{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:25:24Z","timestamp":1787030724622,"version":"build-2736575974"},"reference-count":48,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Health of the Hellenic Republic"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Environ. Res. Public Health","IJERPH"],"abstract":"<jats:p>Background: Public health in Greece has undergone substantial changes since the COVID-19 pandemic, while challenges related to governance, workforce distribution, regional inequalities and service organization remain. This study aimed to map the current public health landscape in Greece by examining its institutional frameworks, stakeholder roles, policy implementation and public health data systems. Methods: A structured situation analysis combining a review of peer-reviewed and gray literature, policy analysis, and stakeholder mapping was conducted. PubMed, EMBASE, and CINAHL were searched for English- and Greek-language publications issued between 2005 and 2026, supplemented by reports, legislation, and policy documents from the Greek Ministry of Health, the World Health Organization, the Organisation for Economic Co-operation and Development, the European Commission, and other relevant institutions. Results: Public health responsibilities were distributed across multiple national, regional, and local institutions, creating challenges concerning coordination and accountability. Regional and socioeconomic inequalities continued to affect access to services, while workforce shortages and skill-mix imbalances constrained public health capacity. Public health information was dispersed across different institutions and data systems, with limitations concerning standardization, accessibility, and interoperability. Recent legislation, prevention programs, and digital-health initiatives indicated increased policy attention to prevention and population health, although publicly available evidence regarding their implementation and outcomes remained limited. Conclusions: Strengthening public health in Greece requires clearer institutional responsibilities, improved coordination across governance levels, sustainable workforce planning and interoperable data systems that support routine monitoring of program coverage, equity, and population-level outcomes.<\/jats:p>","DOI":"10.3390\/ijerph23081059","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T15:48:36Z","timestamp":1786722516000},"page":"1059","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mapping the Public Health Landscape in Greece: Governance, Stakeholders, Data Systems, and Policy Frameworks"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3198-3965","authenticated-orcid":false,"given":"Christos","family":"Triantafyllou","sequence":"first","affiliation":[{"name":"WHO Athens Quality of Care and Patient Safety Office, 10675 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3974-6371","authenticated-orcid":false,"given":"Anastasia","family":"Ntikoudi","sequence":"additional","affiliation":[{"name":"WHO Athens Quality of Care and Patient Safety Office, 10675 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Papachristou","sequence":"additional","affiliation":[{"name":"WHO Athens Quality of Care and Patient Safety Office, 10675 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vion","family":"Psiakis","sequence":"additional","affiliation":[{"name":"WHO Athens Quality of Care and Patient Safety Office, 10675 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valter R.","family":"Fonseca","sequence":"additional","affiliation":[{"name":"WHO Athens Quality of Care and Patient Safety Office, 10675 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8177-4926","authenticated-orcid":false,"given":"Joao","family":"Breda","sequence":"additional","affiliation":[{"name":"WHO Athens Quality of Care and Patient Safety Office, 10675 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/B978-0-12-415766-8.00002-1","article-title":"Expanding the Concept of Public Health","volume":"10","author":"Tulchinsky","year":"2014","journal-title":"New Public Health"},{"key":"ref_2","unstructured":"World Health Organization (2018). Essential Public Health Functions, Health Systems and Health Security: Developing Conceptual Clarity and a WHO Roadmap for Action, World Health Organization."