Perceived barriers to the development of modern public health in Bulgaria: a qualitative study

Abstract

This study is the first to explore specific perspectives and beliefs regarding barriers to the development, modernization, and utilization of public health sciences in Bulgaria. Although the reorientation and strengthening of public health institutions are unlikely to proceed without resistance, optimism for improvement in this field exists now that Bulgaria has joined the EU.

Corruption and population health outcomes: an analysis of data from 133 countries using structural equation modeling

“…High levels of corruption are associated with lower rates of economic growth, inferior public infrastructure, increased public spending, higher income inequality and poverty, and risks to national security (Gupta et al 1998;Louise 2005;Mackey and Liang 2012;Tanzi 1998). Corruption tends to distort the motivations and incentives of decision-makers, service providers, and beneficiaries (Gupta et al 2002;Mackey and Liang 2012;Scott et al 2011). Moreover, the cost of corruption is substantial.…”

“…A large body of literature attests to the negative consequences of corruption in the health sector (Jain 2001;Muldoon et al 2011;Novignon 2015;Schaaf and Freedman 2015;Scott et al 2011;Stipčić et al 2015). For instance, Gupta et al (2002), drawing on data from 89 countries over more than a decade (1985)(1986)(1987)(1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997), found a significant link between corruption and child and infant mortality, low birth weight, lower likelihood of an attended birth, and lower rates of immunization.…”

Political will against funds deficiency: Health promotion for older people in Bulgaria

“…This has not only resulted in a very small health promotion budget but also in limited initiatives in the field of health promotion as well as in the lack of integration between public health programs and other health policy measures [4]. Thus, despite the international collaboration and research projects in Bulgaria, the modern public health and health promotions tools remain largely underutilized [5].…”

“…Various health programs are implemented at the regional level by the 28 RHIs, which are decentralized branches of the Ministry of Health [5]. The RHIs are the most active local stakeholders in the public health area.…”

Health Reforms in South East Europe: An Introduction

“…Policy makers too, by and large, supported the reforms, especially when they were promoted by such influential international organisations as the World Bank. Resistance to the reforms from health professionals, however, was evident in nearly al l the countries of the region, and accounts to some degree for delayed reforms in several of the countries (Scott, Powles et al 2011). Often, reforms failed to reach their proclaimed goals or to improve the accessibility and quality of health care, and robust evaluations of reform e fforts have generally been lacking (Rechel and McKee 2009).…”