Suchergebnisse

Aim To assess the European Union's (EU) impact on the Croatian health policy, and identify which mechanisms and processes were used to shape a particular health policy on the EU and national levels. The study focused on the rare diseases policy to obtain a better insight into the process of policy shaping, starting at the EU level and moving down to the Croatian national level. Methods We conducted actor analysis, policy networks, and semi-structured qualitative interviews with key policy actors at the EU and domestic level. The analysis of actors included actor mapping, the analysis of their relationships, and of their interdependence. Policy networks involved identifying key actors and analyzing them separately to create both policy networks to explain their hierarchy and relationships. Semi-structured interviews included ten key experts at the EU and national health policy levels. Results The implementation of the EU health policy is complex. Hard and soft law were complementary in the way they affected the translation of EU rare diseases policy into Croatian law. Strong and interconnected EU and domestic actors were significant in this process, which resulted in the creation of Croatia's rare diseases policy. Conclusion Given that the rare diseases policy area is a developing policy area, this study contributes to a better understanding of the implementation of the EU health policy, clarifying a mechanism that can enable national governments to adopt specific health policies.

This paper concerns new forms of collective agency in the area of health care in Croatia from 2015 until 2018. These new forms developed in the midst of the growing privatization and commodification of health care and the simultaneous decrease in the accessibility to health care. Privatization has taken place slowly, but continuously over the last 29 years. The traditional civil society organizations in the field of health care used to be characterized by a narrow set of activities, with vertical structures, and were frequently focused on a single-disease approach and collaboration with the pharmaceutical industry. Such practices produced limited results, hence improved forms of activism emerged. In this research, we illustrate their development using the example of three case studies of collective agency. The first case study is looking at the policy analysis and the activist group started by the Organization for Workers' Initiative and Democratization (OWID); the second one focuses on the informal group of medical students called U3 formed at the Andrija Štampar School of Public Health with the aim of developing critical thinking; and the third case study considers the Karika Association, started as an attempt to rethink health care in the community. The main research methods employed included process tracing analysis and research data comparison aimed at showing the differences between the traditional and the new forms of healthcare activism, in addition to the secondary sources of information such as scientific and professional literature. The results show that the new forms of collective agency in the healthcare area include various groups of citizens not necessarily connected with a specific disease, that they have a horizontal structure and are focused on the healthcare system in general. In conclusion, they represent the beginning of a paradigmatic shift in activism from a single-disease approach towards comprehensive health care that has the potential to deal with the growing issue of commercialization, commodification and inequalities in today's healthcare systems.