abuse142 has been issued on state level. Considering
drugs abuse the most susceptible are youth, although the Law does not mention the youth
specifically, it is possible to clam that it is focused on protection of the youth.
         Concrete regulations:

141
   The Framework Law on Primary and Secondary Education at the state level has been unanimously adopted by
The Parliament of BiH, and started it's implementation from July 4th 2003. The Law regulation on primary and
secondary education at all levels in cantons, Republic of Srpska and District Brčko has been harmonised with
The Framework Law. www.oscebih.org/documents 11/23/ 2006

142
      “Official Gazzette of BiH”, No 8/06.




                                                                                                        38
         Article 37, regarding possession and purchasing in medical purposes, the Law
allows that substances from table II and III, and on the base of medical treatment
prescription, can be purchased by persons older than 18 years or parents if the persons
are younger than 18.
          Article 69. in order of prevention predict continues enforcement of education in
family, school, health institutions, associations, religious communities and public media,
and early detection and follow up, treatment of occasional users and addicts.
          Article 70, determines obligation of the parents, teachers, medical staff and
social workers, employers and others to take necessary measures for prevention and
combating of drug abuse by children and youth.

(3) Law on Bases of Transportation Safety on the Roads in Bosnia and Herzegovina,143

        This Law does not refer to the youth specifically in that order that Law contains
regulations which referring explicitly to relations with youth, but the Law provides
impression that it has regulated areas of transportation safety very precisely and with this
has created solid preconditions for contribution on youth health. But, key question is how
these regulations are going to be obeyed. The provision that could be understood as
protection of youth could be the one that provides special treatment of people younger
then 21, for whom the allowed quantity of alcohol in blood is 0,0, while for the other it is
0,3 promils. The persons younger then 23 are not allowed to drive the vehicle in the
period between 23:00 – 5:00 hours, except in the situation where they are accompanied in
the vehicle by person older then 25.


(4) Gender Equality Law in Bosnia and Herzegovina144

       Although this Low is not referring on youth as particular category, important
place in this law has been given to education. From one side equal approach of both
genders in education is being promoted and on the other hand education as the method
for promotion of gender equality, elimination of gender stereotypes which can have bad
consequences on health of population. Like for example, domestic violence, risky sexual
behavior, etc.


 - Strategy of Prevention and Combating HIV/AIDS in Bosnia and Herzegovina,
   2004-2009.

       One of few but very important documents created on level of BiH is Strategy of
prevention and combating HIV/AIDS in Bosnia and Herzegovina, 2004 -2009 which has
been adopted by Council of Ministries in BiH year 2004.

      In situation when HIV/AIDS has become an global problem, in protection of
human health in all world as well in developed countries the largest number of infected

143
      “Official Gazzette of BiH”, No 6/06.
144
      “Official Gazzette of BiH”, No 16/03


                                                                                         39
persons are young age from 15 – 24, BiH has recognized that its relatively low
percentage of HIV/AIDS prevalence opens opportunity for establishment of efficient
supervision and control over this lethal infection and adopted unique state strategy for
prevention and struggle in this sector.
        Work on strategy has been developed trough Advisory Board for struggle against
HIV/AIDS for Bosnia and Herzegovina which has provided participation of all relevant
sectors of politics from entities and District Brčko, international agencies and NVO.
        Basic activity of Advisory Council is establishment of strategic approach with
active participation and coordination of all stakeholders included in this program. In the
year 2001 in BiH has been funded UN Theme group for HIV/AIDS. It is consisted of UN
Agencies in BiH (UNMIBIH, UNFPA, WHO, UNHCR, UNESCO, ILO, UNDCP,
OHCHR, World Bank, IFRC and IOM)
        Strategy, aside to permanent and wide intersectional coordination and education
of all stakeholders of implementation process, assumes creation of suitable legal
framework which provides respect of Human Rights and ethical principles and which is
going to be based on recommendations of the European Union. Namely, legislation of the
European Union prescribes elimination of all forms of discrimination of the persons
living with HIV/AIDS
        Strategy pays a special attention to youth in context of their activities for
prevention of transmission and spreading of HIV. In this context it is education of youth
– introduction of standardized programs of education on this disease, for both teachers
and pupils, is very important, introduction of educational program on safe sexual
behavior and prevention of drug addiction.
Strategies emphasize necessity of improvement of conditions and quality of health
protection for people living with HIV/AIDS. Also it is important to provide psychosocial
support for these persons.




2.1.2.4. Recent changes related to legal regulation of youth health


        As it could be noticed in the previous text, there are no special regulations that
regulate youth health at the state level in BiH. Still, positive steps can be noticed and
these are aimed toward the creation of youth policy which pays special attention to youth
health and prescribes the passing of regulations which will ensure more care for the
prevention and protection of youth health.
        Mental health policy in BiH is in the process of adoption.145Adoption and
implementation of this policy will definitely bring some positive changes in the treatment
of this group of young patients.
    In a lack of legal regulations in the field of youth health, work of numerous NGOs
who, with a financial support that mainly comes from abroad, implement well designed

145
   Parliament of Republika Srpska has adopted it in 2005, while in the Federation of BH it still awaits its
adoption.



                                                                                                       40
and intensive activities on the prevention and protection of young population health in
BiH, is especially emphasized.

         Having in mind that, after a certain period of time, practice itself imposes the need
for it to be legally regulated, it should be expected that youth health, as a specific field in
the health, becomes an issue on the agenda of BiH legislation. And if it is to be judged by
the concept and content of four national laws mentioned previously, European tendencies
in regulating the youth health will be reflected in BiH regulations as well.


2.1.2.5. Youth policy on state level

        Process of implementation of various activities aimed on particular legal
regulation on State level is forthcoming.
        In this sense, the first step was establishing of the Commission for coordination
of youth issues in Bosnia and Herzegovina, December 2004146.
        Commission acts as a permanent body of the Council of Ministers and activities
predicted by decision of funding are permanent activities of the Commission, except
when the time for realization of certain activity has been determined.147
        One of seven Commission activities is creation of document on youth policy in
BiH. Within this frame, Program of work for year 2006 gives midterm recommendations
related to the youth issues in BiH – one of them is Submission of initiatives and
recommendations for resolutions in social and health area (reaction on current needs of
the youth in BiH)
        The first session of the Commission was held not before 25-26 of January 2006,
while on the third session, the conclusion on the initiative “Proposal on the issue for
health insurance of those youth up to the age of 27 who are not insured, inclusion and
support to the action of Ombudsmen in the Federation of BiH” has been adopted to
support this activities.148
        Certainly, starting base for creation of youth policy is going to be collecting of the
existing reports and surveys on state of youth and research of youth problems in BiH.

In this frame three documents are emphasized here:

       - Plan of action for children of Bosnia and Herzegovina, of Ministry for Human
Rights and Refugees, from 2002;
       - Document Building of youth policy from December 2004;
       - Report of Advisory Mission of Council of Europe for Bosnia and Herzegovina-
Department for youth and sport, from May 2005.
       From the material presented above comes that there is no system conditions for
passing legal regulations which regulate health of youth on state level in BiH. But, having

146
    Commission for coordination youth issues in BiH was established by the Decision of Council of Ministers in
BiH of 16.12.2004. (“Official Gazzette of BiH”, No 33/05)
147
    Activities of the Comission are determinate by articles 7. i 8.
148
      See: Conclusions from III meeting of Comission 31.03.2006, www.mladi.gov.ba.


                                                                                                          41
in mind that in recent time, on both global and European level, more and more attention
has been focusing on the youth, and we saw that in the previous chapters, in Bosnia and
Herzegovina in last couple years many studies have been done on the subject of youth.
Some of these studies make surveys of youth health and other segments which influence
health of this population.
        In this context, we will give short review of results of this research and
recommendations for improvement of youth health in BiH

Plan of Action for Children in BiH 2002-2010149

       This Action plan takes in consideration the children from 0 to 14 years.
Given that the subject of our research are regulations that refer on youth health in age 10-
26 years, and that health in early childhood is very important for development of an
individual, our research has included the relevant issues from Plan of Action for children
of Bosnia and Herzegovina 2002.-2010.

        The Action plan is based on the fact that one third of BiH population is children.
In post war society they are, because of poverty, exposed to: domestic violence, bad
position of children in the institutions, expose to drug abuse, exploitation of children in
other aspects of misuse because of growing poverty.150

        In order of creation of the Action plan, certain areas have been emphasized for
strengthening of children position in BiH, as well as the prior activities in each of them.
They are151:
- Economy development: aim is on provision of resources necessary for achievement
    of all aspect for protection and strengthening of Children Rights.
- Administration of justice and legislative reform – to improve and to adjust legislative,
    judicial and institutional protection toward children.
- Children in relation with Law – to improve education of the children about harmful
    consequences of undesirable activities and behaviors to which they are liable in their
    age and to enforce adequate supervision over this population.
- Health - represents the goals defined by the World Conference for children and it
    compares indicators for Bosnia and Herzegovina. Having in mind that the reform of
    health sector in BiH is on going and the concept of Family medicine with focus on


149
      Ministry for Human Rights and Refugees;- Section for human rights , www.mhrr.gov.ba

150
    „Within the Constitution of Bosnia and Herzegovina (Annex I, paragraph 12) involved The Convention on
children’s rights in it’s legal system and by that become obligate to implement this Convention. Aditional
obligations for Bosnia and Herzegovina come from Optional protocol about children’s involvement in armed
conflicts and Protocol aboud children’s trafficking, and other kinds of sexual abuse of the children (prostitution;
pornography) that Bosnia and Herzegovina signed 07. 09. 2000..
One of the basic goals of the general development of the state of Bosnia and Herzegovina is the improvement the
status of children. The status of children is being covered a lot within our legislative system. That is result of the
legislative reforms that refers all questions related to the children.
See: “Action plan for the children in BiH 2002-2010”, page 2.
151
      See: “ Action plan for the children in BiH 2002-2010”, page 3-38


                                                                                                                  42
    primary health care is being more implemented, it is to bee expected that this concept
    will contribute to improvement of children health.152
- Education – beside the other, through health education to include youth in health and
prevention programs. Document announces adoption of the Law on education on the BiH
level. In the meantime, the Framework Law on primary and secondary education has
been passed and it has already been introduced in this paper.
- Social and Child protection – in order of improvement of social conditions in which
children and youth are living, document provides recommendations for amending of
Strategy against poverty, which was adopted by Council of Ministers in BiH in the year
of 2000.153 It also provides recommendations for obtaining of conditions which would
provide accomplishment of good elementary education for poor children. Special
attention has been given to the children and youth with special needs.154
Regarding the misuse of narcotics, sexual exploitation, addictions, and child trafficking
and other kinds of exploitation, torture and imprisonment, juvenile delinquency,
recommends complementary and coordinated activity of the community, police,
educational institutions, centers for social work and media.155
- Protection of the children from land mines - intensive work on mine cleansing on the
mined areas and education of children on mine awareness.
- Other kind of protection – need to work on decrease of number of working children and
to take measures against child trafficking
        Plan of Action defines who are stakeholders of planned activities both on state and
entity levels.156

In order to provide monitoring of the implementation of Action plan, Council of
Ministers in BiH has established Council for children of Bosnia and Herzegovina.157


Council of Europe- Mission Report on Youth Policy in Bosnia and Herzegovina

      In framework of European action focused on strengthening of youth position in
society and creation of national youth policies, experts of Council of Europe –

152
   See: “ Action plan for the children in BiH 2002-2010”, page 14
153
    See: “Action plan for the children in BiH 2002-2010”, page 35.
154
    See: “Action plan for the children in BiH 2002-2010”, page 37
155
   See: “Action plan for the children in BiH 2002-2010”, page 38
156
    Stakeholders of the planed activities are as follows:
„- at the level of BiH: The Council of Ministers of BiH; Ministry for human rights and refugees; Direction for
European integration; Ministry of the Civil Affaires; The Agency for statistic in BiH.;
-in Brčko District : Government of BD
In the Entities: Governments of the Entities: Governments of the entity and canton-responsible Ministries for
social policy, children’s protection, Ministries for justice, internal affairs, sport, education and culture, health,
Institute for statistic, Funds for children’s protection, Courts, Centers for social work and other institutions for
the children’s protection.“
See: “ Action plan for the children in BiH 2002-2010”, page 8
157
      www.mhrr.gov.ba



                                                                                                                 43
                                                                                                 158
Commission for youth and sport, realized mission for youth in politics in BiH                          ,in
summer 2005.

        Considering the fact that there is no unique regulation in this area Mission
concluded “that there is a need to make effort to move towards culture based on citizen
rights – individual rights. To focus from entity and ethnicity toward citizens”159
Regarding the youth, rights of the youth in BiH should be seen as unique rights that
belong to all young in BiH, and a goal of youth policy to clarify the areas in which young
have right on individual support. The area of youth health certainly belongs here.
        Regarding legal framework for youth politics, Mission feels that it s not necessary
that Law regulates this area, but it would be very beneficial to “adopt necessary legal
framework which would consist the most important areas which refer to young
people”.160 While, under health policy we should not consider the treatment of disease
only but to include all surrounding factors which influence on the health, such are:
distribution of wealth and resources, standard of the family, environment and conditions
for education and work.161

        It is important to have in mind that young people are relatively healthy population
in society, this period their life has key significance for health in later period of their life,
because this is the age of life when the choice of life stile have been chosen.

