Home Care Services

Project completed
A young carer looking after an elderly patient in a nursing home.
Thanks to the home nursing service, Lyubomir Tzenov (78) can again lead a more independent life. Home nursing services costs less than care in a hospital and relieves the pressure on family members. © SDC DEZA

Increasing life expectancy in Bulgaria means that there is now a larger number of older people in the country. To enable these people to remain at home in a familiar environment even at an advanced age, this project has introduced a home nursing service in Vratsa districts. Home nursing by  qualified teams enables patients to maintain a degree of independence and improves the quality of life of chronically ill or disabled elderly people.

Country/region Topic Period Budget
Improving social security
Social services for specific target groups
01.07.2011 - 31.12.2017
CHF 2'418'187

Note: the texts under all the headings, with the exception of 'Results achieved', describe the situation before the start of the project.

The average age of Bulgaria's population is increasing. By contrast, the birthrate is low and young Bulgarians are now either emigrating or moving to larger towns. As a result, many older people in Bulgaria are now isolated, both in medical and in social terms. The project provides home nursing services and assistance and thus improves the quality of life of chronically ill or disabled elderly Bulgarians, including members of the Roma community.

Assistance and care at home - the Spitex service

People who need medical care either go to a doctor or to a hospital. There are numerous hospitals in Bulgaria. However, this form of treatment is not always ideal for elderly or marginalised people suffering from chronic illnesses or disabilities. An efficient and effective health system must also provide home care for those who need it. This reduces the pressure on hospitals and on the target groups.

This home nursing system is known in Switzerland as Spitex and is a genuine alternative for the Bulgarian health system. In Switzerland over 200,000 people a year benefit from Spitex services and over 15,000 full-time Spitex staff provide the necessary care.

Maintaining independence until an advanced age

The project has established four contact points for domestic care in four districts in the Bulgarian region of Vratsa. The service provides home nursing for over 350 people. This means that older people can continue to live at home in a familiar environment. They receive regular visits from staff trained to provide care and help with housework. This promotes the independence of the patients concerned until an advanced age.

Another advantage is that this method reduces costs, as home nursing is cheaper than hospital care. This method of treatment also creates jobs for the local population and helps to stem the tendency to move away from rural areas.

Possibility of future services at the national level

The project will also develop national quality standards for home care, with clear definitions of who is responsible for which tasks in the field of home care. The question of whether the offer for the Roma population and other minority groups in Bulgaria needs to be adapted will also be clarified, to enable care methods for these groups to be implemented in a targeted and efficient way.

Finally, on the basis of experience and results, proposals and recommendations for the national level of the health service will be made in order to drive forward health service reforms that have been initiated. The home nursing system will be established at a national level. In future it could also be offered throughout the country, so that demographic and socio-economic challenges in the health system can be tackled in an effective and modern manner.