REGIONAL DECENTRALIZATION, HEALTH POLICY AND COVID-19: THE CASE OF THE REGIONS OF LOMBARDY AND VENETO, ITALY

Date

2025-8

Author

Pehlivan, Hazal

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Crisis constitutes the most critical test for decentralized governance. The COVID-19 pandemic exposed stark differences in the regional crisis management capacities of Lombardy and Veneto, two Italian regions operating under the same national legal framework but governed by distinct models of healthcare decentralization. This paper argues that the effectiveness of regional decentralization hinges upon a triadic condition of efficiency: policy-making must be community-sensitive, regional decision-making must be centralized, and policy implementation must be autonomous. Drawing on Bob Jessop’s strategic-relational approach (2008), which conceptualizes the state through the interrelated dimensions of representation, organization, and intervention, the study explores how different regional healthcare models of Lombardy and Veneto shape regional crisis governance capacities. This framework is operationalized through Şengül’s assemblage (2023) to examine multi-scalar and multi-actor governance of implementation, which allows for an in-depth examination of territorialized crisis responses. While Jessop’s framework theorizes the causal dynamics behind crisis responses, Şengül’s assemblage (2023) captures the relational and scalar mechanisms through which regional actors navigate and negotiate institutional constraints. Together, these approaches provide a robust analytical lens to explain why Veneto’s anticipatory, territorially embedded, and community-sensitive interventions were more effective during the first wave of the pandemic, whereas Lombardy’s fragmented and hospital-centric strategy resulted in systemic overload.

Subject Keywords

Regional decentralization, healthcare governance, COVID-19 crisis

URI

https://hdl.handle.net/11511/115435

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Graduate School of Social Sciences, Thesis