AUTHOR=Karokis-Mavrikos Vassilis , Mavrikou Maria , Yfantopoulos John 

TITLE=Stakeholder perceptions and public health system performance evaluation: Evidence from Greece during the COVID-19 pandemic

JOURNAL=Frontiers in Political Science

VOLUME=Volume 4 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/political-science/articles/10.3389/fpos.2022.1067250

DOI=10.3389/fpos.2022.1067250

ISSN=2673-3145

ABSTRACT=The Covid-19 pandemic has been challenging and testing of public health systems across the globe, engaging them in a prolonged scrutinization of their functions, capacity and resources. While in theory, this process can yield invaluable insights for future policy design and mitigate future adversity, it demands a suitable mode of evaluation.  Often, innovative and ambitious legislative frames are a far cry from policymaking realities plagued with institutional and operational deficiencies. As a result, we decide to move past assessments of the de jure status quo and examine the de facto modus operandi through the eyes of the systems’ participating agents. We focus on the case of Greece, a country which boasts a modern public health systemic design, aligned with contemporary public health thought and international trends. We rely on elite surveying insights from 261 public health policy stakeholders in the country, collected between 15.07.2020 and 13.12.2020. We process our data through a refined version of the public health system performance evaluation framework introduced by Handler and Turnock (2001), focusing on policy outcomes rather than universal systemic metrics. We capture the effect of the Covid-19 pandemic both in a latent fashion, through the timing of our survey, and in a direct one, through explicit inquiry. We conclude that the Greek public health system suffers from an ill-alignment between its mission and the ideational orientation of its stakeholders. While it is intended to serve the holistic approach to health, the system is functioning in a heavily care-centric manner. Processes are disproportionally developed, relevant resources come to be narrow in scope and outcomes are suboptimal, failing to fulfil identified aims. Moreover, high centralization, the absence of public health expertise and undeveloped evaluative channels prevent failures from inducing adjustments. The Covid-19 pandemic has brought the system’s deficiencies to light forcefully and highlighted the essentiality of scientific inputs. Our conclusions stress the invaluable future research directions our proposed mode of evaluation can instigate and identify the necessary policy directions for the Greek public health system to correct its course and cope with modern challenges and demands.