        According to the UNDP Report „The Youth in BiH 2003”, based on the situation
in the certain areas that have a huge influence on position of the youth in BiH, when there
is a health of youth an issue, the Mission notices that162:
- data about youth health are not completed (UNDP Report 2003, page 18)
- obvious increase of suicides within the youth population, especially male (UNDP
     Report 2003, page 20)
- the youth population have difficulties to access the information about reproductive
     health (UNDP Report, 2003 report 20-21)
- very obvious discrimination towards the young homosexuals (UNDP Report 2003,
     page 21-22)

The Mission issued recommendations on improvements of youth health that require:
   1) completing data on youth health ;
   2) development of the advisory non-medical services, adapted to the youth needs
      especially in the rural area;
   3) to organise powerful informative campaign on sexual and reproductive health,
      firstly through schools, youth activities and mass media with special focus on
      identification and work with special groups of youth, especially homosexuals man

158
   Council of Europe-Head office for youth and sport, Mission on politic of youth in Bosnia and
Herzegovina, 29 Mar - 02 Apr 2005: Report from the advisory mission in BiH. Council of Europe Office in
Sarajevo: http://www.coe.ba/pdf/BHReport_last_version_bos.pdf) www.mladi.gov.ba 11/5/06
159
    „Report of the advisory mission in BiH“, page 6
160
    „Report of the advisory mission in BiH“, page 28
161
    See: „Report of the advisory mission in BiH“, page 44
162
    See: „Report of the advisory mission in BiH“, page 45-47


                                                                                                       44
          and lesbians. It is very important to „normalise” sexual preferences and
          determinations;
       4) promotion of sport and recreation for the youth population.


Document of the World Bank „Development of the youth policy in Bosnia and
Herzegovina”163

        This document was aimed to present various options of policy related to the
problems of youth population, and to direct to the legal departments that are in charge
for development of the youth policy in the process of strengthening youth and solving
their problems in Bosnia and Herzegovina. Survey was aimed to contribute to
establishing of the national strategy for youth issues.
        Regarding health protection of youth, this document emphasises that existing law
regulations do not succeed to provide health insurance for whole youth population.
        According to the Country Assessment Study, the high percentage of
unemployment, avoiding of payment of the state taxes and very huge informal sector are
reason that significant number of the population does not have health insurance. (17% in
F of BiH and 35%u RS).164
        “Estimation of poverty from 2003” shows, that “population between 14 and 24
years”, especially those from the poor families, are not health insured because they are
„hidden in the cracks” of the system and lot of youth are unemployed or employed in
non-formal sector.”165
„For youth this crack means that they do not have any access to the primary and
preventive health protection”, that is vital in all activities related to prevention of the
possible infection of the HIV/AIDS-a.”166

      This document shows that the knowledge about possible risk and infection by
HIV/AIDS has been improved, but not enough.


      2.1.3. Concluding remarks

       As we could see from before, there are only four laws at the state level that could
be seen as those with influence on youth health, due to the state decentralisation. Those
are laws that are trying to follow the European tendencies and international documents
signed by BiH. Regarding the youth policy, the Council of Ministers of Bosnia and
Herzegovina has not adopted yet the framework law on youth, although there are certain

163
    World Bank document:” Building politic of youth in BiH-Involving; Developing and Strengthening the
youth ”. Paula F. Lytle, Diana Marginean, ECSSD, 29. December, 2004.god.
 http://www.mladi.gov.ba/ 11/5/ 2006
164
    World Bank, CAS for BiH, str. 21. u „Building politic of youth in BiH”
165
     World Bank, The estimation of poverty in Bosnia and Herzegovina, November 2003, page. 73 „Building
politic of youth in BiH”
166
    See: „Building politic of youth in BiH” , page 13.



                                                                                                    45
activities aimed to creation of this law. The wide regulations that have huge influence on
youth health exist at the entity’s levels and they will be subjects of the further discussions
and analyses.
         The Laws presented in this part does not contain regulations that treat men and
women differently. Formally, laws treat both sexes equally, but in practice there are many
cases of negative behavior towards women, mainly because, in practice, they are not
considered as equals. The implementation of the Gender Equality Law, considering that it
emphasises equality of women, surely contributes to the improvement of status and by
that also the health of women (mental health, sexually transmitted diseases; violence etc.)
        Regarding regulations related to the vulnerable population of youth, the
regulations impacting health of these groups can be found within the Law on prevention
of drug abuse. This Law is dedicated to protection of the vulnerable youth group in the
sense of prevention of using drugs.


2.2. LEGAL REGULATION OF YOUTH HEALTH IN THE FEDERATION
     OF BOSNIA AND HERZEGOVINA

        The purpose of this part is to elaborate legal regulations adopted on the Federal
level that influence youth health. Additionally, some regulations on cantonal level will be
elaborated as well. This part will outline some recent changes happening in this field, as
well as constitutional framework on the level of Federation of BiH.

2.2.1. Constitutional framework of the Federation of BiH

        Constitution of the Federation of BiH, within its General provisions of Chapter I,
Article 2, prescribes that the Federation will provide the highest level of implementation
of internationally recognized rights and freedoms defined by the acts stated in the
Constitution Annex and, especially, among other, protection of the family and children.

        In Chapter III, Article 2 defines the distribution of authorities between the state
and cantons so that health sector and social policy are under mutual authority of both
levels of government. According to Article 3, and in accordance with the needs, this
authority is achieved jointly or individually or by the canton with coordination from
Federal authorities. Besides, cantons have all authorities that are not exclusively given to
Federal authorities and they are especially in charge in the field of determining the
education policy and implementation of social policy (Article 4).

2.2.2. An overview of legal regulations which influence the health of youth in the
Federation of BiH.

    In the Federation of BiH, regulations which regulate or influence the health of youth
are contained in the:

       -   Law on Health Protection167
167
      „Official Gazzette of the Federation of BiH“, No 29/97


                                                                                           46
      -   Law on Health Insurance168
      -   Law on the Basis of Social Protection, Protection of Civil War Victims and
          Protection of Families with Children169
      -   Law on Retirement and Disability Insurance170
      -   Law on the Protection of Persons with mental disorder171
      -   Framework Law on Primary and Secondary Education in BiH172
      -   Family Law173
      -   Law on Protection from Domestic Violence174
      -   Labor Law175
      -   Law on Limited Consumption of Tobacco and Tobacco Products176
      -   Criminal Law177
      -   Criminal Procedures Law178
      -   Law on Bases of Transportation Safety on the Roads in Bosnia and
          Herzegovina179
      -   Law on Displaced Persons - Expatriates and Refugees – Returnees in the
          Federation of Bosnia and Herzegovina180

       If the material allows us, and within the regulations that we analyze, we will
emphasize the regulations which refer to the vulnerable and especially vulnerable groups
of youth and point out situations when regulations differently influence young women
and young men.

(1) Law on Health Protection

        According to this Law, the authorities within the field of health protection for
citizens of the Federation of BiH are divided between the Federation and cantons
(Articles 7, 8, 9).

The Law prescribes:


168
    „Official Gazzette of the Federation of BiH“, No 30/97
169
    „Official Gazzette of the Federation of BiH“, No 36/99
170
    „Official Gazzette of the Federation of BiH“, No 29/98
171
    „Offciial Gazzette of the Federation of BiH“, No 37/01

172
   General law on primary and secondary education at the state level, unanimously adopted by the BiH
Parliament, and took effect on July 4th 2003. Legal regulation on primary and secondary education at all
levels of cantons, in Republika Srpska and Brčko District has been harmonized with General law.
www.oscebih.org/documents 11/23/ 2006.

173
    „Official Gazzette of the Federation of BiH“, No 35/05
174
     „Official Gazette of the Federation of BiH“, No 22/05
175
    „Official Gazzette of the Federation of BiH“, No 43/99 i 29/03
176
    „Official Gazette of the Federation of BiH“, No 6/98, 35/98 and 11/99
177
    „Official Gazzette of the Federation of BiH“, No 36/03
178
    „Official Gazzette of the Federation of BiH“, No 35-36/03
179
    „Official Gazette of BiH”, No 6/06.
180
    „Official Gazette of the Federation of BiH“, No 19/00


                                                                                                           47
- that all citizens are obliged to take care of their health and to participate in all
preventive activities (Article3).

- that the ministry in charge of education, through its curriculums, is to provide the
health education of preschool children and students (Article 4).

 - regarding the organization of implementation of health protection, it does not
prescribes a special protection for youth so that, in the context of our study, it can be seen
as a part of family medicine and school medicine. Regarding genders, it prescribes a
special protection for women and children (Article 6).

- the principles of the implementation of health protection of citizens are:
comprehensiveness, continuity, accessibility and a thorough approach in the primary
health care (Article10).

- within the measures of health protection that relate to all categories of citizens, it
specially emphasizes the need for the provision of a comprehensive health protection
for children and youth, as well as women regarding the family planning, pregnancy,
delivery and maternity. Taking of those measures is within the authority of cantons
(Article 16).

- during the organization and implementation of health protection, within the primary
health care, the law emphasizes the health care and improvement of health among
students, youth and sportsmen (as well as persons above 65 years-of-age, invalids and
other persons (Article 20). When mentioning the measures which are implemented by
primary health care, the law emphasizes the preschool children, women prior, during and
after the delivery, persons with developmental disorders but not youth.

Remark: Law on Health Protection of the Federation of BiH does not contain
regulations which specifically regulate the health protection of youth.

(2)Law on Health Insurance

The Law prescribes that:

- citizens of the Federation, under conditions prescribed by this law, have a right on
health insurance, which includes: compulsory health insurance, extended health insurance
and voluntary health insurance (Article 2).

- Compulsory health insurance have people who are employed and other persons who
perform certain jobs or have certain characteristics, jointly called the insured. When
prescribed by this law, the right on compulsory insurance have members of the family of
the insured as well (Articles 3 and 4). In the law, family members of the insured are
called insured persons.




                                                                                           48
Therefore, health protection of youth which are not employed, and the majority
isn’t, is provided through a belonging to a family of the insured.

- beside persons who are employed, unemployed persons under the terms prescribed by
this law can also have a compulsory health insurance. Although the law does not deal
with issues of health insurance among youth, regulations that refer to youth can be found
in Article 19, items12, 13 and 14, which describe the conditions under which unemployed
persons, students above 15 years-of-age and persons who lost their status as a student can
meet the right on compulsory health insurance.

- regarding youth who meet their right on health insurance as members of families of the
insured, the law (Article 22) provides them with an insurance until their 15th year of life
and if they are regular students – until they reach 26 years. The law does not define
special solutions for vulnerable and especially vulnerable groups nor does it make
the difference between genders.

- if youth can not achieve their health protection through the family, the law provides
insurance for students from secondary schools and universities but only if they are BH
citizens (Article 25).

- the law provides insurance for persons incapable of independent life and work equal to
the insurance prescribed for family members of the insured. There are no special
provisions on youth or vulnerable groups here either (Article 26).

- through compulsory health insurance, under the regulations given by this law, the
insured and insured persons are guaranteed health protection and travel expenses that are
related to the achievement of health protection (Article 31).

- when talking about youth, the scope of health protection provided by this law, includes
health protection for children until 15 years-of-age and health protection for regular
students (Article 32).

        Regarding the achievement of rights from the field of health insurance, primarily
health protection, a special problem exists in BiH – the distribution of funds between
entities and, within the Federation of BiH, between cantons. That is why the youth, same
as other beneficiaries of this right, achieve their right on health protection primarily
within their cantons, i.e. entity, which means that when they try to meet their rights
outside of their cantons and entities they face many problems and difficulties. Inter-entity
and inter-cantonal agreements and measures that are undertaken in order to overcome the
negative consequences of such legal solutions are still insufficient for the provision of
adequate coverage of youth with health protection.181



181
  See “Legal framework of health protection and health insurance in BiH“
www.job22.lol.ba/zdravstvena_zaštita_osiguranje.pdf 11/28/2006.



                                                                                         49
Remark: Law on Health Protection contains provisions which influence the health
of youth. There is a need for those provisions to be better adjusted to the needs of
youth in order to achieve the coverage of entire population of youth with health
insurance and easier accessibility to its achievement. The law does not make the
difference between genders nor does it contain special provisions on vulnerable
groups.

(3) Law on the Basis of Social Protection, Protection of Civil War Victims and
Protection of Families with Children

        When talking about child protection, this law considers persons below 18 years-
of-age as children and, under prescribed conditions, until 27 years-of-age (Article 6). The
Law gives the authority to cantons to regulate social protection activities (Article 8).
When searching for the provisions which refer to youth, in Article 12 we found the listed
categories of persons who are social protection beneficiaries, including: children deprived
of parental care, pedagogically neglected children, children whose development is
disturbed by family circumstances, persons with invalidity and persons disturbed in their
physical or psychological development, person with socially negative behavior182.
Besides, a person with socially negative behavior is a person who “does nothing, wonders
around and begs, who is involved in the prostitution, alcoholism, drug addition and other
types of socially negative behavior” (Article 17), which all are vulnerable or especially
vulnerable groups. Also, the law provides protection for persons in the state of social
need which correlates with our definition of vulnerable and especially vulnerable
persons. Actually, according to Article 18, it is “a person, i.e. family, who finds itself in
the state of need due to the forced migration, repatriation, calamities, death of one or
more family members, returning from medical treatment, dismissal from prison or after
pedagogical measures”.

       Also, under certain conditions, the law prescribes a financial help (Articles 22-23)
and enabling for living and working (Article 29) to certain categories of persons and
children so we can say that it contains regulations that refer to vulnerable and
especially vulnerable groups.


