Preparing for Demographic Change in Campania, Italy

1. Assessment and recommendations

Campania is located in the South of Italy – the Mezzogiorno – with territory stretching along the coastline of the Tyrrhenian Sea and inland. The region features a bustling urban core in Naples, a diverse environmental ecosystem, and a compelling cultural heritage that attracts visitors from around the world. The region has been described as the economic engine of southern Italy, accounting for nearly half of southern Italy’s GDP. As of 2023, Campania has 5.6 million inhabitants, representing 9.5% of the Italian population, and attracted nearly 20.7 million tourists in 2023, representing 4.6% of Italy’s total tourism. The Campania region encompasses the Metropolitan City of Naples, established in 2015, as well as the provinces of Avellino, Benevento, Caserta, and Salerno, and exhibits notable internal imbalances across economic, social, and infrastructural dimensions. The Metropolitan City of Naples, with nearly 3 million residents, covers across about 1 100 km² – implying that more than half the region’s total population lives in less than 10% of its surface area. Of its 550 municipalities, Naples is the region’s largest with more than 920 000 inhabitants, while more than 200 municipalities have fewer than 2 000 residents.

Campania boasts high-quality tertiary educational institutions, a rich and diverse environmental landscape, and a vibrant cultural heritage that continues to draw students from across Italy and visitors from around the world. These strengths provide a solid foundation for future development and innovation in the face of demographic decline and ageing. The region is promoting economic development, urban regeneration, municipal co-ordination, and enhanced access to services to address youth outmigration, enhance employment prospects, and attract greater investment – particularly in areas that have historically struggled. Demographic change in Campania represents an opportunity to rethink service delivery and infrastructure to better integrate urban and rural communities, helping to ensure that residents throughout the region can benefit from its economic and cultural advantages. Continued efforts to bridge the gap between dynamic coastal cities and inland areas through more efficient land use, improved connectivity, and more equitable access to services can unlock the full potential of Campania’s territory and people.

Campania has already taken important actions to address challenges associated with demographic change by attracting and retaining young talent, including by mobilising European Regional Development Fund (ERDF) and European Social Fund Plus (ESF+) funding. For example, Campania’s EUR 60 million investment (including EUR 45 million of ERDF funds) in the San Giovanni Tech Hub under its ERDF Regional Operational Programme (ROP) for 2014-2020 has rejuvenated an underserved neighbourhood in Naples and helped place students in local high-skill jobs. ESF+ funds used by Campania to support local cultural heritage, such as artisanal ceramics production and tourism in Cerreto Sannita (Benevento), have also helped retain young entrepreneurs and create jobs for local youth in rural areas. The region has also established platforms like Table for Inner Areas (Tavolo Aree Interne) to facilitate implementation of the National Strategy for Inner Areas (SNAI), which has helped bring together regional and local stakeholders to co-ordinate investment initiatives and grant municipalities access to related benefits.

Additional targeted policies and refinement of approaches in place could enhance efforts to adapt the region to its demographic reality. Campania can continue to focus on creating opportunities to attract and retain talent, aligning spatial planning to meet evolving territorial needs, bolstering co-operation across all levels of government in the region, increasing stable subnational revenue sources to support service provision, and improving access to services to ensure a sustainable and inclusive future for residents. Specifically, the region can take advantage of the current mid-term review to align existing funds with emerging needs, particularly in housing, skills development, and inter-municipal service provision.

Regional profile and key trends in Campania

Population ageing and population decline are projected to accelerate

Although Campania is currently the “youngest” region in Italy, it nonetheless experiences consistent youth outmigration and projections of population decline and ageing in the coming decades. The existing gaps between the region’s more urbanised coastal area and its rural inland communities are likely to increase as the latter age and decline more rapidly.

Despite historical advantages, Campania’s demography is converging towards national averages. While Campania currently has the lowest old-age dependency ratio of any region in Italy (defined as the share of adults aged 65 and older per 100 inhabitants), the gap between Campania and the national average is expected to narrow by 2043. While Campania’s fertility rate was once the highest in Italy, it decreased from an average of 1.47 children per woman of childbearing age in 2002 to 1.29 in 2023, compared to a regional Italian average of 1.33 children per woman in 2002 and 1.30 in 2023. The region is also projected to lose 11% of its population between 2023 and 2043, up from a loss of 1.9% from 2000 to 2023.

