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Using Structural Funds for Health Equity:

Predisposing Factors and Barriers


Oana Maria Neagu, Elena Botezatu, Natasha Azzopardi-Muscat

Addressing health inequalities through Structural and Investment Funds is an opportunity for public health actors not only for the availability of funding but also for health policy development prospects. Interviews were carried out with national experts involved in negotiations around the Operational Programmes and potential beneficiaries to identify those enablers and barriers to take up structural funds for health projects. The map of opportunities started to change with the 2014 – 2020 financial framework when funding could be directed towards reducing health inequalities under the goal of social inclusion and combating poverty, by addressing risk factors or enhancing access to healthcare. However, to enable this potential, the health sector also needs policy entrepreneurs who could take advantage of policy windows such as the CSR, the ex-ante conditionalities or undergoing national/regional health strategies. They can be a much-needed pull factor to the rather reluctant decision makers or complex bureaucratic public administrations by presenting strategic and creative choices, by using policy framing to redefine how health equity is perceived across governmental levels. The chances of success are dependent on whether relevant policy actors cooperate on this goal and whether participation can be infused in the decision-making processes. This article thus aims to assist the prospective engagement of health actors in a growing multi-level governance system but through its findings to open a wider debate about the gap between European cohesion policy-making and cohesion policy-implementation for health.

Maastricht University, Faculty of Health, Medicine & Life Sciences, Duboisdomein 30, 6229 GT Maastricht, The Netherlands. For correspondence: oana.neagu@maastrichtuniversity.nlRomanian Centre for Economic Policies (CEROPE), 10 Belgrad Street, Bucharest. For correspondence: elenabotezatu@ymail.comUniversity of Malta c/o Mater Dei Hospital, Faculty of Health Sciences, MSD 2019 Msida, Malta. For correspondence:


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