182
    Article 12. Beneficiaries of social protection, in relation to this law, are persons who are in the state of
social need, such as:
1) children deprived of parental care,
2) pedagogically neglected children,
3) children whose development is disturbed by family circumstances,
4) persons with invalidity and persons disturbed in their physical and psychological development,
5) financially uninsured and for work incapable persons,
6) elderly people without family care,
7) persons with socially negative behavior,
8) individuals and families in the state of social need who, due to special circumstances, need an
appropriate kind of social protection.
Cantonal regulations can widen a circle of social protection beneficiaries from Paragraph 1 of this article, in
accordance with social protection development programs and specific circumstances in the canton.




                                                                                                            50
        Certain contribution to the health of youth will be provided by the provisions of
this law which prescribe the protection of families with children by helping families
financially and other types of help, in order to help families raise their children, take care
of them and equip them for independent life and work, for the best interest of a child
(Article 87).

Remark: The law provides social protection of youth and contains special provision
on vulnerable and especially vulnerable groups.

(4) Law on Retirement and Disability Insurance

        The law defines categories of people who have compulsory pension and disability
insurance and people who, according to this law, have status of the insured of compulsory
insurance (Articles 8-18). Through retirement and disability insurance rights defined by
this law are ensured under prescribed conditions and for youth while they are under
certain conditions such as the practical work during their classes or during youth actions,
public works or if they are engaged through youth services (Article 16).

        It can be noticed that the law does not explicitly defines a disability insurance in
case of accidents during education (e.g., in school during classes) whose consequence is
invalidity.

Remark: To a certain extent, the law contains provisions which directly influence
the health of youth.

(5) Law on Protection of Persons with Psychological Disturbances

    This law encounters children whose age is up to 14 years and person who is 14-18
years-of-age and who are capable of working is, according to the law, a minor person
(Article 3).

Remark: Only in one place, the law pays a special attention to youth – if the
psychiatric treatment in health institutions prescribes special and separate
departments meant for the treatment of children and youth (Article 12).

(6) Framework Law on Primary and Secondary Education

        In the Federation, Framework Law on primary and secondary education in BiH is
in use which has been presented in the Chapter No.2.1. of this paper. Since cantons have
special mandates in defining the educational policy, all cantons have their laws in this
field.

       Having in mind that Framework Law has significantly adopted a modern
European tendencies regarding the insurance and health promotion for school children
and that cantonal regulations are coordinated with this law, we did not perform an
individual analysis of cantonal laws.


                                                                                           51
(7) Family Law

       Within the frame of rights and duties of children, the law defines the child’s right
on taking care of their own life, health and personal development (Article 124). It also
defines that a child has a right to get a job which does not harm its health and its
development (Article 126) and, within the family, it has a right to be protected from all
types of violence, abuse, misuse and neglect (Article 127).

        In Article 134, the law explicitly prescribes the duty of parents to take care of
their child’s life and health and it states that they are obliged to protect him/her from all
types of vices (drugs, alcohol, prostitution, sexual abuse, economic exploitation etc.),
which definitely influences the health of youth.

         In case that the family can not provide adequate care for a minor, organ of
guardianship can, for the best interest of a child, send child to another family or
institution (Article 147). In case parental rights are misused or if the child is not provided
with necessary help and protection, the court will deprive parents of their parental right
(Article 154).

Remark: The law contains provisions aimed at the protection of health of children
and youth and it promotes equality among genders.

(8)) Law on Protection from Domestic Violence

       This law regulates the protection from domestic violence and by that it only takes
into account a family member category. There is no provisions specifically related to
youth.

Remark: The law does not contain special provisions that would indicate or
influence the youth health protection but generally, it provides protection for
children as family members.

(9) Labor Law

        This Law contains more provisions related to health protection of youth workers,
as well as women:

        In Article 7, it is prescribed for an employee who is above 15 and below 18 years-
of-age (further in the text referred as: a minor) to have a special protection. It also
prescribes special protection for employed women during pregnancy, delivery and
maternity.

        The law does not allow for a minor to sign a job contract if the job could harm
his/her health, moral or development (Article 15). It also does not allow overtime work
for minors (Article 32); it forbids night work for employed minors (Article 36). Those
rules are sanctioned according to Criminal law (Article 280).


                                                                                           52
       This Law differentiates between a minimum daily rest for minors and other
employees and it defines the minimum of vacation for minor employees (Article 38),
defining the minimum of annual vacation of 24 working days, which is 6 days more
compared to other employees (Article 41).

        Furthermore, the Law explicitly forbids for minors to perform certain types of
jobs183 as well as for women.

Remark: Labor Law in the Federation of BiH contains multiple provisions which
refer to a special protection of youth and women, which definitely influences the
health of youth and women as special youth groups.


(10) Law on the Limited Consumption of Tobacco and Tobacco Products

      Aimed toward the prevention and removal of negative consequences of tobacco
consumption, this law regulates a limited consumption of tobacco products, duties of
manufacturers, banning of advertising and selling tobacco products (Article1).

         The Law strictly forbids the consumption of tobacco products (i.e. smoking) in
educational institutions, institutions for accommodation of children and students, health
institutions, social institutions and other public institutions (Article 3).

        The Law limits the manufacturers and sellers in informing about new products
and it specifically forbids announcing it on radio or TV, as well as in publications meant
mainly for youth (Article 11).

        Furthermore, it explicitly forbids the selling of tobacco products at places that are
less than 100 meters away from pre-school institutions and schools or which are located
within sport areas and sell tobacco products to persons below 15 years-of-age.

        Still, we have to emphasize that the age limit regarding the banning of selling of
tobacco products to youth is below the limit that was set by the WHO, in its Framework
Convention on Tobacco Control (FCTC). In the Federation of BiH the limit is 15 years-
of-age and FCTC defined the limit to be 18 years-of-age. Here we will mention that
regulations from Republika Srpska set this limit to 18 years-of-age, which shows that
there are different approaches toward the issues of youth health within one state.

Remark: This Law contains provisions aimed at the health protection of youth.
However, they could be more in line with FCTC and more strictly implemented.


183
   Article 51. A minor can not perform an extremely difficult physical work, work under ground or water
or other jobs that could harm and increase the risk on their life and health, development and moral, taking
into account its psycho-physical characteristics.
Through a special provision, Federal Minister will define jobs from line 1 of this article.
Labor inspector will ban the work of minors on jobs defined by Paragraph 1 of this article.


                                                                                                          53
(11) Criminal Law

       The Law defines a child as a person below 14 years-of-age and a minor is a
person below 18 years-of-age (Article 2, lines 9 and 10).

        The Law excludes the implementation of criminal legislation toward children
below 14 years-of-age and special rules on educational recommendations, correctional
measures and punishment are implemented for minors (Articles 9 and 10). In articles 80-
83, the law regulates the conditions, types, purpose and choice of recommendations and
in Article 84 it regulates sentences for minors and states that older minor can be
sentences to a juvenile prison only exceptionally.184 The law defines the category of
junior adult with a possibility of milder punishment (Article105). It defines special
circumstances of serving the sentence for minors and older adults, which are juvenile
prison or a special unit within the prison where contacts with older prisoners are avoided
(Article 113).

        If the criminal act of rape has been performed against a minor, the lowest
sentence is higher than the one prescribed for an adult victim (Article 203, line 6); in
Article 207 – sentences for sexual intercourse (are mild); Article 210 - line 4 especially
sanctions the persuasion into prostitution; Articles 219 and 220 sanction the neglecting,
abuse and abandoning of a child; Article 237 sanctions serving of alcoholic drinks to
younger minors; Article 239, line 2, especially sanctions enabling the minors of drug
possession and drug consumption.

Remark: Criminal law contains provisions are aimed toward a special health
protection of minors and protection of their personality. It also contains regulations
regarding especially vulnerable groups. (Actually, in Chapter X, it prescribes special
pedagogical measures for minors who violated the law.)


(12) Criminal Procedures Law




184
    Article 84.
Criminal sanctions for minors: (1) pedagogical measures and certain safety measures can be prescribed for
a minor criminal offender and a sentence of juvenile prison can be prescribed for older minor exceptionally.
(2) A minor who, at the time of a crime, turns fourteen and has not turned 16 (younger minor) can be
prescribed with only pedagogical measures.
(3) A minor who, at the time of crime, turned sixteen and has not turned eighteen (older minor) can be
prescribed with pedagogical measures under the conditions prescribed by this law and, exceptionally, could
be sentenced to a juvenile prison.
(4) A minor could be prescribed with safety measures under the conditions prescribed by this law. Safety
measures can be prescribed for minors under conditions prescribed by this law.
(5) A minor can not be warned by a court nor be on a parole.




                                                                                                         54
        A special chapter of the law (Chapter XXVII) is dedicated to a criminal procedure
against minors. Regulations can be found in articles 361 -395.

Remark: Criminal procedure law contains special provisions regarding the
procedures for minors and, in that way, it influences the protection of minors’
personality and health.

(13) Law on Bases of Transportation Safety on the Roads in Bosnia and Herzegovina

       This Law has already been dealt with within the frame of BH regulations.
According to Article 2, the state, entity and cantonal organs are obliged to provide a
thorough implementation of this law.

Remark: The conclusion remains that the Law, through a comprehensive regulation
of the field of traffic, contributes to the protection of the health of youth, with a
precondition that the Law is thoroughly implemented.

(14) Law on Displaced Persons-Expatriates and Refugees-Returnees in the Federation of
Bosnia and Herzegovina

        In Article 6, the law prescribes the recognition of certain rights in accordance with
this law, other federal laws and cantonal regulations: for displaced persons-expatriates
and refugees-returnees who came back to their previous place of living but not to their
own house or apartment due to their detriment or occupation. The cantonal organ defined
by cantonal regulation (Article 7) decides upon the recognition of their rights. For those
persons, among other, social adaptation, psychological support, health protection,
education of children and youth and, in accordance with financial capabilities of canton,
other rights are provided (Article 11).

Remark: In this Law, we find regulations on health protection of displaced persons
and returnees as members of vulnerable groups in the context of our study, bur
there are no specially separated youth categories.



2.2.3. Recent changes related to legal regulation of youth health in the Federation
       of BiH

        Except for the presented legal regulations which regulate or influence the health
of the youth in the Federation of BiH, strategies and programs in the process of passing
and the proposed changes of existing laws have a significant influence. Those include:

        - A draft of the Law on changes of the Law on limited consumption of tobacco
and tobacco products. The proposed changes refer to a banning of direct or indirect
advertising, designing the package with a warning on smoking harm, banning the




                                                                                          55
smoking in public places. This law could have been adopted already but the interests of
the tobacco industry are preventing it.

        - Federal program for the prevention of alcoholism, drug addiction and other
addictions from 2004 has not been adopted yet.

       - A strategy of fighting against smoking, proposed in 2004 has not been adopted
yet.

       - Strategy for sexual and reproductive health has been prepared but adopted yet.

       - Strategy for primary health care is in the process of adoption.

        - A proposal for the Strategy for health promotion in the Federation of BiH is in
the preparation phase and it will deal with the improvement of health among school
children and youth.

        During the period 1999-2003, a Project on Health Promotion in Schools was
conducted (so called “Healthy schools”) with support from WHO, in both the Federation
of BiH and Republika Srpska Unfortunately, local institutions did not manage to sustain
it and to continue it. For now, there are initiatives for schools to introduce a subject on
health promotion but there are no concrete steps forward yet.

Remark: From the above mentioned, it can be concluded that in the health system
of the Federation of BiH there are numerous activities aimed toward the
improvement of youth health but the road to its elevation to legal regulation level is
often a very long one.

2.2.4. Legal regulation of youth health in cantons

       As we have emphasized at the beginning of this chapter, according to the
Constitution of the Federation of BiH, legal authority in the field of health belongs to the
Federation and cantons. It is achieved jointly so that the policy is defined at the level of
the Federation of BiH and the cantons organize the implementation of health protection
in accordance with their specific needs and possibilities.

        Regarding legal regulations which regulate or influence youth health in cantons of
the Federation of BiH, we will not perform a survey on legislation in all ten cantons due
to the size of this field. Still, having in mind that legal authority of cantons follow the
framework of Federal laws and in order to avoid repeating, we will give an overview of
concrete activities aimed toward the improvement of youth health in several cantons.

2.2.4.1. Bosansko-Podrinjski canton GORAŽDE

        In this canton, the Forum of youth from Bosansko-Podrinjski canton Goražde is
actively working. One of the goals of the organizing of the Forum is an increase of


                                                                                            56
economic and health standards among the youth. During 2005, the Forum prepared an
Action plan for youth which was adopted by the Canton Government. The Government
ordered all ministries, bodies and departments to plan and implement the Action plan
projects.185

       The Action plan for the youth defines six areas of action. In the field of health, the
following health problems among the youth were noted: physical non-activity, nutrition
disturbance, dependency diseases and other diseases, reproduction health (sexual
intercourse, sexually transmitted diseases ad unwanted pregnancy), injuries, mental
health and discrimination on basis of disease. For each of these health problems,
measures for their solution were defined and put into the 2005-2007 timeframe.

       In the field of social policy aimed toward the youth, special attention was given to
persons discriminated on basis of their health status (young addicts, youth with incurable
diseases, youth with infectious diseases, youth with special needs) and delinquents.

