Rechel, Boika, Spencer, Nick, Blackburn, Clare and Rechel, Bernd (2010) Policy challenges to the quality of child health services in Bulgaria. The International Journal of Health Planning and Management, 25 (4). pp. 350-367. ISSN 0749-6753
Full text not available from this repository.Abstract
Background: Our study aimed to explore policy challenges to the quality of child health services in Bulgaria. Methods: The study was based on qualitative in-depth interviews, analysis of regulatory documents, and review of the literature. Respondents included policy-makers, providers and users of health services, from both rural and urban areas. Results: Problems identified included insufficient training of general practitioners, medical errors, delays in response to emergencies, inadequate information provided to patients, and underdeveloped child public health. A common view was that paediatricians provide better quality care than general practitioners. Respondents described a lack of clinical guidelines for rational use of pharmaceuticals, overprescribing of antibiotics, reliance on pharmaceutical companies for information, and unrestricted sales of drugs over-the-counter. ‘Clinical pathways’, introduced as a payment mechanism in hospitals, were perceived as lacking transparency, complicating clinical practice, and forcing doctors to record wrong diagnoses and conduct unnecessary investigations. Conclusions: Our findings indicate the need to develop evidence-based clinical guidelines for primary and secondary care, establish payment mechanisms that facilitate quality improvements, promote rational use of pharmaceuticals, improve continuing training of physicians and strengthen child public health.
| Item Type: | Article |
|---|---|
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| Depositing User: | EPrints Services |
| Date Deposited: | 25 Nov 2010 11:12 |
| Last Modified: | 12 Oct 2025 18:32 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/14840 |
| DOI: | 10.1002/hpm.1030 |
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