Case Studies

This program addresses longstanding challenges in the healthcare system, where limited access to screening services and reliable statistical data has hindered the effectiveness of health policies. The program’s key objectives are multifaceted, focusing on reducing the strain on the healthcare system, enhancing patient quality of life, improving access to healthcare services for marginalized women, and expanding the capabilities of the e-prescription system, aligning with the core action areas of the European Breast Cancer Plan (EBCP).

With the inclusion of innovative digital solutions, the program offers a much-needed opportunity to enhance the quality of life for women, especially those from vulnerable groups, by enabling easier access to critical breast cancer screenings.

By gathering vital data through electronic health records, the program supports the creation of targeted health policies aimed at improving women’s well-being, life expectancy and overall health outcomes.

As part of its commitment to broad accessibility, the program offers free digital mammography exams and ultrasounds (where necessary) to all women aged 45–74 who have a Social Security Number, regardless of their insurance status. This inclusive approach ensures that both insured and uninsured women can benefit from these life-saving services.

By November 2024, a total of 480,000 mammograms (15.25% participation rate) and 16,500 ultrasounds had been conducted, with over 29,000 cases of Birads 3 or higher identified, representing 6.5% of the mammograms. These findings highlight the program’s role in early detection and its potential to save lives by catching breast cancer in its early stages.

Initially, the program targeted women aged 50-69 (from July 2022 to March 2024), however, in response to demand and the need for broader coverage, the program expanded its eligibility criteria to include women aged 45-74 from March 2024 onward.

Despite its successes, the program faces challenges related to geographic disparities. Participation rates in remote and rural areas, including islands and mountainous regions, have been lower due to the limited availability of diagnostic centres. Travel to urban centres for screenings is difficult, leading to underrepresentation from these areas.

To overcome this challenge, plans are underway to deploy Mobile Medical Units equipped with necessary diagnostic tools and staffed with trained personnel to meet the program’s requirements. These units will serve beneficiaries in hard-to-reach regions, ensuring that women in isolated areas can also benefit from the program’s services.

Enablers: The program is funded through the Recovery and Resilience Fund, ensuring continuous financial support until its completion in 2025 (Financing). Immediate compensation for service providers has contributed to the program’s successful implementation. The Ministry of Health oversees the program’s coordination, ensuring quality control, monitoring, and necessary adjustments (Governance). A network with Regional Health Authorities has been established to facilitate effective communication and service delivery across levels (Service delivery). This infrastructure has helped the program achieve effective coordination and responsiveness, ensuring that each phase of the project is executed efficiently. One of the key enablers of the program’s success also, has been the activation of the e-prescription application, which has led to an increase in participation rates. Women who activated the e-prescription system had a significantly higher participation rate of 26.5%, compared to 5% for those who did not activate the application. The system sends SMS reminders to beneficiaries, ensuring timely issuance of necessary referrals and encouraging greater engagement with the program (Resources).

Barriers: A significant limitation of the program is the suboptimal use of breast ultrasound services, which is potentially attributable to extended waiting times.

Lessons learned: As the first national initiative of its kind, the “Fofi Genimmata” program has required adjustments and modifications to overcome challenges encountered in its early stages. The program has made significant progress by collecting valuable data on breast cancer prevalence among Greek women, which will guide evidence-based strategies to address health disparities and improve women’s health. Moving forward, enhancing promotion through various communication channels, increasing awareness among healthcare professionals, and mapping underserved regions will be key to boosting participation, particularly in remote areas. By continuing to address these barriers and improving participation, the “Fofi Genimmata” program can play a pivotal role in reducing breast cancer mortality and improving health equity across Greece.

Contact

For further details on this case study, please reach out to obs-pace@obs.who.int.