2.2.4.2. Zenica – Doboj canton

        In this canton, an Advisory council for youth is active. Among the goals of its
work are the improvement of the status and standard of the youth, as well as activities on
the implementation of European standards regarding the status of the youth. One of the
tasks of the Council is to prepare youth projects in all segments of the society, including
the health of the youth.186

2.2.4.3. Canton Sarajevo

        This canton still does not have a defined policy regarding the youth. The Cantonal
Ministry of Health is basing its projects regarding health protection of the youth on article
16 of the Law on Health Protection of the Federation of BiH.187

2.2.4.4. Tuzla canton

       An Advisor for youth issues operates within the Cantonal Government. A policy
on youth has not yet been defined. An initiative exists for adopting an action plan
regarding the youth which will give special attention to the health of the youth.188

2.2.4.5. Una–Sana canton

        There is no special department for the youth within the Cantonal Government and
there is no policy regarding the youth. Parallel with the regular activities of the Ministry

185
      Forum mladih BPK Goražde – Activity report for 2005.; www.bpkgo.ba 11/25/2006
186
    Information obtained in the Government of the Zenica-Doboj Canton, 11/28/2006
187
    Information obtained in the Ministry of Health of the Sarajevo Canton, 11/28/2006
188
    Information obtained in conversation with the Asdvisor for youth issues in the Tuzla Cantonal
Government, 11/28/2006


                                                                                                    57
of Health and the Public Health Institute on health protection of the youth, the Ministry of
Internal Affairs in cooperation with non-governmental institutions is undertaking actions
on prevention of asocial behavior among young people and the prevention of the use of
drugs. It has been established that there is a need for more care and attention for the youth
in the family as well as in school and all other governing institutions.189

2.2.4.6. Herzegovina–Neretva canton

       A Commission for youth issues is active within the Cantonal Assembly, which
undertakes certain activities on the improvement of the health of the youth but no
concrete document has yet been produced.190

2.2.5. Concluding remarks

        In our efforts to present an overview of regulations which regulate or influence
youth health in the Federation of BiH, we have analyzed fourteen laws. This number has
confirmed the initial statement that youth health requires a multidisciplinary and inter-
sectoral approach, including disciplines which, at a first glance, do not have any
connections with health.

        The analysis has shown that some of these laws contain regulations directly aimed
at the protection of youth health, while provisions of other laws refer to all citizens and,
in its context, the youth is covered with its action. Except for the regulation of Labor
Law, Law on the Basis of Social Protection, Protection of Civil War Victims and
Protection of Families with Children, Family Law, Criminal Law and Criminal
Procedures law, other regulations are not formulated sufficiently clear so that some issues
remain unregulated or they open a possibility of different interpretations.

       A need for special legislation treatment of vulnerable and especially vulnerable
groups, except in few laws, is almost neglected.

       Beside the Labor law, which forbids women to perform difficult jobs, Law on the
basis of social protection, Law on health protection and Law on health insurance that
provide special protection to women related to maternity, the presented regulations do not
contain provisions which differently treat young women and men.

       Except for legal regulations, work on the adoption of strategies and programs
which, through an active implementation, can significantly contribute to the improvement
of youth health in the Federation of BiH, is ongoing.

2.3. LEGAL REGULATION OF YOUTH HEALTH IN REPUBLIKA SRPSKA

The purpose of this part is to elaborate legal regulations adopted on the level of
Republika Srpska that influence youth health. This part will outline some recent changes
189
      Information obtained from the Cantonal Government and Interior Ministry 11/28/2006
190
      Information obtained in the cabinet of the Chairman of the Assembly, 11/29/2006


                                                                                           58
happening in this field, as well as constitutional framework on the level of Republika
Srpska.


2.3.1. Constitutional framework of Republika Srpska

        Chapter II, article 37, of the Constitution of Republika Srpska foresees that
everybody has the right to health protection and this right is guaranteed by the law. Apart
from that, children, pregnant women and the elderly have the right on protection to be
covered form public funds, and other persons, as prescribed by the law. Article 36
prescribes that the family, mother and child, as well as minors deprived of parental care,
enjoy special protection.

In article 68, the Constitution states that Republika Srpska regulates and provides, among
other, social protection, health, education and care of children and youth.

2.3.2. Overview of legal regulations which influence youth health in Republika
       Srpska

       In Republika Srpska, regulations which refer or could influence the health of the
youth are contained in the following laws:

-       Law on Health Protection191
-       Law on Health Insurance192
-       Decision on the Minimal Basic Package of Health Protection193
-       Law on Social Protection194
-       Law on Retirement and Disability Insurance – cleaned version195
-       Law on Protection of Persons with Mental Disorders196
-       Law on Primary School and Law on Secondary School197
-       Law on High Education198
-       Family Law199
-       Law on Protection from Domestic Violence200
-       Criminal Law201
-       Criminal Procedure Law202

191
     „Official Gazette of Republika Srpska”, No 18/99, 58/01i 62/02
192
     „ Official Gazette of Republika Srpska”, No 18/99, 51/01 i 51/03
193
     „Official Gazette of Republika Srpska”, No 21/01
194
    „Official Gazette of Republika Srpska”, No 5/93, 15/96 i110/3
195
     „Official Gazette of Republika Srpska”, No 106/05
196
     „Official Gazette of Republika Srpska“, No 46/04
197
     „Official Gazette of Republika Srpska“ No 38/04
198
    „Official Gazette of Republika Srpska“, No 85/06
199
      „Official Gazette of Republika Srpska“, No 54/02
200
      „Official Gazette of Republika Srpska“, No 118 /05
201
      „Official Gazette of Republika Srpska“, No 49/03


                                                                                         59
-     Labor Law203
-     Law on the Ban of Smoking of Tobacco Product on Public Places204
-     Law on the Ban of Sale and Consumption of Tobacco Products to Persons below 18
      years-of-age205
-     Law on Child Protection206
-     Law on Organizing of Youth207.

Other documents and policies

-     Strategy for the Promotion of Health in Republika Srpska, 1999208
-     Program of Health Policy and Strategy for Health in Republika Srpska until 2010209

(1) Law on Health Protection

    In its Article 2, the Law foresees that health protection provides the highest level of
health of the citizen as an individual, their families and the society as a whole and in
Article 9 it defines the principle of equality in providing health services.

Remark: The Law does not contain provisions that specifically refer to the youth
health or the health of members of vulnerable categories.

(2) Law on Health Insurance

        According to this law, compulsory insurance is foreseen for persons who are
employed, persons who are performing certain types of jobs, war invalids, refugees and
displaced persons, as well as in the cases prescribed by the law also the unemployed,
irregular students and others foreseen by this law. The youth is not specifically mentioned
(Article 10).

       If we are looking for provisions referring to health insurance of the youth, they
achieve their health protection right if they are children of the insured, and that only until
they are 15, i.e. until they reach 26 years-of-life if they are regular students, i.e. until 27
years-of-age if during the regular schooling he/she had to serve military (Article 16).

      The rights arising from compulsory health insurance are health protection and
compensation of the salary for the time of temporary disability for work.



202
     „Official Gazette of Republika Srpska“, No 50/03
203
    „Official Gazette of Republika Srpska”, No 38/00, 40/00, 47/02, 38/03
204
     Official Gazette of Republika Srpska” No 46/04
205
    „Official Gazette of Republika Srpska” No 46/04
206
    „Official Gazette of Republika Srpska” No4/02
207
    „Official Gazette of Republika Srpska” No 98/04
208
     http://www.pcuhealth.org/projekti/hsep/grantovi/grantovi/htm
209
     http://www.pcuhealth.org/projekti/hsep/grantovi/grantovi/htm



                                                                                            60
       Having in mind that the Law prescribes the obligation of personal participation of
the ones insured in the costs of health protection, at the same time it defines certain
categories which are excluded from this rule. This includes children below 15 years-of-
age and pregnant women (Article 45).

Remark: The Law contains provision referring to the youth health as well as
vulnerable groups. It separately regulated the protection of pregnant women.

(3) Decision on the Minimal Basic Package of Health Protection

    Article 3 of the Decision prescribes that the complete health protection, in
accordance with Article 19 (this article lists everything health protection covers), is being
provided to certain categories of population, including children below 15 years-of-age
and women during pregnancy, delivery and up to one year of child’s age.

(4) Law on Social Protection

        Article 3 of the Law prescribes that social protection is provided to citizens in the
state of social need and Article 10 specifically lists certain categories of minors who
enjoy this protection. Article 18 also defines the same for adults with socially
unacceptable behavior, including young adult addicts.

Remark: The Law contains provisions which influence the youth health, as well as
the health of especially vulnerable youth groups.

(5) Law on Retirement and Disability Insurance – cleaned version

        The Law defines categories of persons who have a compulsory retirement and
disability insurance in the Fund and persons who are recognized as the insured by
voluntary insurance (Article 11-15), according to this law – the category of the youth is
not mentioned.

       It also prescribes compulsory insurance of persons under certain conditions,
mainly when young people perform practical work during classes or on youth actions,
public works or while working through the youth service (Article 16).

It should be noted that the Law does not foresee disability insurance in case of accident in
school (e.g., in the school during classes), which results with a disability.

Remark: The Law contains provisions which provide compulsory insurance for the
youth but only under certain conditions.

(6) Law on Protection of Persons with Mental Disorders




                                                                                          61
    The law does not specially regulate the category of youth but it does contain
provisions on minors. According to Article 3, item 11, a minor is a person above 14 years
of age but who has not turned 18.

The law prescribes that psychiatric treatment of children and minors be provided at
special departments of health institutions meant for the treatment of children and youth
and separated from the department for adults (Article 13).

(7) Law on Primary School and Law on Secondary School

    As one of the goals of primary education, the law on primary school defines “the
gaining of knowledge and raising the awareness on the need of taking care of health as
well as the preservation of nature and human environment” (Article 2), while the goal of
the Law on secondary school is “the development of psychological and physical
characteristics of students” (Article 3).

     As a severe violation of the student’s obligations, the law on primary school defines
the consumption or inciting the students to consuming tobacco, alcohol and narcotics, and
`
     The education of children with special needs is regulated by the Articles 87-97 of the
Law on primary school.
     The Law on secondary school prescribes that the respective organ of authority and
the secondary school are jointly responsible “for the provision of school facilities,
equipment and accompanying infrastructure for the unobstructed access and participation
in educational process of handicapped and invalid children, youth and adults” (Article
21).
     In it’s Article 23, the Law prescribes joint activities of school, parents, children and
community on the prevention of negative behavior which harm the student’s health
(drugs, smoking, alcohol, abuse etc) and in Article 77 it prescribes the organization of out
of class activities which contribute to the acquiring of useful living habits.
     For children with special needs, the Law on secondary school prescribes a special
program of education in regular or in special schools (Articles 49 and 50).

    The Law has a special provision on student’s health and prescribes that the care of
the health condition of the students is the obligation of the school and it’s employees
(Article 70)

Remark: The Law contains provisions which influence the youth health, but not
health of specially vulnerable youth groups.

(8) The Law on High Education

    The Law foresees that students with physical handicaps have the right to have an
exam in a way which is adjusted to their capabilities, in accordance with the statute of the
high education institution (Article 37).




                                                                                          62
Except for the provision which states that the high education institution can provide an
organized accommodation for students (campus), there is no mention of activities aimed
toward the protection of student’s health both during the classes and in general, during
the out of class, free time of the students.

Remark: The Law hardly contains provisions which influence the youth health.


(9) Family Law

     In it’s Article 3, the Law prescribes that the RS provides necessary protection for the
family, mother and child in accordance with the internationally recognized human rights
and basic freedoms, and in Article 6, the obligation of parents to take care of the child’s
life and health, it’s upbringing, raising and education is defined.
     A child should not be abused or neglected within the family and if so, the organ of
guardianship can give the guardianship to another parent or institution (Article 97). Still
if the parents abuse or neglect the child, the court will deprive them of their parental right
(Article 106).

Remark: The Law contains provisions which influence the youth health, but not
health of specially vulnerable youth groups.


(10)   Law on Protection against Domestic Violence

     This law does not establish special provisions for children and youth but treats them
as other family members. The only exception is that it foresees higher punishments for
the violent acts performed in front of a minor person or against a minor person (Article
20, item 3 and 4).

Remark: The Law contains general provisions for all family members but they can
influence the youth health.


(11)   Criminal Law

     The law differentiates between the category of the youth, i.e. the minors and adults
regarding the punishment, so that a long term prison sentence (25 to 45 years) cannot be
given to a person who was younger than 21 when the crime was committed as well as to a
pregnant woman (Article 32. item 4).
     Also, it foresees a special kind of sanction for minors who committed a criminal act
(pedagogical measures, recommendations and punishments for minors (Chapter VI of the
Law).
     Apart from that, no criminal sanctions can be applied against a minor who at the time
of the criminal act has not turned 14 (Article 64).




                                                                                           63
    The Law specially treats criminal acts against a child, a minor or a pregnant woman.
Those acts are severely qualified and more severe sanctions are prescribed in comparison
to when the victim is an adult (Articles 149, 168 and 192).

Remark: The Law contains special regulation aimed toward the protection of
physical and personal integrity of minors and women during pregnancy, whether
they are victims or perpetrators of the criminal act.

(12)   Criminal Procedure Law

     Speaking of criminal procedures, the law prescribes special rules for the conducting
of the procedure against minors. Chapter XXVI, Articles 346, 380, are dedicated to this.
These provisions are applied against a person who committed a criminal act as a minor
and during the initiation of the procedure is below 21 years of age; during the conduction
of the procedure, careful handling is prescribed in order to prevent harmful influence of
the procedure on the young person’s development; Only in exceptional cases will
detention be prescribed when a minor is detained separately from adults; during the
procedure against the minor, the public is always excluded.