},{"key":"ref_3","unstructured":"World Health Organization (2024). Defining Essential Public Health Functions and Services to Strengthen National Workforce Capacity, World Health Organization."},{"key":"ref_4","first-page":"43","article-title":"What is public health? public goods, publicized goods, and the conversion problem","volume":"195","author":"Anomaly","year":"2023","journal-title":"Public Choice"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/jphd.12651","article-title":"Population health and public health: Commonalities and differences","volume":"85","author":"Bhosale","year":"2025","journal-title":"J. Public Health Dent."},{"key":"ref_6","unstructured":"World Health Organization (2025). A Global Health Strategy for 2025\u20132028-Advancing Equity and Resilience in a Turbulent World: Fourteenth General Programme of Work, World Health Organization."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e794","DOI":"10.1016\/S2468-2667(25)00188-4","article-title":"Addressing public health and health system challenges in Greece: Reform priorities in a changing landscape","volume":"10","author":"Kyriopoulos","year":"2025","journal-title":"Lancet Public Health"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"DeSalvo, K., Hughes, B., Bassett, M., Benjamin, G., Fraser, M., Galea, S., Gracia, J.N., and Howard, J. (2021). Public Health COVID-19 Impact Assessment: Lessons Learned and Compelling Needs. NAM Perspect., 2021.","DOI":"10.31478\/202104c"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Souliotis, K., Golna, C., Baka, A., Ntokou, A., and Zavras, D. (2025). Barriers in Access to Healthcare Services in Greece Post-COVID-19: Persisting Challenges for Health Policy. Healthcare, 13.","DOI":"10.3390\/healthcare13151867"},{"key":"ref_10","unstructured":"Maresso, A., Mladovsky, P., Thomson, S., Sagan, A., Karanikolos, M., Richardson, E., Cylus, J., Evetovits, T., Jowett, M., and Figueras, J. (2026, January 20). The impact of the crisis on the health system and health in Greece, Economic Crisis, Health Systems and Health in Europe: Country Experience [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK447857\/."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Myloneros, T., and Sakellariou, D. (2021). The effectiveness of primary health care reforms in Greece towards achieving universal health coverage: A scoping review. BMC Health Serv. Res., 21.","DOI":"10.1186\/s12913-021-06678-9"},{"key":"ref_12","first-page":"196","article-title":"Regional distribution disparities of healthcare resources in Greece","volume":"6","author":"Gogos","year":"2022","journal-title":"Eur. Mod. Stud. J."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Mariolis, A., Mihas, C., Alevizos, A., Mariolis-Sapsakos, T., Marayiannis, K., Papathanasiou, M., Gizlis, V., Karanasios, D., and Merkouris, B. (2008). Comparison of primary health care services between urban and rural settings after the introduction of the first urban health centre in Vyronas, Greece. BMC Health Serv. Res., 8.","DOI":"10.1186\/1472-6963-8-124"},{"key":"ref_14","unstructured":"European Commission (2024). Economic Inequalities in the EU: Key Trends and Policies, Publications Office of the European Union."},{"key":"ref_15","unstructured":"Organisation for Economic Co-operation and Development (2026, January 20). Health at a Glance 2023. Available online: https:\/\/www.oecd.org\/content\/dam\/oecd\/en\/publications\/reports\/2023\/11\/health-at-a-glance-2023_e04f8239\/7a7afb35-en.pdf."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1177\/0020731420902604","article-title":"Inequalities Between Migrants and Non-Migrants in Accessing and Using Health Services in Greece During an Era of Economic Hardship","volume":"50","author":"Kaitelidou","year":"2020","journal-title":"Int. J. Health Serv."},{"key":"ref_17","unstructured":"(2026, January 20). Available online: https:\/\/www.moh.gov.gr\/articles\/ministry\/organogramma\/2732-organogramma-toy-ypoyrgeioy-ygeias."