6 Facts About Healthcare In BulgariaBulgaria is an Eastern European country south of Greece, north of Romania and east of the Black Sea. With a population of 7 million and cultural influence from the Ottoman Empire, Greece and Persia, Bulgaria has a unique and diverse background. Health care is a vital aspect of European life and Bulgaria is no different. Here are six facts about healthcare in Bulgaria.

6 Facts About Healthcare In Bulgaria

  1. Bulgaria has Centralized Healthcare. Healthcare in Bulgaria is largely centralized, with the National Assembly, the National Health Insurance Fund and the Ministry of Health standing as the main funders. Social single-payer healthcare is monitored through the NHIF, which covers services included in the benefits package and certain medications. Voluntary healthcare is administered by for-profit insurance companies and deals with both the citizens and providers. These systems, working in collaboration with the Ministry of Health, fund services including emergency care, in-patient mental health care and the development of medical science. The amount of money spent on healthcare in Bulgaria continues to rise, but fees for citizens remain the same.
  2. The Bulgarian Healthcare System Suffers Overcrowding. In 2016, Bulgaria had slightly more than 321 hospitals and less than 50,000 hospital beds as the population was continuing to grow. This led to a severe overcapacity of the healthcare system. Highly more than 5.5% of working adults serve in the healthcare field. While the number of physicians has increased, the number of general practitioners is limited. This is partly due to aging and the ongoing emigration problem. The ratio of nurses is the worst in the EU with just 1.1 nurses per physician. Overall, healthcare in Bulgaria faces challenges such as a lack of medical equipment and healthcare providers.
  3. Overall Health is on the Rise. The primary causes of death in Bulgaria are the same as in most European countries: Circulatory diseases, such as coronary heart failure, strokes and cancers. Despite this, the standardized death rates for circulatory diseases have been steadily decreasing since the 1990s. Deaths by ischaemic heart disease fell by 30% from 2014 to 2015 and cancer deaths have been on the decline for more than a decade. This positive trend is due to improved healthcare in Bulgaria and better lifestyle choices.
  4. The Population is Declining. The Bulgarian population has been declining from 9 million at the end of the 1980s to fewer than 7 million by 2018. The primary reason is a low birthrate, compounded by a high rate of emigration. In 2015, more than 13,000 citizens were leaving the country compared with only 9,000 foreigners entering. However, most Bulgarians end up immigrating to other European countries, with more than 60,000 Bulgarians migrating each year. One reason for emigration is that the country is one of the most impoverished nations within the European Union, with most citizens unable to support themselves and healthcare in Bulgaria being difficult to access.
  5. Bulgaria is Well Behind the Rest of the EU. Although healthcare in Bulgaria is good by some measures, the country is far behind the rest of the European Union. The quality of work is so low that protesters have taken to the streets to stand up against low wages, corruption and high bills. This led to the Bulgarian government resigning, causing more economic instability within the country. The unemployment rates are lower than in crisis-ridden nations; however, because of low wages, more Bulgarians are considering moving to Greece and Spain, which have higher unemployment rates. In 2015, Bulgaria stood as the unhappiest country in the EU, according to a survey.
  6. Bulgaria’s Increased Healthcare Spending. Healthcare in Bulgaria is taking a hard hit due to the novel coronavirus, with an increase in healthcare spending by 250 million leva or €123 million. Half of the increased spending will go to the National Health Insurance Fund, which manages insurance and distributes funds to the healthcare system. A significant portion of the money will go to increasing the salaries of frontline medical staff until the end of the year as well as health personnel in state institutions.

Although Bulgaria is far behind the rest of the European Union in many different ways, Bulgaria is a progressive nation with universal healthcare and low hospital bills. With more investments in general practitioners and healthcare facilities as well as better living conditions and incentives to keep citizens in the country, Bulgaria can progress toward health and prosperity.

– Breanna Bonner
Photo: Flickr

Healthcare and Fake News in Côte dIvoire
Côte d’Ivoire is one of the strongest economic powers in West Africa; nevertheless, Côte d’Ivoire ranks poorly in healthcare and medical services. The First and Second Ivorian Civil War caused the rapid deterioration of the country’s economy, living standards and health system. While the government has largely restored stability, healthcare in Côte d’Ivoire continues to underperform in several sectors under the onslaught of fake news.