Remark: This Law contains provisions relevant for the health of the young
perpetrators and this way influences especially vulnerable group of youth.

(13)   Labor Law

    This Law provides special protection for minor workers as well as for women during
pregnancy and maternity. The regulations are very similar to those contained in the Labor
Law of the Federation of BiH.

Remark: It can be said that the Law contains provisions which influence the youth’s
and women’s health.

(14)   Law on the Ban of Smoking Tobacco Products on Public Places

     In order to protect non-smokers and risk group, where minors belong too, the Law
prescribes the ban on smoking tobacco and tobacco products on public places (Article 1).
If smoking is allowed in some rooms, there has to be a sign on a door saying that persons
below 18 are not allowed to enter (Article 4).

Remark: The Law contains provisions aimed toward the protection of the youth’s
health.

(15) The Law on the Ban of Sale and Consumption of Tobacco Products to Persons
    below 18 years of age

    The Law prescribes: the ban on the use, sale and giving away as a gift tobacco and
tobacco products to persons below 18 years-of-age and by persons below 18 years-of-



                                                                                       64
age, the ban of sale on certain locations and defines the obligation of educational
institutions in regard of what the law prescribes (Article 1).

Remark: The Law contains provisions aimed to protect the youth health and it
follows WHO FCTC directions.

(16)       Law on Child Protection

    The Law defines the obligation of parents and the state to create conditions and
provides a normal psycho-physical development of a child. The Law does not specify the
meaning of the word child but from certain provisions it is clear that children below 15
years-of-age are meant.

Remark: It can be said that the Law contains provisions which influence the youth’s
health, but not significantly.


(17)       Law on Youth Organizing

     The Law defines youth as persons between 16 and 30 years-of-age. Its Article 12
prescribes that the policy on youth “regulates the basic goals, directions of development
and tasks in the youth sector, such as the following issues: upbringing of youth,
maintenance of moral, esthetic, cultural and sport values, development of physical and
spiritual values of a person, awareness of humanity values, personal and social
responsibility, social-health protection, employment, ecology and other.”

     Article 19 of the Law prescribes the obligation of relevant institution of the Republic
Srpska, city and municipality to pay special attention to the development and
implementation of programs concerning the following areas: employment, professional
work and training, sport and culture and, regarding health and social protection, it
foresees work with youth organizations, social and professional groups on preparing
strategies for prevention and rehabilitation.

Remark: It can be said that the Law contains provisions which influence the youth’s
and women’s health.


Other documents

- Regulation of the Government of Republika Srpska about the ban and
consumption of alcohol on public places to persons below 18 years-of-age210 that came
into effect mid November 2006.

- Strategy for the Promotion of Health in Republika Srpska, 1999


210
      http://www.mladi.info/,11/20/2006


                                                                                         65
       Republika Srpska included the Goals from the documents of WHO “Health for
everybody in the XXI century” into its document “Strategy plan for the reform and
reconstruction of health system 1997-2000”. Also, those goals were included in the
document “Strategy for the promotion of health in Republika Srpska.”

       The strategy in the framework of specific measures for the promotion of health
foresees the measures for the promotion of women’s health. This way, until 2005, all
women above 15 years-of-age should be included in the promotion of health regarding:
family planning and avoiding of unwanted pregnancy, behavior regarding health during
pregnancy and other measures.

       The promotion of health among students between 6 and 18 years-of-age foresees:
monitoring of the psycho-physical development, recommending healthy life styles,
prevention of drug consumption and HIV/AIDS infection, smoking and alcoholism,
healthy nutrition, immunization, prevention of cardiovascular diseases.

Remark: To a great extent, this document follows European directions for
protection and improvement of youth health.

-     Program of Health Policy and Strategy for Health in Republika Srpska until
      2010211

       In the framework of Goal No 2 “healthy youth”, the program foresees the
improvement of the health level among youth until 2010, so that they are capable of fully
performing their social role.

This goal foresees that:
- conditions are created for children and adolescents to adopt healthy life habits and
    health life style,
- the decrease of mortality and invalidity caused by injuries and other accidents for at
    least 50%,
- to decrease the number of youth which smoke, consume alcohol and drugs for at
    least 50%,
- to decrease the number of pregnant women among minors for at least 50%.

    In order to achieve this goal, the program foresees the implementation of activities
through the family, school and counseling centers and special attention will be given to
healthy relations between genders, as well as to the measures for avoiding pregnancy
among minors. Also, the program foresees the improvement of education conditions and
employment of youth.

       For the purpose of achieving the health policy, the Program prescribed measures
and activities as well as deadlines for their achievement and has defined the carriers of
the implementation.

211
   Document: from 1999, “Goals and measures of health policy in Republika Srpska until 2020”,
prescribes almost the same measures.


                                                                                                66
Remark: To a great extend, this document follows European guidelines for the
protection and improvement of youth health.

2.3.3. Youth policy in Republika Srpska 2006 – 2010 (draft)212 – in procedure

        According to this document, the youth policy in Republika Srpska should
represent a strategy that will be aimed at the systematic improvement of the position of
the youth in the fields that are related to the life of youth: education, employment,
housing, free time, health and other.
A part of the policy which deals with youth health is specially aimed at: reproductive
health, prevention of sexually transmitted diseases, specially HIV/AIDS, increased
number of accidents and suicides.

The general goals of the youth policy regarding health are:
- adjustment of the curriculum and program, as well as the education of teachers in the
    field of health protection, reproductive health and prevention in the area of youth
    health;
- opening of counseling centers for youth within medical institutions and the work on
    promotion of prevention in the program of health protection;
- opening of special departments for the treatment of different diseases that the youth
    faces, specially with addiction diseases and HIV/AIDS, as well as an appropriate
    health protection of youth with special needs;
- education of youth through schools and media on reproductive health and
    encouraging birth rate by improving the rights and the status of women in the
    reproductive period;
- opening of health funds for youth and children;
- fight against violent and deviant behavior, alcoholism and drug addiction;
- defining a special strategy in the field of health protection among youth and children;
- improvement of legal regulations in this field;

    The policy foresees the adopting of a law on youth labor; opening of youth
counseling centers for fight against drug addiction and other addictions.

    The recommendation of the document is that the youth policy should be based on
European practice and standards.

Remark: The document has been created according to the European guidelines on
youth policy.

2.3.4. Concluding remarks

       The analysis of regulations relevant for the health of the youth in Republika
Srpska covered 17 laws. In that regard, the situation is very similar to the one in the
Federation of BH.
212
      Document was obtained from the Ministry of sport and youth of Republika Srpska in November 2006


                                                                                                        67
        Still, when it comes to the strategy for health promotion and program of health
policy until 2010, Republika Srpska is significantly ahead. Not only that it created those
two documents, but it has also built in modern European tendencies in the treatment of
youth health. Besides, Republika Srpska already has prepared a document Youth Policy
which includes goals such as the improvement of legal regulations in the field of youth
health.
        Regarding the regulations that are relevant for the health of vulnerable groups,
Youth Policy, for now, directs the attention toward the perpetrators and the addicts and it
improves the status of the women in their reproductive period.


2.4. LEGAL REGULATION OF YOUTH HEALTH IN BRCKO DISTRICT

       The aim of this part is to elaborate provisions of the law that concern youth health
in Brcko district, Youth Law that is in the procedure, as well as the Statute of the District
Brcko.

2.4.1. Statute of the Brčko District of Bosnia-Herzegovina213

        According to Article 1 of the Statute, Brcko District is a unique administrative
unit of local self-government under the sovereignty of Bosnia and Herzegovina. The
Constitution of BiH and the positive laws and decisions of the BiH institutions are
directly applied on the territory of the District and the regulations of the district
authorities have to be in harmony with them. Article 9 defines that health and social
protection fall under the functions and responsibilities of the District.

2.4.2. Overview of provisions of the law that concern the youth health in Brcko
       District

Brcko District of Bosnia-Herzegovina (further referred as to Brcko District) adopted
numerous regulations by which it realized its law-making responsibilities to a great
extent. In those fields for which regulations have not been adopted yet, regulations from
both entities are applied.

In Brcko District, regulations that regulate or influence the youth health are contained in:

      -   Law on Health Protection214
      -   Law on Health Insurance215
      -   Law on Social Protection216
      -   Law on Child Protection217
      -   Law on Protection of Persons with Mental Disorders218

213
     http://skupstinabd.ba/hr/index. ; 11/25/2006
214
    „Official Gazette of Brcko District”, No 2/01
215
    „Official Gazette of Brcko District”, No 1/02
216
    „Official Gazette of Brcko District”, No 1/03
217
    „Official Gazette of Brcko District”, No 1/03


                                                                                          68
      -   Law on Education in Primary and Secondary Schools219
      -   Criminal Law of Brcko District220
      -   Law on Application of Criminal and Violation Sanctions221
      -   Labor Law222
      -   Law on Labor Protection223
      -   Law on Youth – draft224

(1) Law on Health Protection

        The Law prescribes that every citizen is obliged to care about his health and to
participate in prevention activities, as well as every citizen has the right on health
protection in accordance with the Law on health protection (Article 3).

        Health department (which is responsible for the implementation of health
protection in Brcko District), in cooperation with the Department for education through
curriculum, ensures the education of pre-school children and students for health self-
protection (Article 4).

       The principles of achieving health protection are: comprehensiveness, continuity
and availability.

       Health protection, among other, is achieved through the following measures:
providing full (preventive, therapeutic, rehabilitation) health protection for children and
youth as well as the protection of women in regard to family planning, pregnancy,
delivery and maternity (Article 13, item 10).

       Within the frame of primary health protection, it mentions the implementation of
measures of health protection and the care for the health status of various categories of
population, whereby youth is a separate category (Article 17, item 3).

Remark: The Law contains provisions which influence the youth health, but not
health of specially vulnerable youth groups.


(2) Law on Health Insurance

       Article 6 of the Law prescribes that all employed persons and other persons who
perform certain jobs or have a specific characteristic recognized by this law, i.e. those


218
    „Official Gazette of Brcko District”, No 12/06
219
    „Official Gazette of Brcko District”, No 9/01, 28/03 and 29/04
220
    „Official Gazette of Brcko District”, No10/03
221
    „Official Gazette of Brcko District”, No 08/00
222
    „Official Gazette of Brcko District”, No 7/00, 8/03, 33/04 and 29/05
223
    „Official Gazette of Brcko District”, No 31/05
224
     Law on Youth of Brcko District in form of draft was obtained at the Department for professional and
administrative jobs of the Brcko District Assembly, 12/01/2006


                                                                                                           69
insured, have the right to compulsory health insurance. Their family members have the
right to compulsory insurance under conditions prescribed by this law.

       Article 18 lists who is regarded as the insured, in accordance to this law. Apart
from others, those are unemployed persons registered in the respective department for
employment, invalids and beneficiaries of invalid allowance and beneficiaries of social
aid – who, in this survey, have the status of members of vulnerable groups.

        Children, as family members of those insured, have the right to health protection
until they reach 15 years-of-age, i.e. until 27 years-of-age if they are regular students.

       The Law foresees exception from paying participation for those insured who have
very low income, pregnant women and those above 65 years-of-age.

Remark: The Law contains provisions which influence the youth health, as well as
the health of women and vulnerable youth groups.

(3) Law on Social Protection

        Article 1 of the Law defines the principles of the protection of persons who still
are in the state of social need and Article 27 defines who those persons are. According to
this law the beneficiaries of social protection are minors with no parental care, those
disturbed in their development, those neglected in their upbringing and neglected minors
as well as abused children. Beneficiaries of social protection are also persons with
socially negative behavior who, according to the definition of article 20, belong to
especially vulnerable groups.

Remark: The Law contains provisions which influence the youth health, as well as
the health of vulnerable and especially vulnerable youth groups.


(4) Law on Child Protection

The Law has the goal to provide every child with approximately the same conditions for
a healthy and appropriate physical, emotional and intellectual development in the family
(Article 1).

Remark: It can be said that the Law contains provisions which influence the youth’s
health.


(5) Law on Protection of Persons with Mental Disorders

       The law defines a child as a person below 14 years of age and a minor as a person
from 14 – 18 years of age (Article 3, h-j).




                                                                                       70
        When deciding upon forced accommodation of child or minor person, the court is
obliged to obtain an opinion from a psychiatrist specialized in treatment of children, i.e.
minor, or at least to have three years of experience in working with children (Article 23,
item10).
        Psychiatric treatment of children and minors is conducted at the department which
is separated from the department for adult patients (Article 9).

Remark: It can be said that the Law contains provisions which influence the youth’s
health.


(6) Law on Education in Primary and Secondary Schools

        In regard to the position health has in the context of regular education, the Law
states that during primary and secondary education, students develop an awareness on
health and protection of the environment (Article 2).
        Besides regular classes, the Law prescribes picnics, camping, excursions which
contribute to physical and mental health (Article 34).
        Article 39 prescribes special conditions for children with psycho-physical
problems and in Article 40A it presents a special program for children who, due to their
invalidity or severe disease, cannot attend school.
        Inciting, giving and helping the use of alcohol and narcotics is qualified as a
severe violation of discipline (Article 74).

Remark: It can be said that the Law contains provisions which influence the youth’s
health.


