Developing a comprehensive school-based physical activity program with flexible design - from pilot to national program.

This article focuses on the process of designing the vital, participatory school-based intervention program aiming to increase the physical activity in schools. The program analyzed is Estonian nationwide comprehensive physical activity program Schools in Motion (SiM) that recently received European Commission's #BeActive Education Award. The program has a good performance in terms of willingness of schools to participate in co-creation of program development, the high interest to join the program and zero dropouts, and strong partnership with ministries which enables to actively participate in policy making. Authors analyze the key elements of the planning, piloting, implementation, and scaling phases of the SiM program and share their lessons learnt in co-working with schools. The difficulties faced during the development process, the strengths and challenges associated with an interdisciplinary approach, and involvement of schools as experts have been addressed.

The emergence of new medical pluralism: the case study of Estonian medical doctor and spiritual teacher Luule Viilma.

Rather than the harmonious coexistence of different therapeutic practices and meaning systems, medical pluralism involves the contestation of norms and meanings related to legitimacy and authority. The implicit cultural norms that shape local understandings of health and legitimate healing methods become more during periods of social and cultural change. This paper demonstrates the contested nature of medical pluralism based on the case study of one significant figure, Estonian gynaecologist and spiritual teacher Luule Viilma. Well-known to the public as a trailblazer and prominent spokesperson for medical pluralism since the 1990s, Viilma's trajectory from doctor to healer reveals some implicit characteristics and mechanisms of power struggles as evidenced by the 'boundary work' carried out by biomedical specialists. By uniting and bridging biomedicine and spiritual self-help, Viilma became a figure whose presence and teachings gave responsibility and power to individuals and helped to legitimize pluralism in health practices. She had the ambition to redefine, in a fundamental way, perceived norms of legitimacy and authority, as well as the patient's position. From interviews with people who have used Viilma's teachings and material from internet discussion forums, it is apparent that the emergence of new forms of medical pluralism has brought several changes in health-related norms and understandings, including more active personal involvement in health-related information seeking and decision-making.

The rising impact of civic activism on health policy: The analysis of the closure of smaller obstetric units in Estonia.

In 2017, the Estonian government performed an administrative reform with the promise to keep vital services available for people. In March 2018, the closure of two smaller obstetrics units (OU) was announced, thereby raising resistance by community members. The aim of the research is to identify public perceptions and information needs during the closure process of smaller maternity units, and examine it in the context of recently performed administrative reform. Data was collected from 226 respondents via a web-based questionnaire. To evaluate the level of information seeking activity for pregnancy- and birth-giving-related information, new aggregated index variables were constructed. For authorities and lay-people "near home" and "safety" had different meanings in the context of childbirth. Findings revealed strong correlations between perceived information availability and sufficiency (for pregnancy, birth-giving and transfer to the hospital). The subjective lack of information appeared in recognition of the start of the labour and how, when, and where to go. Respondents considered both the medical capability and personal aspects to be equally important. Considering the lack of knowledge and hesitancy among Estonians, the arguments of civic activists presented in the debate were well-grounded. To conclude, public communication must be consistent and people need clearer instructions for activities related to labour-period and security that necessary features of medical help and personal approach to be both available.