Understanding medical desertification through consensus-building sessions in Campania and Sicily (Italy)

Medical deserts are still an unknown concept in Italy. This is one of the conclusions from AHEAD partner Cittadinanzattiva’s research on medical deserts and their pilot project activities on consensus-building in Campania and Sicily. During these local consensus-building sessions, Cittadinanzattiva interviewed local stakeholders about their understanding of and perspectives on medical desertification in the two regions in Italy. The outcomes of these sessions confirmed what Cittadinanzattiva found through an analysis of the shortcomings of territorial assistance in Italy. Cittadinanzattiva identified several common patterns and trends which implicitly refer to medical desertification. Above all, three main characteristics in most research articles were: shortage of healthcare personnel, insufficient healthcare services, and lack of adequate territorial assistance, especially in underserved areas. Other key factors involve uneven and fragmented regional health services in rural areas, poor access to medical care and services, scarce prevention and follow-up, and acute hospitals and medical facilities unable to adequately meet safety and quality standards. Geography also appeared to be a key determinant; in fact, distance and rurality represent barriers of cost, time and inconvenience for patients in accessing primary care and prevention. AHEAD will use these findings for wider/national sessions, to ultimately achieve co-created policy options to address medical deserts.

The Italian paper Il Mattino published an item about AHEAD, you can read it here (in Italian).

How can participatory consensus building contribute to successful policies to counteract medical deserts?

One of AHEAD’s unique selling points is our participatory consensus building methodology.

It is known from literature that successful implementation of health workforce policies requires strong inter-sectoral governance and consensus building among the different stakeholders involved. As a consortium, we have therefore set out to draft, test and validate a consensus building methodology, in order to increase the chances of successfully counteracting medical deserts.

With the consensus building methodology, we aim to achieve the following:

• Implemented in the AHEAD partners’ countries, it contributes to the identification and development of practical, feasible and context-specific policy options, that will support policy makers in their decisions on health workforce issues.
• Implemented, contextualised and evaluated across the AHEAD partners’ countries, it will result in a validated methodology, that we will share in a practical guidance document, so that other organisations can apply the same methodology in their own context.

This method consists of two phases at local level and one at national level, all with facilitated dialogues:

Phase 1 (local level): Dialogues among groups of community representatives, among health workers and health managers and among local policy makers/policy implementers to discuss country research findings and set priorities.

Phase 2 (local level): Representatives from each group come together to discuss their priorities and jointly agree upon a priority of policies representing “the ideal mix of measures”, including advantages and trade-offs.

Phase 3 (national level): Discuss and select measures in a dialogue between local and national level policy makers.

We will share more on consensus building on a new page on our website. Stay tuned!

Watch back: online intermediate event of the EU Health Workforce Projects Cluster

Countries can address access to health inequalities in the population by improving health worker retention and task-shifting policies. So, what should these policies look like? On March 29th, the five projects of the Health Workforce Projects Cluster on the EU Health Policy Platform – including AHEAD – presented the first results of their research during their second webinar on ‘Fighting access to health inequalities by improving health worker retention and task shifting policies’.

On behalf of AHEAD, Mirela Mustata and Dana Farcasanu from the Center for Health Policies and Services (CHPS) presented the findings of our literature review on a multidimensional definition of medical deserts. This definition will be the basis of AHEAD’s research on identifying medical deserts and the Medical Deserts Diagnostics Tool (currently in development).

‘’What we discovered during the literature review stage was the variability of terms that are used to indicate medical deserts and the complexity behind this apparently simple concept. Yet, it became clear that two aspects are key when one indicates whether an area is a medical desert or not: low density of health services in certain areas as compared to population characteristics and needs and physical distance to the health care services that are available. From this starting point, different avenues of research are open: which levels of health care to consider in each country (primary care, emergency, specialized care, what types of specialized care), how to better define population needs, what is the referral point, how to measure distance, how to test and validate the solution? ‘’

Mirela Mustata, researcher

Did you miss the webinar? You can watch it back HERE

Upcoming participation in European Health Management Association (EHMA) in June

On June 15-17, 2022, the European Health Management Association’s (EHMA) Annual Conference 2022 – with the theme ‘From people to systems: leadership for a sustainable future’ – will take place in Brussels, Belgium. The conference will bring together key healthcare stakeholders providing the latest evidence on ways to transform health systems. The conference provides opportunities for health managers and health professionals to have their voices heard, to connect with decision-makers, and inform policymaking at the European level.

On behalf of AHEAD, Mirela Mustata (CHPS) will present our literature review findings on a multidimensional definition of medical deserts.

Would you like to attend the conference? Please register on EHMA’s website

Save the date: Webinar on fighting access to health inequalities by improving health worker retention and task shifting policies on March 29

On March 29th, 2022 (2:30-4:30 PM Brussels time), the Health Workforce Projects Cluster will organise its second webinar. During the webinar ‘Fighting access to health inequalities by improving health worker retention and task shifting policies’, the five Cluster projects will share their progress so far, focusing on the findings from literature review and applying varying methodologies that the projects are implementing. Mirela Mustata and Dana Farcasanu (Centre for Health Policies and Services, Bucharest) will present findings on behalf of the AHEAD project.

Besides the speakers from each project, the Cluster also invited several external speakers. The webinar will be opened by Miklós Szócska – Director, Semmelweis University, Health Services Management Training Centre and Andrzej Rys – Director Health systems, medical products and innovation, DG SANTE, European Commission. The keynote speakers will be Sarada Das, from Standing Committee of European Doctors, who will present their updated workforce strategy, followed by Heather L. Rogers, (Biocruces Bizkaia Heath Research Institute) with an intervention on the mental health opinion of the Expert Panel on effective ways of investing in health.

We are also excited to hear reflections from Ber Oomen, Executive Director of ESNO (European Specialist Nurses Organisation).

Maya Matthews, Head of Unit Performance of Health Systems, DG SANTE, will conclude and close the webinar, with some reflections from DG SANTE.

The Health Workforce Projects Cluster consists of five EU co-funded projects under the umbrella of the 3rd Health Programme. The projects focus on three key topics – medical deserts, task shifting and retention policies:

• Action for Health and Equity – Addressing Medical Deserts: AHEAD
• MEnTal hEalth: fOcus on Retention of healthcare workers: METEOR
• prOmoting evidence-bASed rEformS: OASES
• Empowering EU health policies on Task SHIfting: TaSHI
• A Roadmap OUT of mEdical deserts into supportive Health WorkForce initiatives and policies: ROUTE-HWF

AHEAD: in full research mode

From autumn 2021 onwards, the AHEAD partners have been busy conducting the in-country research and engaging with their stakeholders in project countries.

This stakeholder engagement is aimed at learning about the lived experiences of affected communities and health workers in medical deserts areas. This will help us validate our working definition of medical deserts that we developed earlier in 2021:

“Medical deserts imply the inability of a given population (and / or a population group) to access health services, or the state of isolation when it comes to receiving health services, based on three categories of quantitative and qualitative barriers (‘dimensions’), which are interrelated and dependent on each other, in varying degrees and modalities.”

These barriers are: (1) physical barriers, (2) social barriers and (3) policy barriers. Read more on our website.

Furthermore, we will be circulating surveys and conducting focus group discussions in spring this year.  If you are working in remote areas or are interested to find out more about AHEAD’s research, please get in touch via the contact us form on the AHEAD website.