Medical Deserts – Program Evaluation Case Study

Healthcare systems are highly labour-intensive and depend on their workforce for functioning and performance. In the last decade, the term ‘medical deserts’ has come into widespread use across European countries to describe underserved areas in terms of local medical density or disparity between healthcare supply and demand. As such, investigations around the different manifestations of medical deserts in Europe are critical to the development of policy solutions to improve the availability of skilled healthcare workers for all. Although healthcare policies across Europe aim to ensure Universal Healthcare Coverage (UHC) for all, even countries with a large number of doctors, access to healthcare services can still be a challenge to many. In Serbia, for example, although the number of physicians and nurses per 100 000 inhabitants increased between 1991 and 2016, the distribution of health professionals is still unequal across the country and there is a shortage of some specialties. This is particularly true in rural and remote areas – both in Serbia and other countries – where healthcare providers and general practitioners are lacking, compared to the national average.

Even though a pattern can be seen in the way medical deserts come to life in Europe, Medical Desertification is not a well studied challenge in the region, particularly using a country specific lense. This is especially true when considering the ongoing COVID-19 pandemic, where additional strain was placed on healthcare systems, exacerbating pre-existing challenges.

Organizations across the globe are working to address Medical Deserts. Examples include the Action for Health and Equity Addressing Medical Deserts (AHEAD) Project, that was launched in April 2021. It aims to achieve better access to health services, especially in underserved areas, and more equitable access to sufficient, skilled and motivated health workers in Italy, Moldova, the Netherlands, Romania and Serbia. Through the AHEAD project, the consortium wants to ​​investigate the different manifestations of medical deserts in the aforementioned European countries and develop policy solutions that will improve the availability and accessibility of skilled health workers or all.

Q3 Strategy was contracted by Wemos, as the lead partner of the consortium, to perform an external evaluation of the AHEAD project, both at its mid-point (May 22) and end-point (April 23), to provide important insight to inform programmatic reform and guide policy development and implementation. The overall objective of this evaluation is to assess the progress and measure the effectiveness and impact of the AHEAD Project in achieving its objectives to;

  1. Generate evidence and build stakeholder knowledge on medical deserts and related policies in each study country (by October 2022).
  2. Develop and build consensus on context-specific, feasible policy measures to support policy makers to counteract and prevent medical deserts (by April 2023).
  3. Ensure joint reflection on effective, feasible and acceptable policy measures to prevent and counteract medical deserts, among national and European key stakeholders (by April 2023).

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