Consistent with economic and social disparities along more affluent urban and coastal area and poorer rural and inland towns in the region, the rural inland provinces of Avellino and Benevento (7% and 5% of Campania’s population, respectively) are expected to bear the brunt of demographic decline. By 2043, among Campania’s five provinces, Avellino and Benevento are the ones with the highest projected population loss (14% each), the highest loss of young workers aged 15-39 (29% and 27%, respectively), and to have the highest old-age dependency ratios (44 and 43, respectively). While all provinces in Campania face demographic challenges, they appear to be particularly acute in the more rural inland parts of the region, furthest from the economic hub of Naples.

Campania is at risk of being in a “talent development trap”

In some regions, demographic decline is compounded by a shrinking base of highly educated individuals, leaving them without the talent needed to drive economic recovery and adapt to change. In its 2023 Communication on Harnessing Talent in Europe’s Regions, the European Commission identifies Campania as one of the 82 regions most exposed to this risk. “Talent development trap” regions face both a declining working-age population and challenges in attracting or retaining skilled workers, undermining their long-term development. Youth outmigration from Campania has been high in recent decades. In 2022, the number of young people (ages 15-29) dropped by 0.2% compared to increases of 1.1% in Italy and 1.3% in the EU27, in line with a long-running trend: between 2008 and 2020, Campania experienced a net loss of between 7 000 to 10 000 young people per year to other regions in Italy. The young leaving the region have historically been better educated than the average resident, contributing to brain drain.

Many young people continue to leave the region, driven principally by limited prospects in rural areas, low wages and high rates of formal unemployment compared to national averages. Unaddressed, demographic shifts are likely to accelerate talent loss, increase pressure on already tight labour markets, and diminish attractiveness for young workers and residents.

A range of national, regional and local programmes, including those funded through the ERDF and ESF+, are already being implemented to help develop, retain and attract youth in Campania – a key part of overcoming the “talent development trap”. These multi‑sectoral and multi-level efforts reflect the need for comprehensive and co-ordinated policies to both adapt to and mitigate demographic change and youth outmigration across the region. Experiences from other regions can also provide additional insights. For example, Portugal’s Norte region recently introduced a set of Active Employment Policies under a 2023 Decree-Law. These nationally led measures target individuals under 35 and promote job creation, vocational training, and career development through programmes such as “+Talent”, “+Employment”, and “Start”. Such targeted approaches could inspire complementary action in Campania, particularly in advancing talent retention at the regional level.

Labour productivity and employment rates are low

Campania’s economy benefits from its geography and cultural heritage, which facilitates activity in diverse industries such as shipping, agriculture, and tourism. Nonetheless, in 2021, per capita income was less than two-thirds of the national average, and unemployment was 17.4%, more than double the 7.7% national rate, creating challenges in retaining those seeking jobs, including young people. As of 2022, labour productivity stood at 83% of the national average, and informal employment at 23%, the highest in Italy. Labour market tightness (the number of job vacancies per unemployed person) in Campania is 80% lower than the Italian average, in line with the relatively high unemployment rate. However, there are signs of skill mismatches as labour market tightness is higher for higher-skill jobs in the region.

Youth outmigration, population ageing and low fertility threaten to reduce the size of the workforce, shrink tax revenues, and increase per capita costs for infrastructure and services, creating a “scissor effect” where revenues decline as expenditures rise. Campania has low formal childcare coverage, particularly for children under three, with only 12% of eligible children enrolled in childcare in 2022 compared to 31% in Italy and 36% in the EU. Insufficient childcare also adversely affects employment for working-age women, which is the lowest in Italy (31.1% vs. 52.5% nationally), and among the lowest in the OECD. Campania, like other regions in Italy, spends four times the average among OECD subnational governments on healthcare (80% vs. 20% of total public expenditure), due in part to greater responsibilities in the health sector among Italian regions compared to many regions across the OECD. Projected spending increases related to population ageing could worsen the fiscal balance by 5 percentage points of regional GDP, detracting from investments in other key areas that can enhance attractiveness for young and working-age people.

