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Overall, the Maltese health system has been making remarkable progress, with improvements in avoidable mortality and low levels of unmet need. Maltese life expectancy continues to be high, and Maltese people spend on average close to 90% of their lifespan in good health, longer than in any other EU country. Malta has recently increased the proporti...
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Maltese life expectancy is high, and Maltese people spend on average close to 90% of their lifespan in good health, longer than in any other EU country. Malta has recently increased the proportion of GDP spent on health to above the EU average, though the private part of that remains higher than in many EU countries. The total number of doctors and...
Citations
... All state health services are free of charge to permanent and employed residents. The private sector also offers all types of services (accident and emergency services, primary care and tertiary care) on a fee-for-service basis (Azzopardi-Muscat et al., 2017). The accessibility to outpatient clinic services and surgeries is perceived as good with the waiting lists been substantially reduced as a general trend across specialties from years to couple of months (World Health Organization [WHO], 2019). ...
Targeting and reducing health inequities is a requisite for public health. The Maltese Islands are divided into six geographical districts with a total area of 316 km ² . It is anticipated that the close geographical proximity and social integration would result in similar population health status. This study aims to identify whether geographical health inequities exist despite the small country area. A cross-sectional health examination survey was conducted. Participants with type 2 diabetes (T2DM) and impaired fasting blood glucose (IFG) were identified, depending on their medical and drug history and fasting blood glucose levels. Those with body mass index ≥30 kg/m ² were labeled as obese. Different health status was compared between the residents in the different districts according to demographic, socioeconomic, lifestyle, and medical history. Regression analysis was carried out to identify links between the different districts, BMI, IFG, and T2DM diagnosis, while adjusting for confounders. Geographical inequities were evident despite the close proximity. The Gozo district exhibited distinctive metabolic inequities compared to the other districts. An independent relationship was present between IFG diagnosis and residence in Gozo and Northern districts. Obesity was linked to residing in Gozo. Health inequities were evident between the close districts of the Maltese Islands despite similar socioeconomic, lifestyle, and healthcare provision. Psychosocial factors might be the underlying causes for these inequities. Public health officials and government should work to enhance public education and set up local policies and interventions to target these inequities.
... While Greece has a single insurer, Israel has a National Health Insurance with four insurers. Population coverage for health care is universal in all the countries, and except in Greece, general practitioners (GPs) are gatekeepers for specialist care [2][3][4][5][6][7][8][9] . ...
This paper conducts a comparative review of the (curative) health systems’ response taken by Cyprus, Greece, Israel, Italy, Malta, Portugal, and Spain during the first six months of the COVID-19 pandemic. Prior to the COVID-19 pandemic, these Mediterranean countries shared similarities in terms of health system resources, which were low compared to the EU/OECD average. We distill key policy insights regarding the governance tools adopted to manage the pandemic, the means to secure sufficient physical infrastructure and workforce capacity and some financing and coverage aspects.
We performed a qualitative analysis of the evidence reported to the ‘Health System Response Monitor’ platform of the European Observatory by country experts. We found that governance in the early stages of the pandemic was undertaken centrally in all the Mediterranean countries, even in Italy and Spain where regional authorities usually have autonomy over health matters. Stretched public resources prompted countries to deploy “flexible” intensive care unit capacity and health workforce resources as agile solutions. The private sector was also utilized to expand resources and health workforce capacity, through special public-private partnerships. Countries ensured universal coverage for COVID-19-related services, even for groups not usually entitled to free publicly financed health care, such as undocumented migrants.
We conclude that flexibility, speed and adaptive management in health policy responses were key to responding to immediate needs during the COVID-19 pandemic. Financial barriers to accessing care as well as potentially higher mortality rates were avoided in most of the countries during the first wave. Yet it is still early to assess to what extent countries were able to maintain essential services without undermining equitable access to high quality care.
... Although the relative risk of mortality in older people with increased body mass index (BMI) is not as great as in younger people, it is associated with a similar increased risk of mortality from noncommunicable diseases (World Health Organization, 2018). Locally, a number of strategies are in place to address modifiable risk factors, such as an unhealthy diet which might lead to obesity (Azzopardi-Muscat et al., 2017). Although these shall continue to underpin a national effort towards health promotion and disease prevention in the Maltese population, there is a dearth of data on diet quality and pattern of older persons. ...
In the Maltese Islands, the proportion of individuals aged 65 years and over is expected to increase significantly in the coming decades, placing significant burdens on healthcare and support services. One example of a costly consequence of ever-longer life expectancy is the increase in people with dementia, especially Alzheimer’s disease. The ageing process may involve changes in physiological, pathological and socio-environmental circumstances of an older adult. Such factors, alone or in combination, might affect nutritional needs with the consequence of malnutrition, encompassing undernutrition, overnutrition and nutrient-related deficiencies. Nutrition screening and assessment is vital in identifying and monitoring the nutritional status of older adults. Local data is scarce but required to inform policy and develop nutrition guidelines for the older population. Approaches to nutritional intervention involve a holistic approach and necessitates being individually adapted to the number of challenges encountered during ageing. Thus, meeting the dietary and nutrition needs of older people is crucial for the maintenance of health, functional independence and quality of life.