(7) Criminal Law

        The Law defines a child as a person below 14 years-of-age and a minor is a
person between 14 and 18 years-of-age (Article 2, items 9 and 10).
        Criminal law is not implemented against a child who, at the time of performing
the act, is below 14 years-of-age (Article 9).
        Just like the entity laws, it prescribes special measures for punishing minors:
against minors it applies rules about pedagogical recommendations, measures and
punishment of minors contained in Chapter X of the Law (solutions are similar to those
in the Federation of BH).
        For the criminal act of rape of a minor person it foresees a more severe
punishment than for an adult victim (Article 200).
        The Law foresees criminal sanctions for neglecting and abusing a child and a
minor (Article 216).

Remark: The Law contains special regulation aimed toward the protection of
physical and personal integrity of minors, whether they are victims or perpetrators
of the criminal act.



                                                                                        71
(8) Law on Application of Criminal and Violation Sanctions

       The Law prescribes separate imprisonment for men and for women, as well as for
minors;
       Pedagogical measures for minors are implemented according to their age,
psychological development, capabilities and inclinations (Article 65, item 2).

Remark: This Law contains provisions relevant for the health of the young
perpetrators and this way influences especially vulnerable group of youth.


(9) Labor Law

        In the context of this law, a minor is a person between 15 and 18 years-of-age
(Article 2, item 17).
        Employment contract can not be made with a person younger than 15 years-of-
age. For the employment of a minor, a positive medical results and parents’ approval are
required (Article 10).
        The Law prohibits overtime work for pregnant women and mother of children
below 1, i.e. 2 years-of-age, unless she provides a written statement about her consent for
overtime work (Article 25).
        The Law prohibits night work for minors and defines the time which is regarded
as night work for minors (Article 28).
        A minor has a longer annual vacation than adult employees (Article 32).

       The Law also foresees special provisions regarding the protection of minors, i.e. it
can not perform dangerous or difficult jobs (Article 41), and the protection of women –
they can not work under the ground, except in exceptional cases (Article 42).
Furthermore, articles 43-50 of the Law prescribe special working conditions and salary
compensation for women in time of pregnancy, delivery and care for a child below one
year-of-age.

Remark: It can be said that the Law contains provisions which influence the youth’s
and women’s health.


(10) Law on Labor Protection

        The Law prohibits working in night shifts for workers below 18 years-of-age,
invalids, as well as pregnant women during their pregnancy and mother with children
below 2 years-of-age (Article 33).

Remark: It can be said that the Law contains provisions which influence the youth’s
and women’s health.



                                                                                        72
2.4.3. Law on Youth – in procedure

        The draft law defines that the care for the youth is of general interest for Brčko
District (Article 10). In this regard, it foresees the adoption of documents concerning
youth policy which will define special programs for various areas of youth life, including
also the youth health (Articles 11 and 14). Besides, organs and institutions of Brcko
District will pay special attention to the creation and implementation of health protection
programs and other programs which contribute to youth health (Article 16).

2.4.4. Concluding remarks

        The legal regulations of youth health in the Brčko District were presented through
the analysis of 10 laws.
        The Law on Health Protection of the Brčko District underlines the youth as a
special category in primary health care, which is not stressed in the entity laws.
        Other laws prescribe a similar scope and types of solutions, as the entity laws. The
provisions on vulnerable and especially vulnerable groups can be found in the Law on
Health insurance, Law on Health Protection, Criminal Law and Law on Application of
Criminal and Violation Sanctions. Labor Law pays special attention to minors and, under
certain circumstances to women as well.

        In regard of the legal regulations of youth issues, Brčko District went the farthest
because only there the law on youth is in procedure of adoption. However, it is unclear
how the law, once adopted, and the authorized institutions will contribute to the legal
regulations and in general improvement of youth health.

       2.5. Conclusion

        In our efforts to make an overview of regulations which regulate or impact youth
health in Bosnia and Herzegovina we have analyzed forty five laws on the levels of the
state, both entities and District Brčko. Besides the laws, we have presented various
activities ongoing within the country aimed at improvement of health status of youth in
BiH.

         This comprehensive survey has confirmed the initial statement that youth health
requires a multidisciplinary and inter-sectoral approach, including disciplines which, at a
first glance, do not have some significant relations to the health.

       On the base of the analysis presented throughout this chapter, the following
conclusions have been defined:

- On the state level, there are only four laws that contain provisions that indirectly impact
youth health. Legal regulation of health is in jurisdiction of the entities so the main part
of the BiH regulation has been found in forty one laws belonging to Federation BiH (14),



                                                                                          73
Republika Srpska (17) and Brčko District (10). Solutions given in the same laws of
entities and Brčko District are quite similar which means that advantages and
disadvantages are mostly common. These could be sufficient reason for creation of a
framework law or strategy at the state level which would include all issues related to
youth health and define precise guidelines for their regulation on the level of entities.

- The analysis has shown that some of the presented laws contain regulations directly
aimed at the protection of youth health, while provisions of other laws refer to all citizens
and, in its context, the youth is covered with its action. Except for the regulation of
Labour Law, Law on Social Protection, Family Law, Criminal Law and Criminal
Procedure Law, other regulations are not formulated sufficiently clear so that some issues
remain unregulated or they open a possibility of different interpretations.

- A need for special legislation treatment of vulnerable and especially vulnerable groups,
except in few laws, is almost neglected.

- Beside the Labour Law, which forbids women to perform difficult jobs, Law on Social
Protection, Law on Health Protection and Law on Health Insurance that provide special
protection to women related to maternity, the presented regulations do not contain
provisions which differently treat young women and men.

- Brčko District has the Law on youth in procedure of adoption. This law should pay
special attention to the creation and implementation of health protection programs and
other programs which contribute to youth health. However, it is unclear how the law,
once adopted, and the authorized institutions will contribute to the legal regulations and
in general improvement of youth health

- Regarding the other documents and activities, Republika Srpska has the Strategy for
health promotion and Program of health policy until 2010, based on modern European
tendencies in the treatment of youth health. Besides, Republika Srpska already has
prepared a document Youth Policy which includes goals such as the improvement of
legal regulations in the field of youth health.

- Regarding the regulations that are relevant for the health of vulnerable groups, this
Youth Policy, for now, directs the attention toward the perpetrators and the addicts and it
improves the status of the women in their reproductive period.




                                                                                          74
3. LEGAL REGULATION OF YOUTH HEALTH IN SURROUNDING
COUNTRIES

The aim of this part is to explore regulation of youth health in two surrounding countries:
Croatia and Slovenia, which at the one hand share the similar socio-political background
with Bosnia and Herzegovina, while they are currently on different stage towards relation
to European Union. While Bosnia and Herzegovina is still not the EU candidate country,
Croatia recently has become candidate country, while Slovenia is already EU member
state.

3.1. Croatia

Croatia is in the category of candidate countries in relation to EU. In the Negotiating
Framework, Luxembourg, 3 October 2005 there is no referral to health legislation,
youth, or youth health225. By signing Stabilization and Association Agreement in 2001,
Croatia started changes in legislation. The serious changes took place at the end of 2003.

Health care as the main responsibility of Ministry of Health and Social Care does not
present the separate chapter within legislation of EU. As has been seen in the first
chapter, the components of this sector could be found within different chapters. Since
Ministry of Health is not in charge (fully) for any of 35 chapters, at the very beginning of
the Pre-Accession Program received rather low priority within Ministry of Health, but
more responsilibilities within some other ministries. The key tasks in harmonization with
legislation and practice of EU are determined by National Program for EU accession for
2005 (NPPEU 2005) and Pre-accession Economic Program 2005-2007 (PEP). Within
these documents the tasks related to the work of Ministry of Health are outlined as
well226. Within National Program of Republic of Croatia for the Accession to European
Union, 2005, there is no referral to youth health227.

Within draft National Strategy for Health Development seven aims have been set up, with
no referral to youth or youth health, neither within aims, or responsible bodies for the
implementation. It is necessary to say that Croatia has long tradition of school medicine,




225
    Enlargement. European Commission. NEGOTIATING FRAMEWORK, Luxembourg, 3 October
2005. http://ec.europa.eu/enlargement/pdf/st20004_05_HR_framedoc_en.pdf 11/20/2006
226
    NACRT PRIJEDLOGA NACIONALNE STRATEGIJE RAZVITKA
ZDRAVSTVA 2 0 0 6 . — 2 0 1 1 , Z a g r e b , M a y , 2 0 0 6
227
    Republika Hrvatska. Ministarstvo vanjskih poslova i evropskih integracija. „Nacionalni Program
Republike Hrvatske za pridruživanje Evropskoj Uniji – 2005 godina“.
http://www.mvpei.hr/ei/download/2005/05/11/NPPEU_2005_hrv.pdf


                                                                                                     75
health promotion among school and youth population. This is particularly related to the
work of National Institute for Public Health228.

From the August 2004 Croatia has the National Program of Action for Youth. It is within
responsibility of Ministry of the Family, Defenders and Inter-generational Solidarity.
Within this Program as the leading diseases of children and youth (7-19) within primary
health care are “diseases of respiratory system (49,3%), communicable and parasitic
diseases (7,9%), skin diseases, dangers and poisoning, eye diseases, urinary diseases and
genital diseases”229. It has been additionally noticed that tobacco, alcohol and drugs abuse
are in increase. Sexual transmitted diseases are also in increase. Different forms of abuse
are great public health concern. Regarding mental health of youth there is lack of
research. This could be an important problem due to post-war situation. From this very
short overview it is clear that special approach needs to be applied to this population230.
Although in Croatia there is long and successful health care of school children, students
and youth, the changes in planning needs to be focused on:

         “preventative and health educational programs;
         Development of inter-sectoral collaboration
         Organization of health care of the places where youth live; attend school and
         work, and on that make it accessible, and use all advantages and possibilities of
         action with youth and for youth
         Involvement of youth in implementation of health programs
         Improvement of development of specific health care and specific education of
         doctors
         Encouraging development of specific health care and specific education of
         doctors
         Encouraging of foundation and work of multifunctional health centers with
         multidisciplinary teams;
         Timely discovering of leading and known disorders diseases and youth problems;
         Monitoring health indicators and evaluation of performance”231

Operative Plan of the National Program of Action for Youth for 2006-2007 consists of
numerous measures aiming to promote health education (healthy lifestyles, education on
risky behavior etc.) within schools as supplementary programs, as a part of informal
education through workshops, peer education, through media etc. Moreover, one of the
measures is directed to the education of health professionals, educators and social

228
    „N A C R T P R I J E D L O G A N A C I O N A L N E S T R A T E G I J E R A Z V I T K A
ZDRAVSTVA 2 0 0 6 . — 2 0 1 1 “ , Z a g r e b , M a y , 2 0 0 6
229
    Republika Hrvatska. Ministarstvo oblitelji, branilaca I medjugeneracijske solidarnosti. “Nacionalni
program djelovanja za mlade”. August, 2004, pp. 22, available at
http://www.mobms.hr/page.aspx?PageID=42
230
    Republika Hrvatska. Ministarstvo obitelji, branilaca I medjugeneracijske solidarnosti. „Nacionalni
program djelovanja za mlade”. August, 2004, pp. 23, available at
http://www.mobms.hr/page.aspx?PageID=42
231
    Republika Hrvatska. Ministarstvo oblitelji, branilaca I medjugeneracijske solidarnosti. „Nacionalni
program djelovanja za mlade”. August, 2004, pp. 23, available at
http://www.mobms.hr/page.aspx?PageID=42


                                                                                                          76
workers on early recognition, follow up and intervention in the cases of mental health
disorders and youth232.

The Ministry of the Family, Defenders and Inter-generational Solidarity prepared the
Strategy for the Protection from Domestic Violence (2005 – 2007). Within this document
it is emphasized that major victims of this kind of violence are women and children.
Thus, the Strategy poses many short-term and long-term measures where most of short-
term measures refer to adjustment of other legislation in line with this, as well as
development of new complementary strategies. The long-term measures refer mainly to
educational programs on gender equality aiming to reduce gender inequality and its
consequences. In this respect youth and school population are particularly focused233.

13th Congress of European Union for school and higher education medicine took place
12-15 October in Dubrovnik. The organizer of this event was EUSUHM, Croatian
Society for school and higher education medicine, Croatian Institute for Public Health
and other local public health institutes. The product of this Conference is so called
Dubrovnik Declaration whose main principles are that health protection of school and
youth population should take the important place in each country. It further underlines
that health difference between children and youth are greater and greater. According to
this Declaration, school is ideal place for application of health program aimed for
youth234.

Recent changes

According to Progress report on Croatia from 8 November 2006 the following has been
done in the field of legislation that regulates or impact youth health:

Within the health and safety at work, no legislation in line with acquis was not
adopted235. Joint Inclusion Memorandum process between EU and Croatia is going well.
However, regarding social exclusion and poverty in Croatia still a lot has to be done. A
more strategic approach is needed in order to advance the position of the most vulnerable
group of population. A certain progress has been made in the field of anti-
discrimination, although a comprehensive national strategy in this field still needs to be
adopted. In this field there is no legislation transposing the acquis. Any progress in
establishment of Equality body has not been done as well. Some progress has been

232
    Republika Hrvatska. Ministarstvo oblitelji, branilaca I medjugeneracijske solidarnosti. Operativni plan
nacionalnog programa djelovanja za mlade 2006-2007, available at
http://www.mobms.hr/page.aspx?PageID=42
233
    Republika Hrvatska. Ministarstvo oblitelji, branilaca I medjugeneracijske solidarnosti. Nacionalna
strategija zaštite od nasilaj u obitelji of 2005 – 2007, august, available at
http://www.mobms.hr/page.aspx?PageID=42
234
    Healthy Youth Investment for Future. 13 Congress of European Union for School and University Health
and Medicine. Dubrovnik 12-15 October 2005. http://www.hzjz.hr/skolska/kon2005.htm
235
   Enlargement Strategy and Progress Reports 2006. Progress Report on Croatia. 4.19. Chapter 19:
Employment and Social Policy.
http://ec.europa.eu/enlargement/pdf/key_documents/2006/Nov/hr_sec_1385_en.pdf 11/20/2006


                                                                                                        77
noticed in the field of equal opportunities, where in September 2006, the Government
adopted the National Policy for the Promotion of Gender Equality 2006-2010236.