Co-ordination and administrative capacity remain challenging

Campania, like all the Italian Regions called a “Statuto Ordinario”, is granted broad legislative, administrative and fiscal autonomy, retaining legislative power over all subject matters not explicitly reserved to the state. Campania holds significant responsibilities in sectors such as health, transport and housing. In practice, however, many of these competencies are shared with the central government (“concurrent competencies”), whereby the central government defines the national service standards and the financing mechanisms, and the regional government exerts legislative powers within these boundaries. Since the distinction between defining principles and legislation has not always been clear, this has resulted in challenges in vertical co-ordination between central and regional government. With population ageing expected to significantly increase the demand for healthcare, the need for co-ordination is particularly acute, since the system of transfers for healthcare expenditures relies on agreements between the central and regional governments.

At the local level, responsibilities are mainly carried out by the 550 municipalities of the region. Local responsibilities mainly involve local road networks, general public service provision, urban management (town planning, environment) and the construction and maintenance of schools. Despite their importance in providing essential local services, efficiency has been negatively impacted due to a fragmented municipal landscape, which can lead to limited economies of scale. 37% of municipalities have fewer than 2 000 residents, lower than the national average (excluding municipalities in Campania and Rome) of 46%, yet significantly higher compared to 19% for OECD unitary countries on average in 2024. Despite efforts to reduce fragmentation, inter-municipal co-ordination mechanisms such as Unions of Municipalities, a pre-requisite for the 2021-27 SNAI Strategy, which can help pool resources, achieve economies of scale, and improve service delivery among small, shrinking, and rural municipalities have been used much less in Campania than elsewhere in Italy.

The provinces and the Metropolitan City of Naples play a key role in fostering co-ordination among municipal governments. Following the 2014 territorial reform (Law 56/2014), provinces were restructured from autonomous government entities into inter-municipal co-operation bodies. The reform also established metropolitan cities, such as Naples, which replaced provinces in major urban areas and were assigned important responsibilities, including spatial planning and transport co-ordination across their constituent municipalities. However, as in many OECD countries aiming to rationalise multi-level governance, provinces and metropolitan cities in Italy often lack the legal authority and financial resources needed to effectively carry out their mandates despite their intended role as co-ordinators. This challenge appears particularly acute in the Metropolitan City of Naples. Although it has a high population density, it lags behind its northern and central counterparts in terms of productivity, indicating that it has yet to fully leverage the agglomeration benefits typically associated with densely populated urban areas.

Nationwide hiring restrictions aimed at curbing public expenditure have contributed to declining administrative capacity in Campania, a trend that may be further exacerbated by ongoing depopulation and population ageing. For example, between 2011 and 2020 in Campania, the number of local public employees per 1 000 residents fell by 36%. At the same time, the public workforce is losing institutional knowledge, as experienced staff retire, with the proportion of municipal employees with over 20 years of service steadily decreasing. The difficulties faced by a smaller public workforce are also evident from the fact that municipalities in the Centre-South region, including Campania, manage the highest fund value per employee from the National Recovery and Resilience Plan (Piano Nazionale di Ripresa e Resilienza – PNRR). These challenges highlight the urgent need to expand opportunities for increasing municipal staffing levels and strengthening local administrations, as well as for providing upskilling and professional development for public employees in the region. For instance, the 2025 Training Directive mandates 40 hours of annual training per public employee. It forms part of a broader initiative of the PNRR, supported by the EU Recovery and Resilience Facility, aimed at strengthening administrative capacity. This initiative signals an important step towards rebuilding and modernising the technical competencies of the public workforce.

Cohesion Policy funds are already enabling Campania to adopt a place-based approach in its ERDF ROP 2021-27, particularly through support for more sustainable land use, inter-municipal planning, integrated service hubs, rural housing rehabilitation, and strategic infrastructure aligned with demographic and territorial strategies. Campania's ongoing commitment to implementing and updating its ERDF and ESF+ programmes reflects its intention to align EU funding with emerging needs. In fact, based on the results that will emerge from the interventions, the Region intends to use the resources also with the aim that the mid-term review offers the opportunity to strengthen this alignment.