},{"key":"ref_18","unstructured":"National Printing Office (1997). Law 2503\/1997, Administration, Organisation and Staffing of the Regions, Regulation of Local-Government Matters and Other Provisions, Government Gazette A\u2032 107\/30 May 1997."},{"key":"ref_19","unstructured":"National Printing Office (1997). Law 2519\/1997, Development and Modernisation of the National Health System, Organisation of Health Services, Pharmaceutical Provisions and Other Provisions, Government Gazette A\u2032 165\/21 August 1997."},{"key":"ref_20","unstructured":"National Printing Office (2021). Law 4771\/2021, Provisions Concerning the Organisation and Operation of the National Health System and Other Matters, Article 27."},{"key":"ref_21","unstructured":"National Printing Office (2005). Law 3370\/2005, Organisation and Operation of Public Health Services and Other Provisions, (In Greek)."},{"key":"ref_22","unstructured":"National Printing Office (2026). Law 5314\/2026, Local Government Code, (In Greek)."},{"key":"ref_23","unstructured":"National Printing Office (2010). Law 3852\/2010, New Architecture of Local Government and Decentralised Administration\u2014Kallikratis Programme, (In Greek)."},{"key":"ref_24","unstructured":"Economou, C., and Giorno, C. (2009). Improving the Performance of the Public Health Care System in Greece, OECD Publishing. OECD Economics Department Working Papers."},{"key":"ref_25","unstructured":"National Printing Office (2020). Law 4675\/2020, Prevention, Protection and Promotion of Health, Development of Public Health Services and Other Provisions, (In Greek)."},{"key":"ref_26","unstructured":"(2026, January 20). National Action Plan for Public Health 2021\u20132025|Country Planning Cycle Database [Internet]. Available online: https:\/\/extranet.who.int\/countryplanningcycles\/planning-cycle-files\/national-action-plan-public-health-2021-2025."},{"key":"ref_27","first-page":"187","article-title":"Action plan for the reduction of prevalence of childhood obesity in the area of Thessaloniki\u2019s Health Center","volume":"24","author":"Konstantina","year":"2025","journal-title":"Rostrum Asclepius\/Vima Tou Asklipiou"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"506","DOI":"10.54660\/.IJMRGE.2024.5.2.506-509","article-title":"Digital transformation in the health sector in Greece","volume":"5","author":"Emmanouel","year":"2024","journal-title":"Int. J. Multidiscip. Res. Growth Eval."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2899","DOI":"10.1007\/s40520-021-01922-y","article-title":"The role of collaborative, multistakeholder partnerships in reshaping the health management of patients with noncommunicable diseases during and after the COVID-19 pandemic","volume":"33","author":"Monaco","year":"2021","journal-title":"Aging Clin. Exp. Res."},{"key":"ref_30","unstructured":"Hellenic Statistical Authority (2020). Health Interview Survey 2019, Hellenic Statistical Authority. Available online: https:\/\/www.statistics.gr\/en\/statistics\/-\/publication\/SHE22\/2019."},{"key":"ref_31","unstructured":"Hellenic Statistical Authority (2016). Microdata of Statistical Surveys, Hellenic Statistical Authority. Available online: https:\/\/www.statistics.gr\/en\/micro-data."},{"key":"ref_32","unstructured":"National Public Health Organization (2026, July 30). Mandatory Notification System, Available online: https:\/\/eody.gov.gr\/el\/symvanta-dimosias-ygeias\/epidimiologiki-epitirisi\/systimata-epitirisis\/systima-ypoxreotikis-dilosis.html."},{"key":"ref_33","unstructured":"E-Government Center for Social Security Services SA (2012). Electronic Prescribing, E Government Center for Social Security Services S.A. Available online: https:\/\/www.idika.gr\/erga\/ilektroniki-syntagografisi\/."},{"key":"ref_34","unstructured":"E-Government Center for Social Security Services SA (2025). National Digital Patient Health Record: National Electronic Health Record, E-Government Center for Social Security Services SA. Available online: https:\/\/www.idika.gr\/erga\/sygchrimatodotoumena-espa\/taa\/national-digital-patient-health-record-ndphr-ethnikos-ilektronikos-fakelos-ygeias\/."