Young Forum Gastein and European Observatory on Health Systems and Policies

European Health Systems
Case study – Croatia

After its turbulent history and independence in early 90s, Croatia has shown its efforts to become a part of the European family and finally joined the EU in the latest enlargement wave on 1st July 2013, becoming the 28th Member State. Five years later, in the series of European Health Systems workshops, the Young Gasteiners met in Zagreb ahead of the country´s first presidency of the Council of the European Union in the beginning of 2020.

Despite the crisis and major fiscal pressures on health expenditure, Croatia has kept publicly funded health services accessible to the entire population, and has made progress in recent years in improving the health status of its population. However, regardless of its accessibility and major medical successes (i.e. organ transplantation), the Croatian health system is currently facing many challenges, especially in the context of smoking, alcohol and obesity, structural issues related to centralization and geographical accessibility, corruption and financing, hospital accreditation and performance measurement, workforce and brain-drain.

From this outline, it is clear that there is a window of opportunity for a discussion in the framework of the Young Forum Gastein activities with the involvement of both Croatian and other European senior experts.

The first day was dedicated to an in-depth analysis of all of the components of a health system, with all the examples being taken from the Croatian health system, facilitated by two appointed lecturers from the European Observatory on Health Systems and Policies, Dr. Anne Spranger and Dr. Bernd Rechel. Croatian Deputy Minister of Health, Dr Mate Car, explained the main challenges detected within the scope of the national system, setting the scene for the interactive part of the workshop.

The Young Gasteiners then split into previously assigned groups and were expected to work on a specific challenge and come up with the tools and recommendations on how to approach it. Each group had a Croatian expert working closely on the topic who provided the background and additional context of the issues. The groups worked on two main topics; health workforce and hospital accreditation, management and performance.

The second day of the workshop was dedicated to the presentation of the group work to an audience of key Croatian stakeholders. An impressive range of policy makers, public health professionals, representatives of national health insurance, the pharmaceutical industry, academia and civil society were present to hear the Young Gasteiners’ ideas.

First, the two groups that had worked on the challenges in the health workforce presented their ideas. Interestingly, the two groups had come up with quite different solutions. The first group presented actions in planning, recruiting and retaining the future health workforce, based on the Framework for Remote Rural Workforce Stability. The second group focused on nurses, presenting a ten-step action plan to improve their status in the Croatian health care system, ending with the Yoda-esque wish ‘May the workforce be with you’.

Next, the two groups that had focused on hospital management came forward with their ideas. The first group started refreshingly by pointing out the things that Croatia does well. Topics that still need to be addressed are trust, vision, accountability and implementation, and the way to do this is to launch a governance framework for vertical collaboration and to ensure continuity of knowledge and expertise retention. The second group presented a three-tiered approach to improve quality and safety, performance monitoring and the use of patient experiences in hospital monitoring.

Both sets of presentations were followed by lively discussions between the Young Gasteiners and the experts. These discussions focussed both on the promisingness of some of the presented solutions as well as the barriers for implementing them, these barriers sometimes being typically Croatian, sometimes universal. How can we uncover and link data? How can we implement actions, what incentives are needed? How can we shift focus from ‘making yourself seem the best’ to actually improving quality? Who is responsible for making the necessary decisions?

This workshop has truly been a thrilling learning experience. The process of diving into a country’s health system and its challenges, coming up with solutions in a short time spam and presenting and discussing these with high-level experts provides an invaluable opportunity to refine skills necessary for our future as public health experts. This concept is unique of its kind, it breaks the silos and helps us better understand different organizations we work in and challenges we face in delivering health care. And hopefully, the diverse perspectives from our different countries and backgrounds gave the Croatian experts new ideas on how to tackle the challenges facing the health workforce and hospital management.

Finally, let us not forget the social part of our stay in Zagreb. Young Forum Gastein is above all a network, and the intervals of leisure time between the hard work is where true connections and friendships are formed and knowledge is shared. Thanks to our host, we also had the opportunity to enjoy a lovely dinner and the beautiful scenery of the city of Zagreb during the light festival season.

Many thanks to YFG, European Observatory on Health Systems and Policies and ‘Andrija Stampar’ School of Public Health for hosting this workshop. We hope the delivered ideas and solutions will be of use and have a positive impact on national health system. We look forward to our next meeting in another country!