Civil Wars in Côte d’Ivoire

After its independence from France in 1960, Côte d’Ivoire became West Africa’s second-largest economy thanks to its cocoa and cashew exports. It enjoyed prosperous economic growth until the First Ivorian Civil War brought political and economic crises that ended recently in 2007.

The country recovered rapidly from the first civil war and maintained several years of uninterrupted economic growth. The 2010 elections also promised a hopeful continuation for the healthcare in Côte d’Ivoire: compared to previous healthcare coverage of only 10 percent of the population, child mortality was now decreasing and immunization rates were on the rise.

The outcome of the elections, however, was disastrous. The results reignited tensions, and the nation quickly descended into its second civil war. The conflict brought about dire consequences to the country’s economy, infrastructure, and consequently, the healthcare system. Coverage of routine immunization — needed to fight the spread of diseases like Malaria, the top cause of death for the people of Côte d’Ivoire — dropped from 85 percent in 2010 to 62 percent just a year later.

Post Civil War

Since the Second Ivorian Civil War, Côte d’Ivoire’s economy has been growing again. Over the past five years, the country has demonstrated an average annual GDP gain of 8.1 percent, probably as the result of substantial foreign investments. Since 2018, the government has also acted to simplify bureaucratic procedures and corporate taxes to support small and medium-sized businesses. It also joined the Asian Infrastructure Investment Bank in 2019. Clearly, Côte d’Ivoire has a resilient economy. Attempts to revive its healthcare, however, have been less successful, despite efforts made to improve access to health services by rehabilitating and building new facilities.

Healthcare in Côte d’Ivoire

The Ivorian government even made health care coverage mandatory in 2014. It established the National Health Insurance Fund to manage health financing schemes. Furthermore, the 2016-2020 National Health Development Plan works for an annual budget increase of 15 percent and channels investments towards individuals with the most urgent health issues.

Nevertheless, several factors indicate a troubled healthcare system. Côte d’Ivoire has one of the lowest life expectancy rates in the world at 57.4 years as of 2018. Furthermore, the maternal mortality rate is extremely high. In 2017, there were 617 maternal deaths per 100,000 births. More than 33 infants died per 1,000 births. Though decreasing, Malaria caused 33 percent of medical consultations in 2017. HIV/AIDS affected 2.6 percent of adults in 2018. Tuberculosis infected 142 out of 100,000 inhabitants. While the numbers are slowly improving, the difference between economic and healthcare recovery in Côte d’Ivoire is striking.

Fake News

There are several reasons why healthcare in Côte d’Ivoire continues to struggle despite government legislation. For example, medical clinics are still too far from certain remote villages and affordability remains an issue for many people. A recent problem, however, has also been the spread of fake news. Ismael Ben Farouck Fofana, a professor of advanced molecular biology at Boston College originally from Côte d’Ivoire, spoke with The Borgen Project. He explained that “a big problem now is the internet. [There is a lot of] misinformation and conspiracy theories are going around. We now have so many experts.” The people are misinformed on topics like diseases and vaccinations, and so they avoid healthcare in Côte d’Ivoire out of fear of nonexistent side-effects and complications.

There Is Hope

Thankfully, there are several fronts fighting to diminish fake news and empower its citizens to make educated decisions. In 2019 the U.S. embassy in Abidjan, Côte d’Ivoire sponsored the training of ten applicants about fact-checking. These individuals were taught to recognize fake videos and photos, especially those posted on social media.

In May 2020, an Ivorian telephone company donated CFA 300 million to the Ivorian Ministry of Youth Promotion and Employment in support of its “Le Bon Son” (The Right Sound). This campaign was started to fight fake news regarding COVID-19. The funding was used to equip a call center with a greater processing capacity (5,000 free calls, daily), for a faster flow of information.

Despite a powerful economy, fake news has had terrible effects on healthcare in Côte d’Ivoire. Recognizing an issue is the first step to solving it.  Now empowered with the truth, Côte d’Ivoire has started fighting back against the onslaught of falsehood that takes advantage of vulnerable populations.

Margherita Bassi
Photo: Flickr