Adapting land use and spatial planning in Campania

Updating local plans to increase land use efficiency and attractiveness

Campania has implemented or facilitated several important initiatives to improve land use efficiency, promote urban regeneration, and limit land consumption, as envisaged in Law 5/2024, through the Provincial Territorial Co-ordination Plans, the Territorial Plan for the Metropolitan City of Naples, and Masterplans which, once finalised, become Integrated Valorisation Programmes (programmi integrati di valorizzazione, PIVs). Yet many local urban plans still do not adequately reflect demographic realities, leading to low-density development despite population decline. Between 2010-21, built up area increased by as much as 30% in many small municipalities that lost up to 20% of its population. The region can build on the important urban planning reforms of Law 5/2024 to empower local governments to update urban plans, benefit from inter-municipal planning, promote urban regeneration, and protect natural resources in line with population trends.

Campania has also considered the use of EU Cohesion Policy funds under Objective 5 (“a Europe closer to citizens”), directing municipalities towards territorial planning that considers their demographic profile and defines wide-area strategies. These strategies aim to promote integrated and inclusive social, economic, and environmental development, as well as culture, natural heritage, sustainable tourism and safety in both urban and rural areas. For instance, resources have been allocated to the development of regional walking routes which, within the broader framework of slow tourism or ecotourism, represent economic and cultural investment in and revival of Inner Areas. Key actions include:

• Updating the Regional Territorial Plan to reflect demographic trends. To fully align spatial planning with long-term regional needs related to demographic decline, the Regional Territorial Plan (Piano Territoriale Regionale, PTR) would benefit from the explicit integration of demographic trends and projections. The Campania Region has, to date, chosen to await the adoption of the Landscape Plan before proceeding with the update of the PTR, even though the former is not legally binding.

• Ensuring all municipalities have updated Municipal Urban Plans. Campania should continue efforts to ensure all municipalities have up-to-date Municipal Urban Plans (Piani Urbanistici Comunali, PUCs) and other local plans that reflect population trends, prioritise urban regeneration, and restrict new land consumption. Support for municipalities should go beyond financial assistance to include technical expertise. Priority regeneration zones should be formalised within urban centres. Provincial level plans should be updated with these considerations as well to ensure consistency.

• Zoning the region for place-based planning policies by adopting Masterplans. As part of an overarching regional strategy to address demographic change, Campania could explore a granular zoning of territories, e.g. below the NUTS31 level, to support place-based policies. Zoning should go beyond population size to incorporate factors such as density, land use and proximity to service centres. Such zoning would also support the catchment areas for formalised inter-municipal planning instruments.

Supporting smart densification to enhance environmental sustainability and public service efficiency

Built-up volume decreased in Campania during the 2010-20 period despite built-up surface area increasing 12%, indicating low-density land consumption despite population decline and high rates of vacancies and abandoned properties. This leads to environmental degradation and greater per capita costs for services. Many municipalities lack tools or technical capacity to incentivise densification and urban regeneration. To address this, the region can apply a combination of land value capture (LVC) mechanisms and land readjustment policies to promote compact, sustainable development and discourage land hoarding, speculative vacancies and blighted properties. Campania could explore using Cohesion Policy funds related to Policy Objective 2 (“a greener, low-carbon Europe”) to support more rational land use and settlement patterns aligned with its demographic reality.

Smart densification can help address these challenges through approaches aligned with the New European Bauhaus principles, creating attractive, sustainable and inclusive spaces that appeal to the educated, mobile workforce essential for escaping the talent development trap. Efficient spatial development is essential to protect Campania’s precious and valuable environmental landscapes that form the region's identity. Higher densities can also facilitate the provision of affordable and social housing, a recognised priority in the EU Cohesion Policy mid-term review, directly addressing the housing challenges that drive youth outmigration. Given Campania’s exposure to climate impacts and demographic pressures, smart densification can deliver co-benefits by reducing emissions, preserving natural capital, and creating inclusive, vibrant communities that can successfully compete for talent in an increasingly mobile European labour market, in line with Cohesion Policy Objectives 1 (“a smarter Europe”) and 2 (“a greener Europe”).

