During the 17th Public Health World Congress in Rome, held 2–5 May, participants discussed how borders affect people’s access to health care services near their homes. The WHO Regions for Health Network (RHN) brought together representatives from different regions and institutions – including the Healthacross Initiative, Cross-border Institute of Healthcare Systems and Prevention (CBI) and euPrevent Foundation – to consider current developments as well as lessons learned from the COVID-19 pandemic. The main result was to show how borders still represent a significant obstacle to addressing the health needs of people living close by, and to showcase examples of how to confront these issues.
Approximately 1 in 3 European citizens live in a cross-border region. These regions often share common economic, cultural, and social ties, and individuals should be able to seek health care services across borders when needed. Enhancing cross-border collaboration can improve health care accessibility, reduce disparities, and strengthen the overall health outcomes of these populations.
Citizen participation
The key enabling factors for cross border-cooperation include acquiring knowledge on the context and issues to be addressed, stakeholder involvement and citizen participation, and the implementation of cooperation projects to address bottlenecks.
The first step is to have a clear idea of how borders affect the free movement of people and, more specifically, their access to local health care services. Adriana Perez Fortis, Scientific Coordinator at the Cross-border Institute of Healthcare Systems and Prevention (CBI), presented current cross-border health research projects focused on comparing health care structures, processes, and outcomes in the Northern German-Dutch cross-border region. These allow for comparative epidemiological data and health system analysis, which can then be used as the basis to design implementation initiatives aimed at improving the health and well-being of citizens residing in the Northern Dutch-German border region.
To secure stakeholder involvement and citizen participation, the euPrevent Foundation advocates for citizen summits to discuss specific topics, such as equity, participatory approach, human resources for health, and COVID-19 and public health service. Marleen Struss, a project worker at euPrevent, underlined how citizen participation in the decision-making processes of border regions helps to ensure that project outcomes are closely aligned with the lived reality for people in these areas.
Cooperation projects
Examples of cross-border cooperation projects were presented by Julia Winkler, EU Project Manager at the Healthacross Initiative. The Initiative is run by the Lower Austria government and supports communities across borders to have better and equitable access to health services close to home, which is especially crucial when considering emergency cases. The Healthacross Initiative recently built a primary health care center in Gmund, on the border between Lower Austria and the Czech Republic, which helped secure improved and faster access to primary care services in an efficient and cost-effective way for people on both sides of the border. Other projects focused on allowing access to specialized neonatology services in Slovakia for patients across the border in Austria, and facilitating hospital and emergency services in the Lower Austria-South Bohemia border region.
Dr Bettina Menne, Senior Policy Advisor at the WHO Venice Office, concluded the session by discussing the critical challenges surrounding cross-border cooperation, including a lack of clarity in promoting patients' rights, limited awareness among citizens, and a lack of cooperation from health institutions.