Within the chapter on Health and Consumer Protection among other things it was
noted that good progress has been made in the area of public health. The National
Strategy for Combating Drug Abuse was adopted in December 2005 for the period 2006-
2012, while the Action Plan for this Strategy was adopted in February this year. The
general conclusion of the Report regarding this chapter is that still lot needs to be done in
order to adopt and implement acquis237.

      3.2. Slovenia

Slovenia is the first, and till now the only former Yugoslav country that joined European
Union. This fact presupposes that it fully harmonized its legislation to EU, and by the act
of accession adopted EU legislation. How this process went, and what were the EU
evaluations related to process of legal harmonization in the part of laws and regulation
that regulate or impact to youth health will be presented in this sub-chapter.

Besides various specific programs, such as those in the field of public health, within the
field of social affairs EU legislation covers “health and safety at work, labor law and
working conditions, equal opportunities for men and women, coordination of social
security schemes for migrant workers, and tobacco products”238.

A new Law on Health and Safety at work was adopted in Slovenia in June, 1999. Eight
implementing decrees transferring EU provisions have been adopted since then. Since
May 2000, Slovenia is the active participant in Community Programmes on “health
promotion, the fight against cancer, combating drugs and AIDS prevention”239

According to 2003 Evaluation Report, the legislation of Slovenia is in the large measure
in line with Acquis on labor law. Slovenia has also adopted the legislation which was
necessary in order to be in line with Acquis on young people. According to the same
Report, Slovenia has aligned its legislation with Acquis in the field of public health, with
demand for continuation of fostering administrative capacity to implement EU
requirements for control of communicable diseases. Regarding equal treatment of women
and men Slovenia has transposed all legislation and the legislative transposition is


236
   Enlargement Strategy and Progress Reports 2006. Progress Report on Croatia. 4.19. Chapter 19:
Employment and Social Policy.
http://ec.europa.eu/enlargement/pdf/key_documents/2006/Nov/hr_sec_1385_en.pdf 11/20/2006
237
    Enlargement Strategy and Progress Reports 2006. Progress Report on Croatia. 4.194.28. Chapter 28:
Consumer and Health Protection
 http://ec.europa.eu/enlargement/pdf/key_documents/2006/Nov/hr_sec_1385_en.pdf 11/20/2006
238
    Activities of European Union. Summaries of Legislation. Slovenia.
http://europa.eu/scadplus/leg/en/lvb/e02110.htm 11/28/2006 2/3
239
    Activities of European Union. Summaries of Legislation. Slovenia.
http://europa.eu/scadplus/leg/en/lvb/e02110.htm 11/28/2006 2/3


                                                                                                        78
following acquis. The implementing body has been created within Office for Equal
Opportunities240.

In Slovenia, the Office for Youth is functioning within Ministry for schooling and sport,
and it is responsible for Youth policy in Slovenia241.

3.3 Conclusion

This analysis offers possibility to see where countries are positioned regarding regulation
of youth health. It also offers possibility to see which kind of legal reforms Bosnia and
Herzegovina still need to pass.




240
    Activities of European Union. Summaries of Legislation. Slovenia.
http://europa.eu/scadplus/leg/en/lvb/e02110.htm 11/28/2006 2-3
241
    Republika Slovenija. Poslanstvo. http://www.uradzamladino.gov.si/ 1/2, 11/29/2006


                                                                                        79
4. CONCLUSIONS AND RECOMMENDATIONS

This chapter aims to outline the overall conclusion of conducted study, and well as some
of recommendations that Bosnia and Herzegovina needs to conduct in order to improve
regulations of youth health. The study, as such, offers possibility of making much more
recommendations that will be drawn here.

4.1. Conclusion

Regulations that refer to youth health, both on global and European level provide the
guidelines to the Member States how to regulate this issue. Having in mind the wide
diapason of sectors that influence youth health, the need to inter-sectoral approach to this
issue has been strongly emphasized on all levels.

On the base of conducted analysis on BiH legal regulations/policies, the following results
have been found:

- On the state level, there are only four laws that contain provisions that indirectly impact
youth health. Legal regulation of health is in jurisdiction of the entities so the main part
of the BiH regulation has been found in forty one laws belonging to Federation BiH (14),
Republika Srpska (17) and Brčko District (10).

- The analysis has shown that some of the presented laws contain regulations directly
aimed at the protection of youth health, while provisions of other laws refer to all citizens
and, in its context, the youth is covered with its action. Except for the regulation of Labor
Law, Law on Social Protection Basis, Family law, Criminal Law and Criminal Procedure
Law, other regulations are not formulated sufficiently clear so that some issues remain
unregulated or they open a possibility of different interpretations.

- A need for special legislation treatment of vulnerable and especially vulnerable groups,
except in few laws, is almost neglected.

- Beside the Labor Law, which forbids women to perform difficult jobs, Law on Social
Protection Basis, Law on Health Protection and Law on Health Insurance that provide
special protection to women related to maternity, the presented regulations do not contain
provisions which differently treat young women and men.

- Brčko District has the law on youth, which is in procedure of adoption. This law should
pay special attention to the creation and implementation of health protection programs
and other programs which contribute to youth health. However, it is unclear how the law,
once adopted, and the authorized institutions will contribute to the legal regulations and
in general improvement of youth health


                                                                                          80
- Regarding the other documents and activities, Republika Srpska has the Strategy for
Health Promotion and Program of Health Policy until 2010, based on modern European
tendencies in the treatment of youth health. Besides, Republika Srpska already has
prepared a Youth Policy document which includes goals such as the improvement of
legal regulations in the field of youth health.

   -   Regarding the regulations that are relevant for the health of vulnerable groups,
       this Youth Policy, for now, directs the attention toward the perpetrators and the
       addicts and it improves the status of the women in their reproductive period.

The analysis of regulation of youth health in Croatia and Slovenia offers possibility to see
where countries are positioned regarding regulation of youth health. It has been noted that
surrounding studied countries have this issue better regulated. Having in mind that these
countries, as well as Bosnia and Herzegovina have the common aim regarding EU
integration (where Slovenia has already accomplished this aim), the analysis also offers
possibility to see which kind of legal reforms Bosnia and Herzegovina still need to pass
in order to improve youth health.

In our efforts to make an overview of regulations which regulate or impact youth health
in Bosnia and Herzegovina, this comprehensive survey has confirmed the initial
statement that youth health requires a multidisciplinary and inter-sectoral approach,
including disciplines which, at a first glance, do not have some significant relations to the
health.



4.2. Recommendations

On the basis of conducted study on the state of regulation of youth health in Bosnia and
Herzegovina, the following recommendations, gathered around the major youth health
problems, are proposed:

Health for All
Adjust all legislation in order to provide equal access of all citizens, and youth among
them, to health services. This particularly means:
   - right to health services within the whole country. According to present legislation
   that follows decentralization of health services, right to health can not be enjoyed
   within the whole territory of Bosnia and Herzegovina. On state level this particularly
   means that right to health cannot be enjoyed in the entity different of entity of
   residence, while within Federation, this principle is applicable among cantons. In this
   respect, the adoption of Law on Health Insurance on state level, or Inter-entity and
   inter-cantons agreements that would regulate this huge problem and ensure health for
   all within the whole territory of BiH seems as one of priorities
   - right to health services for all citizens of BiH – Current laws on health insurance
   formally cover all categories of population. However, in reality it is not the case.
   According to current laws, unemployed persons, which are not students, and not



                                                                                          81
   registered at the Office for Employment, are not covered by health insurance. Due to
   the large unemployment rate in Bosnia and Herzegovina, as well as lot of people
   whose work is not registered this become a great problem. This kind of problem
   should be addressed targeting particularly young people where some minimum
   package of health care should be provided to all young people (no matter of their
   status). In this respect recommendations from White Paper “A new Impetus for
   Youth” should be taken as basis.
   - physical accessibility of health services – Due to the significant number of
   physically disabled young persons in post-war Bosnia and Herzegovina there is a
   need to incorporate provision on physically accessible facilities and service in all
   legal acts in Bosnia and Herzegovina.

Health Promotion
Health promotion as an activity has been underlined within all crucial documents on both
international and European level. For our target group this kind of activity should be done
though parental education, children and youth education, schools, media etc.
Republic of Srpska has its own Strategy on Health Promotion, while in the Federation of
Bosnia and Herzegovina preparations of this document are ongoing.
The recommendations are:
    - to finalize, adopt and implement Strategy on Health Promotion for the Federation
        of BiH
    - to prepare, adopt and implement Strategy on Health Promotion for Brcko District

Smoking prevention
Although participated in the design of the WHO Framework Convention on Tobacco
Control, Bosnia and Herzegovina has not adopted it yet. Both Federation and Srpska have
regulations (different laws) which in the large measure follows the provisions of the
Convention. Unfortunately, these provisions are not well implemented. RS legal
regulation forbids the sell of tobacco to youth younger then 18 years, while according to
the Federal law, this provision is not in accordance with the Convention, allowing youth,
older then 15 to buy tobacco products. The recommendations are
    - BiH to adopt the Framework Convention on Tobacco Control
    - To adjust current laws with the Convention in complete
    - To take multisectoral approach to this issue and its regulation
    - To ensure the implementation of the laws
    - To incorporate within existing laws provisions where the harmful impact of
        tobacco produces influence men and women differently

Alcohol
There is no law on limited consumption of alcohol. On Federal level there is draft of
Federal Program of Prevention of Alcoholism, Drug Consumption and Other
Dependencies. In Republika Srpska there is a draft of National Plan of the Combat of
Alcoholism. The aim of this document is to design National Strategy on Alcohol and
other psycho-active substances control consumption.
The recommendation is:




                                                                                        82
   -   there is a need for legal regulation on limited consumption on alcohol, which
       would particularly deal with youth people, and follow the Council
       Recommendation 2001/458/EC of 5 June 2001 (see more under 1.2.3.1)

Drug abuse
The Law on Combating and Preventing Drug Abuse has passed on BiH level in February
2006. There is no particular provisions where youth are mentioned. However, due to the
fact that youth are the most exposed to this problem, it could be stated that this is
direction to the regulation of youth health. A huge part o this law is dealing with
prevention through various methods of health promotion. On the Federal level there is a
Program on Prevention of Alcoholism, Drug Consumption and Other Pependencies.
The recommendation is:
    - full implementation of the state law, particularly the provision regarding
        education in all spheres, prevention and eradication of use.

Injuries
The huge number of traffic injuries involves youth people. They are the main victims of
car accidents. On the state level there is the Law on basics of road safety passed in
January 2006. Although there is no provision that specifically refer to young people, the
overall impression is that is quite modern and advanced law. The provision that could be
understood as protection of youth could be the one that provide special treatment of
people younger then 21, for whom the allowed quantity of alcohol in blood is 0,0, while
for the other is 0,3 promils. The persons younger then 23 are not allowed to drive the
vehicle in the period between 23:00 – 5:00 hours, except in the situation where they are
accompanied in the vehicle by person older then 25.
Regarding domestic violence, the Family Law (s) provides protection from all kinds of
violence on children. The Criminal Law (s) predicts quite strong sentences for criminal
acts of violence on children. The Law on Protection from Domestic Violence does not
contain the particular provisions regarding the violence on children, but only use the
category the family member.