... Turning the gaze to the realm of healthy ageing, it is noteworthy that in the year 2000 the World Health Organization classified Malta as the fifth best performing health system from a total of 191 countries. Indeed, the Maltese health system has been making remarkable progress, recently even increasing the proportion of GDP spent on health to above the average European Union rates (Azzopardi-Muscat et al., 2017). Total government expenditure on health as a percentage of GDP reached 6.7% in 2014, up from 3.8% in 1995 (World Bank, 2018). ...
... Although the relative risk of mortality in older people with increased body mass index (BMI) is not as great as in younger people, it is associated with a similar increased risk of mortality from noncommunicable diseases (World Health Organization, 2018). Locally, a number of strategies are in place to address modifiable risk factors, such as an unhealthy diet which might lead to obesity (Azzopardi-Muscat et al., 2017). Although these shall continue to underpin a national effort towards health promotion and disease prevention in the Maltese population, there is a dearth of data on diet quality and pattern of older persons. ...
This edited volume provides a broad ranging view of the challenges and responses to the increasing age and age-associated morbidity of Malta's population, from considerations about the provision of a sustainable income in retirement to end-of-life and long-term care. The chapters range in scope from an overview of Malta's ageing population to considerations of various aspects of healthcare, ranging from oral health to dementia, nutrition to coronary disease, with a nice mix of both objective and subjective perspectives. The ageing of society will differ from country to country, and it is particularly valuable for countries with relatively well established programmes of gerontological education and training to be able to access information about the ageing of other, smaller countries. The opportunities afforded to small nations for developing a coherent, holistic approach to healthy active ageing enrich the field of gerontology, and this edited volume provides an excellent illustration of what can be done and what scope there is for further developments. This edited collection provides a full and comprehensive coverage of key issues related to health and activity in the context of ageing. With its broad perspective on the determinants and scope of health in later life, the collection is genuinely focused on preventive strategies as well as seeking to maximize the quality of life of older people who depend on health and care systems. The book will be of benefit to those working with older people in health and social care services in Malta as well as to researchers and students of gerontology. It is a unique and original contribution to gerontology. Active and Healthy Ageing in Malta: Gerontological and Geriatric Inquiries documents the outstanding progress in living conditions for older persons in Malta which resulted from policy advances in social and health care policies, and charts the challenges faced by Maltese society in providing improved and more equitable gerontological and geriatric services.
This paper conducts a comparative review of the (curative) health systems’ response taken by Cyprus, Greece, Israel, Italy, Malta, Portugal, and Spain during the first six months of the COVID-19 pandemic. Prior to the COVID-19 pandemic, these Mediterranean countries shared similarities in terms of health system resources, which were low compared to the EU/OECD average. We distill key policy insights re- garding the governance tools adopted to manage the pandemic, the means to secure sufficient physical infrastructure and workforce capacity and some financing and coverage aspects. We performed a qualitative analysis of the evidence reported to the ‘Health System Response Mon- itor’ platform of the European Observatory by country experts. We found that governance in the early stages of the pandemic was undertaken centrally in all the Mediterranean countries, even in Italy and Spain where regional authorities usually have autonomy over health matters. Stretched public resources prompted countries to deploy “flexible”intensive care unit capacity and health workforce resources as agile solutions. The private sector was also utilized to expand resources and health workforce capacity, through special public-private partnerships. Countries ensured universal coverage for COVID-19-related services, even for groups not usually entitled to free publicly financed health care, such as undocumented migrants.
The World Health Organization (WHO) predicts a shortage of healthcare workers, specifically nurses in West European countries (Gottlieb, 2016; WHO 2017 in Anita Ham, 2019). This phenomenon is also applicable to Malta’s public healthcare service sector (Buttigieg et al. 2018). Malta is experiencing a high inflow of foreign specialised labour, an ageing, local population and increasing expectations of quality in health services; in the process creating greater demands and stress on this sector. Within this evolving scenario, this study seeks to determine what factors are influencing the engagement of foreign nurses and the variables affecting their stay in Malta. This paper refers to international literature and selected theoretical frameworks that serve as a basis for fieldwork research. Elite interviews were held with key institutional actors, drawing out thematic patterns.
Cross-border healthcare has become a major policy issue in the past years across the European Union. Professional mobility as a means of providing specialised health services has not been given sufficient attention in both the research and policy agendas. This paper presents a case study of the contribution made by visiting overseas medical specialists to the health system in Malta. Twenty-five semi-structured interviews were conducted. A grounded theory approach was utilised in view of the limited amount of literature available on the subject. Qualitative content analysis revealed one superordinate theme, being the value of the service, and three further subthemes, which include the quality of the service provided, its longevity and durability, as well as the critical contributions of expatriates. The service is an integral component of the local health service. This study makes an important contribution to the literature on cross-border healthcare. Lessons learnt may be transferable to other small island states and territories. The European Reference Networks being developed at EU level may need to focus more on the benefits that can accrue through short term professional mobility than has been the case to date. The findings also serve to propose, several important features that need to be in place to increase the chances of longevity, sustainability, quality and cost effectiveness in cross border health care services.
As we celebrate 20 years of MAPHM, we have asked some of our members, all experts in their respective fields, to reflect upon the main public health issues facing Malta and the added value of a vibrant public health community that has shaped the development of health and health systems in Malta during this period. We were overwhelmed by the positive response and interest that our proposed special issue elicited. The result is an overview of public health in Malta encompassing simultaneously a unique collection of historical processes and events made available in the public domain for the first time, together with the evidence-base needed to address the key challenges foreseen in the coming years.
The PDF version and e book are available to download from https://maphm.org/publications/