Key actions include:

• Incentivising urban regeneration. The region could support increased use of LVC mechanisms such as developer obligations, density bonuses, and differentiated fee structures to encourage urban regeneration and compact growth. LVC contributions can be required for tourism development in areas already facing high demand such as the Metropolitan City of Naples. Incentives should be linked to the inclusion of permanent residential units alongside tourism accommodation. In rural areas, Campania could reinvest proceeds from LVC and use developer obligations to internalise the externalities that arise from sparse development patterns to deter low-density sprawl. The region can also provide technical support to municipalities eligible to benefit from such mechanisms, including through its Regional Register of Commissioners, in line with EU Cohesion Policy Objective 5 (“a Europe closer to its citizens”) and in support of multiple objectives related to supporting local administrative capacity in its Regional ERDF Programme 2021-2027.

• Facilitating land readjustment, transfer of development rights, and the regeneration process of rural areas. The region should incentivise landowners to consolidate fragmented plots for better-serviced and more compact developments. Inter-municipal planning instruments and joint planning agreements for rural municipalities should embed and increase incentives for repurposing land for sustainable agriculture, eco-tourism, or industrial parks. Stronger fiscal and technical incentives could be introduced for demolishing and replacing unfit properties with dense, multi-use developments, industrial parks, or nature reserves. Streamlining expropriation procedures for long-abandoned properties would also support efforts. Campania could link efforts to return unused developed land to natural use to EU Cohesion Policy funds related to Policy Objective 2 (“a greener Europe”), as well as to actions 4.3.2 and 4.6.1 of the Regional ERDF Programme 2021-2027 – which support the recovery, reuse and re-functionalisation of assets confiscated from organised crime and the role of culture and tourism in inclusive economic development, respectively.

Matching housing supply with demand to alleviate housing pressures and retain young people

Housing development in Campania is not aligned with demographic realities, leading to over-construction in shrinking areas while existing homes sit vacant or abandoned. Vacancy rates are highest in rural provinces of Avellino (34%), Benevento (33%) and Salerno (30%) compared to the regional average of 24.7%. While many rural areas have rich potential for agricultural production and rural eco-tourism, poor quality housing and poor connectivity of low-density settlements to opportunities and key services diminishes demand. The Metropolitan City of Naples accounts for 37% of the region’s total housing vacancies (265 742 out of 709 914 units) despite intense housing demand, likely due to a combination of land speculation, tourism demand, and poor housing quality.

Increased tourism has intensified housing market pressures, with rent prices increasing most in heavily touristic areas around Naples and along the region’s coastline. This trend mirrors broader EU challenges recognised in the Cohesion policy mid-term review, which has proposed several measures to address affordable housing concerns in response to a 52% rise in EU house prices since 2015, recognising that high housing costs also create challenges for regional attractiveness and competitiveness, as companies in affected areas struggle to attract workers due to unaffordable living costs. This trend is particularly concerning in Campania, as it runs parallel to high vacancy rates.

The combination of tourism-oriented housing development, high vacancy rates, and an ageing housing inventory creates conditions that challenge the region's ability to retain and attract young residents in need of affordable housing close to work opportunities. This housing crisis directly threatens demographic sustainability by preventing young people from settling down and starting families, creating a critical barrier to maintaining viable communities and ensuring residents' effective right to stay in their home territories. Across OECD countries, about half of 20-29 year-olds continue to live with their parents, a figure that has been on the rise over the past two decades. On average, across EU countries, as of 2019, 26% of the young population lives in overcrowded dwellings compared to 17% for the general population. Aligning local housing permitting with demographic trends, prioritising urban regeneration, and increasing the supply of affordable and social housing can help the region retain young people struggling with housing affordability.