The recommendations are:
   - the full implementation of the Law on Basics of Road Safety
   - full implementation of Family Law (s)
   - full implementation of Criminal Law (s)
   - within Law on Protection of Domestic Violence to incorporate provisions which
       specifically refer and sanction violence on children
   - adoption of the Law on limited use of alcohol, as significant cause of injuries
   - collaboration with other sectors
   - following of EU recommendations regarding prevention of injuries


Reproductive and sexual health
Reproductive health of women in the period of pregnancy, child birth and post-natal
period is protected and regulated by Law on Health Protection, Law on Health Insurance




                                                                                      83
and Labor Law (both entities and District). Within this law with regards to reproductive
health there are no special provisions that would refer to youth.
Regarding sexual health, within laws on education there is no provision that would refer
to sexual health, but only health education in general. Sexual health was part of the health
education through the “Healthy school”, the project that was implemented in Bosnia and
Herzegovina for the certain period of time. Reccommendations are:
    - full implementation of provisions regulating reproductive health
    - incorporation of provisions that would specifically refer to reproductive health of
        youth
    - incorporation of provisions on education on sexual health within laws on
        education
    - implement the provisions of international documents that Bosnia and Herzegovina
        ratified and that refers to reproductive and sexual health
    - use of European guidelines

HIV/AIDS
On the state level there is the Strategy on the Prevention and Combating HIV/AIDS. It
aims to set up the legal framework which would enable the respect of human rights and
ethical principles, and which will be based on the recommendations of European Union.
In accordance to that it has for the aim elimination of all forms of discrimination of
persons living with HIV/AIDS. It deals in the large measure with preventative measure
through introduction of educational program of safe sex behaviors and drug prevention.
The other part deals with improving the health care of persons living with HIV/AIDS and
psycho-social support. Recommendations are:
    - to foster adoption of the legal framework which would formalize the Strategy
        recommendations
    - to promote safe sex education and educational programs on drug prevention
        incorporating that provision in law on education
    - to improve the health care of person living with HIV/AIDS through the
        incorporation of provisions in Law (s) on Health Protection
    -

Mental Health
The Mental Health Law exists on entity level (including District Brcko). Youth are
mentioned in the part where special departments for treatment of youth exist. There is a
Mental Health Policy on the state level which is still not adopted but whose main
principles are mainly in line with Green Paper on Mental Health. Recommendations are:
    - adoption of Mental Health Policy on state level and its implementation
    - following the guidelines from Green Paper on Mental Health

Nutrition
Bosnia and Herzegovina does not have legal act regulating this issue. With regards to
youth, this issue could be addressed through legal acts on education and in that context
the recommendation will be:
    - to include education on nutrition within school education programs and to ensure
        healthy food in the schools



                                                                                         84
   -   adopt the legislation on food safety in accordance to EU standards
   -   to follow the EU guidelines regarding nutrition and regular physical activity
   -   to adopt law which would regulate this issue, with special emphasis on youth




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       Health Organization. Information Series on School Health Document 10, 2003
   -   “Health for All in XXI century”, World Health Organization, Regional Office for
       Europe in Strateski Plan za reformu i rekonstrukciju zdravstvenog sistema 1997-
       2000 (Strategic Plan for reform and reconstruction of health system 1997-2000),
       Republika Srpska, May 1997 http://www.pcuhealth.org/dokumenti/sp972000.pdf
   -   The World Bank. “WHO European Ministerial Conference on Mental Health.
       Facing Challenges, Building Solutions”, Helsinki 12-15 January 2005.
       http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTHEALTHNUTRI
       TIONANDPOPULATION/EXTMH/0,,contentMDK:20330307~pagePK:148956
       ~piPK:216618~theSitePK:384012,00.html
   -   World Health Organization. Regional Office for Europe. “Life without Injuries
       and Violence in Europe (LIVE)” Newsletter of the WHO/Europe programme on
       violence and injury prevention.
       http://www.euro.who.int/Document/VIP/VIP_News_Sep06.pdf

Council of Europe and EU documents/reports

   -   Council of Europe. Pompidou Group.
       http://www.coe.int/T/dg3/Pompidou/default_en.asp visited 11/28/06




                                                                                   86
-   European Commission. Health and Consumer Protection. Green Paper
    “Promoting the mental health of the population. Towards a strategy on mental
    health for the EU” (COM(2005)484 final of 14 October 2005).
    http://ec.europa.eu/health/ph_determinants/life_style/mental/green_paper/mental_
    gp_en.pdf
-   PH Strategy of 2000 + Action Program in PH 2001-2006.
    http://europa.eu/scadplus/leg/en/s03001.htm
-   Activities of the European Union, Summaries of the legislation, PUBLIC
    HEALTH HEALTH DETERMINANTS: LIFESTYLE. TOBACCO.
    http://www.europa.eu/scadplus/leg/en/s03003.htm
-   Activities of the European Union, Summaries of the legislation, PUBLIC
    HEALTH HEALTH DETERMINANTS: LIFESTYLE. ALCOHOL.
    http://www.europa.eu/scadplus/leg/en/s03003.htm
-   Activities of the European Union, Summaries of the legislation. Public Health.
    Health Determinants. Drugs and Substances.
    http://ec.europa.eu/health/ph_determinants/life_style/drug_en.htm 1
-   Activities of the European Union, Summaries of the legislation, PUBLIC
    HEALTH HEALTH DETERMINANTS: LIFESTYLE. NUTRITION.
    http://www.europa.eu/scadplus/leg/en/s03003.htm
-   Public Health. Mental Health.
    http://ec.europa.eu/health/ph_determinants/life_style/mental_health_en.htm
    11/26/2006
-   European Commission. Health and Consumer Protection. Green Paper
    “Promoting the mental health of the population. Towards a strategy on mental
    health for the EU” (COM(2005)484 final of 14 October 2005).
    http://ec.europa.eu/health/ph_determinants/life_style/mental/green_paper/mental_
    gp_en.pdf
-   European Commission. Public Health. Sexual Health and HIV/AIDS.
    http://ec.europa.eu/health/ph_determinants/sexual_health_en.htm
-   Activities of European Union. Summaries of Legislation. “Action programme to
    prevent AIDS and certain communicable diseases 1996-2002”.
    http://www.europa.eu/scadplus/leg/en/cha/c11533.htm
-   European Commission. Press release. Questions and answers on EU action on
    fighting HIV/AIDS.
    http://europa.eu.int/rapid/pressReleasesAction.do?reference=MEMO/06/428&for
    mat=HTML&aged=0&language=EN
-   European Union. Public Health. Injuries Prevention. “Commission
    Communication on “Actions for Safer Europe” 23.06.2006
    http://ec.europa.eu/health/ph_determinants/environment/IPP/documents/com_328
    _en.pdf
-   Social inclusion of young people / RESOLUTION on the social inclusion of
    young people of 14.12.2000. http://europa.eu/scadplus/leg/en/cha/c11605.htm
-   European Commission. Youth. White Paper on Youth. “EUROPEAN
    COMMISSION WHITE PAPER A NEW IMPETUS FOR EUROPEAN
    YOUTH”. 21.11.2005
-   http://ec.europa.eu/youth/whitepaper/download/whitepaper_en.pdf



                                                                                 87
-   Enlargement. European Commission. Accession Criteria.
    http://ec.europa.eu/enlargement/enlargement_process/accession_process/index_en
    .htm
-   Enlargement. European Commission. The Content of the Aquis.
    http://ec.europa.eu/enlargement/enlargement_process/accession_process/how_doe
    s_a_country_join_the_eu/negotiations_croatia_turkey/index_en.htm#acquis
-   Enlargement. European Commission. Directory of Community legislation in
    force.
    http://ec.europa.eu/enlargement/pdf/enlargement_process/accession_process/how
    _does_a_country_join_the_eu/negotiations_croatia_turkey/table_of_corresponden
    ce_2_2006_en.pdfr

Croatia and Slovenia
- Enlargement. European Commission. Negotiations with Croatia and Turkey.
   http://ec.europa.eu/enlargement/enlargement_process/accession_process/how_doe
   s_a_country_join_the_eu/negotiations_croatia_turkey/index_en.htm
- Enlargement. European Commission. Directory of Community legislation in
   force.
   http://ec.europa.eu/enlargement/pdf/enlargement_process/accession_process/how
   _does_a_country_join_the_eu/negotiations_croatia_turkey/table_of_corresponden
   ce_2_2006_en.pdf
- Enlargement. European Commission. NEGOTIATING FRAMEWORK,
   Luxembourg, 3 October 2005.
   http://ec.europa.eu/enlargement/pdf/st20004_05_HR_framedoc_en.pdf
   11/20/2006
- NACRT PRIJEDLOGA NACIONALNE STRATEGIJE
   RAZVITKA ZDRAVSTVA 2006. — 2 0 1 1 , Z a g r e b , M a y ,
   2006
- Republika Hrvatska. Ministarstvo vanjskih poslova i evropskih integracija.
   „Nacionalni Program Republike Hrvatske za pridruživanje Evropskoj Uniji –
   2005 godina“.
   http://www.mvpei.hr/ei/download/2005/05/11/NPPEU_2005_hrv.pdf
- Republika Hrvatska. Ministarstvo oblitelji, branilaca I medjugeneracijske
   solidarnosti. Nacionalni program djelovanja za mlade. August, 2004, pp. 22,
   available at http://www.mobms.hr/page.aspx?PageID=42
- Republika Hrvatska. Ministarstvo oblitelji, branilaca I medjugeneracijske
   solidarnosti. Operativni plan nacionalnog programa djelovanja za mlade 2006-
   2007, available at http://www.mobms.hr/page.aspx?PageID=42
- Republika Hrvatska. Ministarstvo oblitelji, branilaca I medjugeneracijske
   solidarnosti. Nacionalna strategija zaštite od nasilaj u obitelji of 2005 – 2007,
   august, available at http://www.mobms.hr/page.aspx?PageID=42
- Healthy Youth Investment for Future. 13 Congress of European Union for School
   and University Health and Medicine. Dubrovnik 12-15 October 2005.
   http://www.hzjz.hr/skolska/kon2005.htm
- Enlargement Strategy and Progress Reports 2006. Progress Report on Croatia.
   4.19. Chapter 19: Employment and Social Policy.



                                                                                 88
       http://ec.europa.eu/enlargement/pdf/key_documents/2006/Nov/hr_sec_1385_en.p
       df
   -   Enlargement Strategy and Progress Reports 2006. Progress Report on Croatia.
       4.194.28. Chapter 28: Consumer and Health Protection
   -   http://ec.europa.eu/enlargement/pdf/key_documents/2006/Nov/hr_sec_1385_en.p
       df
   -   Activities of European Union. Summaries of Legislation. Slovenia.
       http://europa.eu/scadplus/leg/en/lvb/e02110.htm 11/28/2006


Bosnia and Herzegovina

   -   Constitution of Bosnia and Herzegovina - http://www.parlament.ba/bos/ustav
   -   Komisija za koordinaciju pitanja mladih u BiH (Committee for the coordination
       of youth issues) set up by decision of Council of Ministers of BiH from
       16.12.2004 (“Official Gazette of BiH”, No. 33/05)

Laws of Bosnia and Herzegovina - -Official Gazzette of BiH

   -   Law on Ministry’s and the Other Government Agencies of Bosnia and
       Hezegovina
   -   Framework Law on Primary and Secondary Education
   -   Law on Prevention of Drugs Abuse
   -   Law on Base of Transportation Safety on the Roads in Bosnia and Herzegovina
   -   Gender Equality in Bosnia and Herzegovina
   -   Strategy of Prevention and Combating HIV/AIDS in Bosnia and Herzegovina,
   -   2004-2009.

Laws of the Federation of Bosnia-Herzegovina - „Official Gazzette of the Federation of
BH“

   -   Law on Health Protection
   -   Law on Health Insurance
   -   Law on the Basis of Social Protection, Protection of Civil War Victims and
       Protection of Families with Children
   -   Law on Retirement and Disability Insurance
   -   Law on the Protection of Psychologically Disturbed Persons
   -   Family Law
   -   Law on Protection from Domestic Violence
   -   Labor Law
   -   Law on Limited Consumption of Tobacco and Tobacco Products
   -   Criminal Law
   -   Criminal Procedures Law
   -   Law on Displaced Persons - Expatriates and Refugees – Returnees to the
       Federation of Bosnia-Herzegovina




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Law of Republika Srpska – Official Gazzette of Republika Srpska
- Law on Health Protection
- Law on Health Insurance
- Decision on the Minimal Basic Package of Health Protection
- Law on Social Protection
- Law on Retirement and Disability Insurance – cleaned version
- Law on Protection of Persons with Mental Disorders
- Law on Primary School and Law on Secondary School
- Law on High Education
- Family Law
- Law on Protection from Domestic Violence
- Criminal Law
- Criminal Procedure Law
- Labor Law
- Law on the Ban of Smoking of Tobacco Product on Public Places
- Law on the Ban of Sale and Consumption of Tobacco Products to Persons below 18
   years-of-age Law on Child Protection
- Law on Organizing of Youth.

    Other documents and policies
-   Strategy fro the Promotion of Health in Republika Srpska, 1999
-   Program of Health Policy and Strategy for Health in Republika Srpska until 2010


- World Bank Document:” Building Policy of Youth in BiH-Involving; Developing and
Strengthening the Youth ”. Paula F. Lytle, Diana Marginean, ECSSD, 29. December,
2004.god.

- Council of Europe-Head office for youth and sport, Mission on politic of youth in
Bosnia and Herzegovina, 29 Mar - 02 Apr 2005: Report from the advisory mission in
BiH. Council of Europe Office in Sarajevo

- Action Plan for the Children in BiH 2002-2010

- Projekat za mlade i zdravlje mladih za područje Balkana, Plan implementacije projekta
Bosna i Hercegovina“, august 2006.

- Functional Review of Health Sector in Bosnia and Herzegovina – Tools for Functional
Review”, 30 August 2004. page 7 -The European Union’s CARDS Programme for
Bosnia and Herzegovina.



Laws of Brčko District - Official Gazzette of Brčko District
   - Law on Health Protection
   - Law on Health Insurance



                                                                                      90
    -   Law on Social Protection
    -   Law on Child Protection
    -   Law on Protection of Persons with Mental Disorders
    -   Law on Education in Primary and Secondary Schools
    -   Criminal Law
    -   Law on Application of Criminal and Violation Sanctions
    -   Labor Law
    -   Law on Labor Protection
    -   Law on Youth – draft

www.mladi.gov.ba
www.mhrr.gov.ba
http://www.parlament.ba/bos/zakonodavstvo/zakonarh
www.vijećeministara.ba
http://www.pcuhealth.org/projekti/hsep/grantovi/grantovi/htm
http://skupstinabd.ba/hr/index
www.oscebih.org/documents

“Legal Framework of Health Protection and Health Insurance in BiH“
www.job22.lol.ba/zdravstvena_zaštita_osiguranje.pdf




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