According to the Operational Programme “Greece-Bulgaria 2014-2020”, “the health status indicators in the cross-border area have not been satisfactory for a long time, despite the satisfactory levels (in terms of quantity) of healthcare infrastructure in the area, indicating a lack of effectiveness and proper spatial distribution of such resources.

The rise of poverty in the cross-border area now exerts increased pressure on health care systems, while it also places vulnerable groups (which have a significant presence in the CB area) at increased risk of peril. At the same time, economic recession and disinvestment prevent many CB area inhabitants from gaining access to healthcare services (uninsured civilians).

Health inequalities in the CB area are shaped by the inequalities in availability, access and quality of services, by the financial burden these impose on people, and even by the linguistic, cultural and gender-based barriers that are often embedded in the way in which clinical practice is conducted.

Supply gaps are still a reality in the border-zone or buffer area, making the extension of health service networks across the border a priority concern. Further, service delivery reforms are needed to transform conventional healthcare delivery into primary care, optimizing the contribution of health services – local health systems, health-care networks, health districts – to health and equity while responding to the growing expectations for better health performance.

Especially in the low income parts of the CB area, the opportunity exists to reorient existing health services towards primary care, to improve the health of affected communities”.

To this extent, within the Investment Priority 9a and the Specific Objective 8 of the Programme, the Member States seek to achieve:

• Increased capacity and effectiveness of the primary health-care system – which exhibits better territorial and social coverage than secondary and tertiary health-care, and more specifically (a) increased diagnostic and therapeutic procedures provided at primary healthcare level and (ii) increased quality and efficiency of primary health-care.
• Diversion of a significant volume of health care visits from secondary and tertiary facilities to primary care facilities.
• Increased access to healthcare for vulnerable groups and marginalized communities with high CB Mobility.

Source: Operational Programme “Greece-Bulgaria 2014-2020”, available online at

http://www.greece-bulgaria.eu/com/16_Programme-main-documents