Written by Lilian van der Ven and Franjo Caic

Young Gasteiners meet with WHO-EURO Chief Scientist & Representative to the EU Roberto Bertollini

On 15 January 2015, a group of ten Young Gasteiners came together at the WHO Office at the European Union in Brussels to meet with Roberto Bertollini, current Chief Scientist of WHO-EURO and Representative to the European Union. Organised by the fellow Young Gasteiner Sofia Ribeiro, the group talked informally about the future role and functioning of WHO in an ever more multipolar world.
After a short presentation of the Young Gastein Network and its role in each European Health Forum Gastein, as well as an overview of the activities which took place, the workshop proceeded with the intervention of Roberto Bertollini. We had an overview of the WHO history, with a focus on recent challenges such as the reform and the international health threats. Also we discussed the relations between WHO and the EU and respective challenges in their cooperation. The workshop ended with a question and answer session, covering WHO related issues and possibilities of employment within the organization.  After a very informative talk, the group of Young Gasteiners ended the evening the proper way – in a Belgian beer-café.

From left to right: Roberto Bertollini (WHO), Kolia Bénié, Claudia Fischer, Sofia Ribeiro, Anna Gallinat, Laurène Souchet, David Ritchie, André Peralta, Ute Linnenkamp, Christoph Aluttis, Marie Delnord

From left to right: Roberto Bertollini (WHO), Kolia Bénié, Claudia Fischer, Sofia Ribeiro, Anna Gallinat, Laurène Souchet, David Ritchie, André Peralta, Ute Linnenkamp, Christoph Aluttis, Marie Delnord


This blog was written by:

Christoph Aluttis

Christoph Aluttis

Sofia Ribeiro

Sofia Ribeiro

Claudia Fischer

Claudia Fischer








Announcing..the EHFG “POETRY BREAK”!

Poetry-SlamImage taken from:

Let’s get creative! Are you a budding Byron, Angelou or Goethe?!

Please send us a poem on “The Europe I want”.

The poems will be presented in one of the plenaries, either by the author or a fellow delegate.

The rules are:

  • no more than 8 lines (or maybe even a Haiku?),
  • English language.

Submission: Please hand in your ideas to no later than 30th September.

All I want for summer is the ECDC Summer School


Introductory meeting with ECDC Director Dr Marc Sprenger

Stockholm, 9-12 June 2014

I don’t know about you but the moment I hear “course” I develop an autoimmune reaction. It’s not that I don’t like learning, come on, I have a six year career, two masters degrees, four years of specialty in Public Health and I’m doing a PhD while working… So no, it’s not that I don’t like learning, but I just can’t bear to sit for hours listening to someone talk the day away. Therefore if you are like me, the ECDC summer course is your thing. It starts with a very formal meeting and then the crowd is quickly divided into groups. From the moment you enter your assigned room, you know this won’t be a typical learning environment: the chairs are organised around four tables and none of them are directly facing the front of the class. You are in here to talk and discuss, not to be talked at.

ECDC and the external experts´ mission, was to help us understand how evidence becomes health policy. If you think this is easy, let me make this clear: it is not. We started by learning how to calculate the burden of disease, analysed which factors helped or limited the evidence from transforming into public health actions, and what were the determinants of decision-making. How many times do you read an abstract and don’t understand how the conclusions can lead to a public health action? Exactly! We need to publish answers to these fundamental questions: what do you want to say and why is it important? Now of course, decisions need a public health ethics framework. The ethics workshop was definitely a workshop where the level of discussion and debate was high.

Once you have your evidence and health policies ethically disposed, you should be prepared for future threats, especially the cross border ones. We learned about existing tools for risk assessment and in no time were role-playing. Suddenly Young Gasteiners had to take decisions on how to operate during an infectious outbreak in Scan Mark, a fictional very wealthy country. We solved it by creating an island where diagnosed patients were taken for care upon entering the country, to avoid provoking an epidemic (as you might imagine we also had laser swords and a throne made of syringes…). The fact that our imaginary countries were wealthy or not was not a mere detail: money, or more precisely, cost-effectiveness, makes the world go round. Therefore our last workshop was dedicated to this fascinating topic.

At the end of the course I was exhausted due to the 4am sunrise light coming through my unblinded hotel windows every day, but I felt satisfied by the fact that I had learned… while having fun. Young Gasteiners, you will be invited next year, please don’t miss this opportunity!

Yaiza Rivero Montesdeoca
Yaiza participated in the ECDC 2014 Summer School with fellow Young Gasteiners Kolia Bénié and Héðinn Svarfdal Björnsson

Young Gasteiners hard at work!

The goal of the ECDC Summer School is to strengthen mentoring and technical skills in applied epidemiology and public health microbiology. This is achieved through a series of workshops on selected topics for prevention and control of communicable diseases and by providing an opportunity for sharing best practices within the ECDC expert networks. The International Forum Gastein would like to thank the ECDC for their generous support of the Young Forum Gastein Network in offering three places on the 2014 summer school to Young Gasteiners.