Table 2 The summary of the identified barriers and facilitators in the four analysed countries
Level | Category | Themes | CZ | PL | SK | HU |
|---|---|---|---|---|---|---|
Macrosystem | Morality | Drug use as a sin | NA | − 1 | − 1 | − 2 |
Addiction as a life choice | − 1 | − 1 | − 1 | − 2 | ||
Criminal law | Legal status of drug possession (decriminalisation–criminalisation) | + 1 | − 2 | NA | − 2 | |
State politics | Engagement (engagement–indifference) | + 2 | − 1 | − 1 | − 2 | |
Consensus (consensus–opposing views) | + 2 | − 2 | − 2 | − 2 | ||
Attitudes (hostility–support) | + 2 | 0 | NA | − 2 | ||
Policy in general | Competition of drug policy with other policy fields | NA | − 2 | NA | − 2 | |
Drug policy | Competition with other pillars of drug policy (i.e. prevention, treatment) | + 1 | − 2 | − 2 | − 2 | |
Coverage of demand reduction services in general | + 1 | − 2 | − 2 | − 2 | ||
Completeness of the demand reduction system | − 1 | − 2 | −2 | − 2 | ||
The framework of HR service delivery by NGOs | Regulations/policies (reasonable–inadequate) | − 1 | − 1 | − 1 | −1 | |
Resources | Amount of funds (scarce–ample) | + 2 | − 2 | − 2 | − 2 | |
Stability of funds (stability–instability) | + 1 | − 1 | − 1 | − 2 | ||
Donor-imposed limitations | 0 | − 2 | − 2 | − 2 | ||
Time-consuming procedures | − 1 | − 2 | − 2 | − 2 | ||
Embedment of harm reduction in policy documents and public tenders | + 2 | + 1 | + 1 | −2 | ||
Education/labour market | Country-level shortage of professionals (e.g. nurses) | − 1 | − 2 | − 2 | NA | |
Low level of recognition/respect for social workers and outreach workers employed in harm reduction services | NA | − 2 | − 2 | NA | ||
Exosystem | Local politics | Motivation (public good–self-interest) | 0 | − 2 | − 2 | − 2 |
Attitudes (hostility–support) | 0 | − 1 | − 1 | − 1 | ||
Scapegoating | NA | NA | NA | − 2 | ||
Mesosystem | Community | Not in my backyard attitudes | 0 | − 2 | − 1 | − 2 |
Conflicts | NA | − 1 | − 1 | − 1 | ||
Violence | NA | NA | − 2 | NA | ||
Criminal underworld | Direct contacts with the criminal underworld | NA | 0 | NA | NA |