Citizen participation in healthcare in Bulgaria: the gap between citizens, health experts, and local officials

Abstract

PURPOSE: To investigate the views of the different stakeholders about the citizen involvement in healthcare decision-making on the local level in Bulgaria. MATERIAL AND METHODS: Opinion poll in three Bulgarian municipalities with different demographic, socio-economic, geographic and ethnic profiles was carried out. Representatives from three groups (citizens, municipality officials and health experts) took part in personal interviews. RESULTS: There was a significant difference (p<0.0001) in the opinion among the three groups about the citizen role in the healthcare decision-making in the municipalities, the availability of information and opportunities for citizen participation, and the consideration of the citizen's views by municipal decision makers. The experts and the municipal officials would like that citizen played a more prominent role in the healthcare decision-making in contrast to citizen's opinion. More than 60% of the municipal officials thought that the citizens are informed, have possibilities for participation and views considered by the municipal decision-makers while the majority of the health experts and citizens had the opposite opinion. CONCLUSION: There were significant opinion gaps between the groups about the healthcare decision-making in the three Bulgarian municipalities. Bridging the gaps required not only proper information or possibilities for participation but also motivated citizens by mutual respect, openness and better understanding of the benefits and values of citizen's involvement in public health. Scripta Scientifica Medica 2013; 45(3): 82-85.