International Journal of Public Health

, Volume 56, Issue 2, pp 191–199 | Cite as

Perceived barriers to the development of modern public health in Bulgaria: a qualitative study

  • Kirstin Woody Scott
  • John Powles
  • Hilary Thomas
  • Boika Rechel
Original Article
First Online:
Received:
Revised:
Accepted:

Abstract

Objectives

This qualitative investigation documents Bulgarian perspectives on public health following its accession to the European Union (EU) and explores perceived obstacles to the modernization of public health sciences to more effectively address the country’s high rates of premature avoidable mortality.

Methods

28 semi-structured interviews were conducted throughout Bulgaria in April 2007 with Bulgarian academics, clinicians, policymakers and students in Sofia, Varna and Pleven. Full transcripts were subjected to formal thematic analysis.

Results

Respondents identified various barriers to the development and modernization to public health infrastructures in Bulgaria that were classified by four key interlinked themes: (1) institutional and political, (2) financial, (3) dearth of local epidemiological studies, and (4) insufficient public health capacity.

Conclusions

This study is the first to explore specific perspectives and beliefs regarding barriers to the development, modernization, and utilization of public health sciences in Bulgaria. Although the reorientation and strengthening of public health institutions are unlikely to proceed without resistance, optimism for improvement in this field exists now that Bulgaria has joined the EU.

Keywords

Public health Bulgaria Qualitative study Health policy Eastern Europe Barriers 
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Notes

Acknowledgments

This project was partially financed by the Department of Public Health & Primary Care and Churchill College of the University of Cambridge. The authors wish to thank the interviewees who remain nameless in this study yet are deserving of our greatest appreciation as this project would have been impossible without their participation.

Conflict of interest statement

None declared.

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Copyright information

© Swiss School of Public Health 2010

Authors and Affiliations

  • Kirstin Woody Scott
    • 1
  • John Powles
    • 1
  • Hilary Thomas
    • 2
  • Boika Rechel
    • 3
  1. 1.Department of Public Health and Primary Care, Institute of Public HealthUniversity of Cambridge, University Forvie SiteCambridgeUK
  2. 2.Centre for Research in Primary and Community CareUniversity of HertfordshireHatfieldUK
  3. 3.School of Medicine, Health Policy and PracticeUniversity of East AngliaNorwichUK

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