Original scientific paper
https://doi.org/10.20901/pm.63.3.07
Systemic Barriers to Health Policy Implementation: An Analysis of Cardiovascular Disease Prevention Policies in Croatia
Lovre Klarin
; Ured gradonačelnika grada Zagreba
Dagmar Radin
; University of Zagreb, Faculty of Political Science
Abstract
This study investigates the causes of failure of Croatian health policies in preventing and reducing the incidence of cardiovascular diseases, which remain the leading cause of mortality in Croatia. The qualitative research comprises a thematic analysis of strategic and regulatory documents published between 2012 and 2025, as well as semi-structured interviews with policymakers and street-level bureaucrats, namely actors directly involved in the implementation of preventive measures. The findings indicate that the main barriers to successful policy implementation include a lack of political support, limited institutional and financial capacities, weak intra- and intersectoral coordination and collaboration, and the absence of systematic evaluation of existing policy outcomes. Emphasis is placed on the discrepancy between formally defined strategic objectives and their actual implementation in practice, resulting in fragmented and unsustainable preventive interventions. The study concludes that improving health policies in the field of cardiovascular disease prevention and the reduction of associated risk factors requires strengthening the capacities of street-level bureaucrats, establishing clearer mechanisms of vertical communication between different levels of government, and developing institutionalized intersectoral collaboration and evaluation mechanisms. Only an integrated and coordinated approach can contribute in the long term to reducing mortality and improving health outcomes in line with the standards achieved by more developed European countries.
Keywords
Cardiovascular Diseases; Health Policies; Prevention; Policy Implementation; Institutions; Intersectoral Collaboration; Street-Level Bureaucrats
Hrčak ID:
352505
URI
Publication date:
27.10.2026.
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