Health Management in South-Eastern Europe: challenges and opportunities

21 December 2022

At the moment, the South-Eastern Europe Health Network (SEEHN) provides the leading example of a collaborative intergovernmental body for health in the South-Eastern European region and has been working on broad initiatives for collaboration between countries since its inception in 2001. However, there is space for further regional collaboration on health issues, particularly to address existing challenges related to health management. For this reason, in June 2021 we created a Special Interest Group on South-Eastern Europe (SIG SEE) to support health managers in the region to address these challenges.

Broadly, the SIG SEE aims to strengthen health management capacity to create more resilient health systems that deliver excellent quality care and improve health outcomes for the region’s citizens. Achieving this aim involves many interrelated activities, including dissemination of evidence-based practices in health management, ensuring that these practices are supported by strong policy, creating a forum for health managers to exchange knowledge, supporting the implementation of lessons learnt from the COVID-19 pandemic, and helping to meet the training needs of the health workforce.

As a first step in this work, the SIG SEE requires a strong understanding of the issues faced by health managers across the region. This paper aims to provide this understanding through a comprehensive literature review covering the current health management challenges present in each country in the region. Rather than presenting data and statistics on health systems and health outcomes, which is already widely available through national government sources and organisations like the World Health Organization, this review will focus specifically on outlining the landscape for each country specifically from the health management perspective, including workforce, policy and economic considerations.



This report supports the work of the EHMA Special Interest Group on the South-Eastern European region, which aims to:

  • Identify the main challenges that health systems in South-Eastern Europe face and share best practices to increase resilience.
  • Build on the expertise and insights of leading health experts in the region to brainstorm practical steps countries can take to increase health management capacity and capability.
  • Support the efforts of the South-Eastern Europe Health Network (SEEHN) and promote collaboration between SEE countries to foster mutual learning and improve the health of citizens.
  • Mobilise relevant local, national, and regional stakeholders around identified priority reforms to transform healthcare systems.
  • Raise awareness about the challenges and strengths of the SEE healthcare systems and build commitment to address these challenges at the EU level.
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The development of this report is co-funded by the EU4Health Programme of the European Union under grant agreement No 101082904. This page and the publications contained herein only reflect the author’s views. The European Union is not liable for any use that might be made of the information contained in this page and publications.


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I have been active in EHMA since the first years of the '90s and I have seen its evolution from a small association of members interested in sharing knowledge on health management practices to the current status of reference and advisory key player for EU, health systems and organisations, stakeholders associations, industry and universities. EHMA is now a unique knowledge hub, policy advisor, community of practice and network of best in class organisations involved in health policy and management. A place where health managers can build their competences, policy-makers and stakeholder associations envision how to implement and sustain change through health management, industry leaders understand how to engage more effectively with health organisations and systems. The right place to nurture and grow health management capabilities and capacity for every stakeholder of health systems.

Prof. Federico Lega, University of Milan, Italy

Health management has a crucial function in shaping public health and health system challenges. The Medical University of Varna, Bulgaria had success in collaborating with EHMA on EU-funded projects that has resourced us to create new health management competencies for the future workforce. In addition to all classical definitions, health management is a science dealing with individuals, groups, and society at large. It is an art contributing to the beauty of our lives and an interactive communication process at all levels of institutions and human energy. I have also had the pleasure to chair the South Eastern European Special Interest Group which gives members a space to discuss and tools to address how health systems are managed in our regions.

Prof. Todorka Kostadinova, Medical University of Varna, Bulgaria

I enjoy the high level of interaction and engagement in EHMA’s activities, in particular during the annual conference where the panel discussions are rich and well prepared. As a hospital manager and professor of health management, EHMA motivates and inspires me to be creative. You go back home feeling energised from seeing old friends and making new connections, as well as being convinced of serving as EHMA’s ambassador. It’s a strong feeling of interdisciplinary engagement, but it also feels like being part of family-like community.

Prof. Sandra C. Buttigieg, University of Malta, Malta

EHMA is a pre-eminent organisation for everyone working in planning, managing and delivering health services across Europe. As a long standing member of EHMA I have always been impressed by the vibrant community of managers, researchers and academics it has created and by the many opportunities for sharing knowledge and funding opportunities it has brought to its members. Its international scope is impressive and its impact is often felt in management and research across European and national health systems.

Prof. Axel Kaehne, Edge Hill University, UK

Health workforce has become more essential in operating, managing and maintaining health systems lately, particularly in crisis and emergency situations. European healthcare professions and the workforce need to be high on the agenda of managers and decision makers. The Health Services Management Training Centre, Semmelweis University in Hungary is a longstanding EHMA member, because it connects us with collaborators and experts, with whom we can have complex debates, from whom we can learn and at the end find solutions in various challenging fields of healthcare management.

Dr Eszter Kovács, Health Services Management Training Centre, Semmelweis University, Hungary

As a hospital administrator and health management professor, I see on a daily basis that the healthcare challenges require talented and skilled managers to transform it. the EHMA membership has been beneficial to bring healthcare management research and education to the demanding healthcare services world, promoting healthcare management competencies and knowledge creation.

Dr Alexandre Lourenco, APAH - Association of Portuguese Hospital Managers, Portugal

Many healthcare systems in Europe and beyond are facing similar challenges which require innovative and creative solutions. EHMA’s annual conference, webinars, Programme Directors’ group and other activities and resources provide incredible opportunities for networking, connecting and sharing experiences. A distinct feature of EHMA is the diversity of members with representation from many countries, sectors and different communities of practice – academic, policy-makers, practitioners, managers, leaders and students. The annual conference is a highlight in the calendar year, offering a friendly, fun and learningful environment for emerging and established members to engage, collaborate and meet up with old and new friends. I am proud to be a member of the EHMA Board.

Prof. Ann Mahon, University of Manchester, UK

Society evolution, pandemics and ageing modify health needs. So, health policies and services are to change dramatically. EHMA, through webinars, workshops and annual conference provides an excellent insight to a professional changing world, favouring closeness to management innovation and the protagonists of these changes. As a primary care services’ manager, participating in EHMA activities is really worth it and allows to involve oneself in the innovation processes.

Dr Antoni Peris Grao, Consorci Castelldefels Agents de Salut (CASAP), Spain