},{"key":"ref_35","unstructured":"Ministry of Health of Greece (2026, July 30). Launch of the Universal Implementation of the New NHS Digital Platform for the National Electronic Health Record, Available online: https:\/\/www.moh.gov.gr\/articles\/ministry\/grafeio-typoy\/press-releases\/13365-enarksh-katholikhs-efarmoghs-ths-neas-pshfiakhs-platformas-toy-esy-gia-ton-ethniko-hlektroniko-fakelo-ygeias-ehfy."},{"key":"ref_36","unstructured":"National Organization for the Provision of Health Services (2026, July 30). Health Insurance Record, Available online: https:\/\/www.eopyy.gov.gr\/el\/insuredguide\/."},{"key":"ref_37","unstructured":"Ministry of Health of Greece (2026, July 30). Design and Implementation of the Greek National eHealth Interoperability Framework (NeHIF), Available online: https:\/\/www.moh.gov.gr\/articles\/ehealth\/6765-design-and-implementation-of-the-greek-national-ehealth-interoperability-framework-nehif."},{"key":"ref_38","unstructured":"OECD and European Observatory on Health Systems and Policies (2025). Greece: Country Health Profile 2025, OECD Publishing and European Observatory on Health Systems and Policies. State of Health in the EU."},{"key":"ref_39","unstructured":"Bernal-Delgado, E., Angulo-Pueyo, E., Ridao-L\u00f3pez, M., Urbanos-Garrido, R.M., Oliva-Moreno, J., Garc\u00eda-Abi\u00e9tar, D., and Hern\u00e1ndez-Quevedo, C. (2024). Spain: Health System Summary, European Observatory on Health Systems and Policies, WHO Regional Office for Europe."},{"key":"ref_40","unstructured":"Fronteira, I., Augusto, G.F., and Maresso, A. (2025). Portugal: Health System Summary, 2024, European Observatory on Health Systems and Policies, WHO Regional Office for Europe."},{"key":"ref_41","first-page":"507","article-title":"Digital Transformation Efforts in Greece: Evaluation of the E-Prescription System","volume":"305","author":"Georgopoulou","year":"2023","journal-title":"Stud. Health Technol. Inform."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Flokou, A., Aletras, V., Miltiadis, C., Karaferis, D., and Niakas, D. (2024). Efficiency of primary health services in the Greek public sector: Evidence from bootstrapped DEA\/FDH estimators. Healthcare, 12.","DOI":"10.3390\/healthcare12222230"},{"key":"ref_43","unstructured":"(2026, January 20). Launch of the HEALTH-IQ Project in Greece: Improving Quality of Care Across the WHO European Region [Internet]. Available online: https:\/\/www.who.int\/europe\/news-room\/events\/item\/2024\/02\/16\/default-calendar\/launch-of-the-health-iq-project-in-greece--improving-quality-of-care-across-the-who-european-region."},{"key":"ref_44","unstructured":"Ministry of Health (2025). National Strategy for Quality of Care and Patient Safety for Greece 2025\u20132030."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1176\/appi.focus.20190041","article-title":"Practicing Cultural Competence and Cultural Humility in the Care of Diverse Patients","volume":"18","author":"Stubbe","year":"2020","journal-title":"Focus J. Lifelong Learn. Psychiatry"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e41446","DOI":"10.2196\/41446","article-title":"Data Quality in Health Research: Integrative Literature Review","volume":"25","author":"Bernardi","year":"2023","journal-title":"J. Med. Internet Res."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Khalil, H., Marcucci, J., and Liu, C. (2024). Leveraging new methodologies for public health crisis management. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1508417"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Spanakis, M., Stamou, M., Boultadaki, S., Liantis, E., Lionis, C., Marinos, G., Mariolis, A., Matthaiou, A.M., Mihas, C., and Mouchtouri, V. (2025). Enhancing Competencies and Professional Upskilling of Mobile Healthcare Unit Personnel at the Hellenic National Public Health Organization. Healthcare, 13.","DOI":"10.3390\/healthcare13141706"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/8\/1059\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:27:12Z","timestamp":1787027232000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/23\/8\/1059"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":48,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["ijerph23081059"],"URL":"https:\/\/doi.org\/10.3390\/ijerph23081059","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]}}}