The EXIT project, funded by the European Union’s Horizon Europe program, explores sustainable strategies for tackling territorial inequalities using an intersectional approach. It uses mixed research methods to analyse in depth the discriminating concept of “left behind”, used to describe territorial inequalities in depraved areas. The project aims to identify strategies and practices for tackling these inequalities, and to better understand why these areas are perceived as “left behind”.
Accessibility to healthcare refers to the ease with which the population can access healthcare services in terms of distance (geographical distribution), cost, time and staff availability (Service Public de Wallonie, 2025). Accessibility can vary from one region to another, due to mobility difficulties, centralization, saturation of health services, socio-economic limitations and a lack of knowledge of existing services and the social security system, particularly among the most disadvantaged population.
Although Belgium’s social security system is widely recognized as an efficient one, enabling the reimbursement of a wide range of healthcare services and even reducing out-of-pocket costs for certain administrative categories of citizens, the complexity of the healthcare system is a major barrier to access to care. In fact, the administrative procedures for obtaining coverage and extending it through supplementary insurance, choosing a contracted care provider, accessing financial support or reducing costs are complex to grasp. What’s more, the health’s digitalization of social and administrative services is also reducing access for people who are not computer literate or who lack the necessary equipment (European Social Observatory, 2020).
To overcome these difficulties, several initiatives have been developed in Belgium, such as mobile medical services and medical centers. The first lever is deployed at local level, where public institutions or associations develop itinerant health services to offer them medical and psychological follow-up, child health monitoring and even free care. However, these services are often extremely costly and require subsidies from the public authorities.
The Belgian federation of medical centers groups together 140 structures deployed throughout the country and recognized by the INAMI[1] and mutual insurance companies[2]. These structures guarantee free care to their members by working on a lump-sum basis rather than on a fee-for-service basis. It means that the patient benefits from free care with no remuneration for the provider. The insurance companies pay a fixed fee per patient directly to the medical center. The structures are multi-disciplinary, to guarantee a comprehensive, integrated diagnosis that considers the whole person’s physical, psychological and social well-being. Medical centers are set up in specific deprived neighborhoods. Patients are required to live in the area where the facility is located, and to consult the facility’s therapists (nurse, doctor, physiotherapist, etc.). Administrative and social support is also provided to assist patients in all aspects of their daily lives (Fédération des maisons médicales, 2025).
Sources :
- BAETEN R., CES S., « Les inégalités d’accès aux soins de santé en Belgique – Rapport de synthèse », European Social Observatory (OSE), Juillet 2020 ;
- Service Public de Wallonie, « Vers une Belgique en bonne santé», https://www.belgiqueenbonnesante.be/fr, juillet 2025
Fédération des maisons médicales, « santé et solidarité », https://www.maisonmedicale.org/, juillet 2025
[1] Belgian public health insurance and benefits organization.
[2] Union-linked health insurance organizations that allow for extended health care reimbursements through the payment of a supplementary contribution.
