We are pleased to announce the publication of a new article by Assoc. Prof. Ralitsa Simeonova-Ganeva and Assoc. Prof. Kaloyan Ganev from the Faculty of Economics and Business Administration at Sofia University in the latest issue of Comparative Southeast European Studies (73, no. 1). This important study sheds light on the persistent shortages in Bulgaria’s healthcare system by analyzing data spanning nearly eight decades. The authors explore three critical periods—communism (1944–1989), transition (1990–2002), and EU integration (2003 onward)—to understand how historical policies and socioeconomic shifts have shaped the country’s human capital in healthcare.

What makes this research stand out?

• A rare historical lens: The article highlights how early investments in medical education during the communist era helped build substantial healthcare capacity. It also shows how later underfunding and restrictions on private practice made medical professions less attractive, especially for nurses and midwives.
• Innovative benchmarking approach: Instead of relying on speculative views, the authors assess shortages by comparing Bulgaria’s data to median levels across European countries—an approach that is both cautious and analytically sound.
• Sharp distinction between brain drain and care drain: The article distinguishes between the emigration of doctors and nurses (“brain drain”) and the more widespread exit of nurses and midwives from the system (“care drain”), especially during the transition period—a particularly insightful contribution to the international literature.
• A call for historically rooted policy: The study stresses that overcoming current shortages requires a long-term commitment to investment in training, infrastructure, and decent working conditions. It argues convincingly that future policy must learn from the past, particularly in a context of open labor markets and demographic aging.

Familiar but vital insights

While some of the findings—such as the underappreciation of nurses or the reliance on retired professionals—are well-known in the region, the article places them in a compelling historical and policy context. This gives new depth to ongoing debates and reinforces the urgency of comprehensive reform.

Read it here (Open Access): https://doi.org/10.1515/soeu-2023-0017