Quelles étaient les tendances observées dans les indicateurs de la santé publique au cours de ces quatre dernières années ? Quels facteurs influencent la santé et quels sont les défis pour l'avenir ? Comment les systèmes de santé peuvent-ils contribuer à l'amélioration de la santé des populations de la Région européenne de l'OMS ? En répondant à ces questions, ce rapport présente les réformes de grande ampleur entreprises par les pays afin de renforcer la performance de quatre fonctions fondamentales des systèmes de santé: la prestation de services, l'obtention de ressources, le financement et la fonction de direction (" stewardship "). Ce rapport présente des informations essentielles de santé publique afin d'aider les pays à opter pour des investissements judicieux. Il doit encourager la mise en oeuvre efficace de réformes et de politiques dans le domaine des systèmes de santé, et contribuer à l'amélioration de la performance des systèmes de santé nationaux de manière à dispenser des soins efficaces, axés sur les patients et de haute qualité. L'annexe reprend certaines des données utilisées dans l'analyse.

What are public health services? Countries across Europe understand what they are or what they should include differently. This study describes the experiences of nine countries detailing the ways they have opted to organize and finance public health services and train and employ their public health workforce. It covers England France Germany Italy the Netherlands Slovenia Sweden Poland and the Republic of Moldova and aims to give insights into current practice that will support decision-makers in their efforts to strengthen public health capacities and services. Each country chapter captures the historical background of public health services and the context in which they operate; sets out the main organizational structures; assesses the sources of public health financing and how it is allocated; explains the training and employment of the public health workforce; and analyses existing frameworks for quality and performance assessment. The study reveals a wide range of experience and variation across Europe and clearly illustrates two fundamentally different approaches to public health services: integration with curative health services (as in Slovenia or Sweden) or organization and provision through a separate parallel structure (Republic of Moldova). The case studies explore the context that explain this divergence and its implications. This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe Division of Health Systems and Public Health. It accompanies two other Observatory publications Organization and financing of public health services in Europe and The role of public health organizations in addressing public health problems in Europe: the case of obesity alcohol and antimicrobial resistance (both forthcoming).

Health Politics in Europe: A Handbook is a major new reference work, which provides historical background and up-to-date information and analysis on health politics and health systems throughout Europe. In particular, it captures developments that have taken place since the end of the Cold War, a turning point for many European health systems, with most post-communist transition countries privatizing their state-run health systems, and many Western European health systems experimenting with new public management and other market-oriented health reforms. Following three introductory, stage-setting chapters, the handbook offers country cases divided into seven regional sections, each of which begins with a short regional outlook chapter that highlights the region's common characteristics and divergent paths taken by the separate countries, including comparative data on health system financing, healthcare access, and the political salience of health. Each regional section contains at least one detailed main case, followed by shorter treatments of the other countries in the region. Country chapters feature a historical overview focusing on the country's progression through a series of political regimes and the consequences of this history for the health system; an overview of the institutions and functioning of the contemporary health system; and a political narrative tracing the politics of health policy since 1989. This political narrative, the core of each country case, examines key health reforms in order to understand the political motivations and dynamics behind them and their impact on public opinion and political legitimacy. The handbook's systematic structure makes it useful for country-specific, cross-national, and topical research and analysis.

Noncommunicable diseases pose the greatest threat to the health of the people in the WHO European Region, yet this is an area where the greatest health gains are available at relatively modest cost. This book gives detailed insight into policy development in eight European countries over several decades to address the challenge of noncommunicable diseases, and draws out the main themes to assist policy-makers in formulating their own responses. While originally developed to support countries in implementing the WHO European Strategy for the Prevention and Control of Noncommunicable Diseases, the insights are likely to be of benefit to a much wider audience.

Examining which actors determine undocumented migrants’ access to healthcare on the ground, this volume looks at what happens in the daily interactions between administrative personnel, healthcare professionals and migrant patients in healthcare institutions across Europe. Borders across Healthcare explores contemporary moral economies of the healthcare-migration nexus. The volume documents the many ways in which borders come to disrupt healthcare settings and illuminates how judgements of a health-related deservingness become increasingly important, producing hierarchies that undermine a universal right to healthcare.