The upcoming Cohesion Policy mid-term review should present an opportunity to channel additional ERDF resources toward strategic housing rehabilitation and rural housing projects that address both demographic decline and affordability challenges. For instance, the region could tie housing-related recommendations designed to address demographic change to Cohesion Policy Objectives 4 (“a more social Europe”) and ROP action 4.3.1, which aims to combat housing hardship for targeted groups. Campania can also build on current efforts to provide youth-friendly housing (including the creation of 465 new student housing units across four cities) to prioritise the reuse of buildings for co-housing for students and young single people, and families, co-working hubs, and creative industries, aligning such efforts with schemes to attract youth-led start-ups or returning graduates. Key actions include:

• Issuing housing permits in alignment with current and future demographic trends. Urban planning, with regard to regional law, could require municipalities to evaluate housing permits based on the compatible development of their territory, including through Urban Building Regulations (RUEs), limiting new and low-density construction and streamlining renovation, rehabilitation, and dense and vertical development in well-connected areas.

• Deploying incentives and mechanisms to reduce and manage vacant properties. Although the region cannot directly tax vacant property, it can explore methods to encourage municipalities to do so. Campania can encourage the use of empty homes, or the demolition of those unfit for use followed by denser development or by returning the land to rural use, through a combination of policy incentives and deterrents such as public grants and subsidised loans, rental voucher schemes, simplified permitting for rehabilitation or change in use, providing technical support, and acquiring vacant properties and managing rehabilitation directly. The region could also establish funds or a land bank to obtain unused property and integrate it into rehabilitation programmes for strategic redevelopment. The region could provide administrative and financial support and incentives to municipalities and private owners for acquisition, demolition and renovation of vacant properties through the Campania Agency for Residential Housing (Agenzia Campana per l’Edilizia Residenziale - ACER) or the Urban Redevelopment Programme for Housing at Affordable Rent (Programma di Riqualificazione Urbana per Alloggi a Canone Sostenibile - PRUACS). ACER could also be used to facilitate renovations and rental agreements related to these properties. Such investments could also be tied in part to Objective 2.1 of ERDF POR 2021-2027 related to promoting energy efficiency where appropriate.

• Boosting provision of affordable and social housing. The regional government could reassess and align its housing programmes with demographic trends and territorial goals, evaluating the impact of funding sources like the PNRR, Law 145/2018, and PINQUA as well as administrative efficiencies such as ACER, in addressing housing needs. In-kind and monetary contributions obtained through LVC instruments should be reinvested in affordable and social housing, infrastructure and services in less developed areas. Properties generated through demolition and renovation initiatives could be utilised for affordable and social housing purposes. In the short to medium term, Cohesion Policy investments could be utilised to repurpose vacant properties and land towards more relevant uses, such as public service centres and social and affordable housing, in line with Objectives 4 (“to increase access to housing”) and 5 (“as part of local housing strategies”), as well as Action 4.3.1 of ERDF ROP 2021-2027.

Promoting inter-municipal spatial planning to optimise service provision and resource allocation

In March 2024, the Managing Authority for Campania’s ERDF Regional Programme 2021-2027 issued new guidelines (Decree No. 218/2024) to help local authorities simplify how they plan, manage, and spend EU funds, especially for complex projects involving multiple municipalities. These guidelines aim to improve coordination and efficiency in the implementation of Masterplans and Territorial Strategies for Inner Areas, funded under Policy Objective 5 of Cohesion Policy. The guidelines are part of an update to the Programme Implementation Manual (approved by Decree No. 49/2024) and include, among other tools, a model agreement that local authorities can use to set up clear and consistent partnerships. This model is based on Article 30 of the national law governing local authorities and is intended to support better co-operation in designing, delivering, and managing area-based strategies. In addition, Regional Law 5/2024 establishes joint planning agreements between municipalities and offers financial incentives, technical support, and simplified administrative processes.

Despite these efforts, participation in inter-municipal planning is voluntary, and uptake has not yet been significant. This may be due to a combination of weak technical capacity in small municipalities to support participation, weak or unclear incentives, limited knowledge of the new law, and resistance to collaboration due to perceived competition for development and residents between shrinking municipalities. As a result, spatial planning in Campania remains fragmented across small rural municipalities. Stronger inter-municipal co-ordination (IMC) is needed to ensure land use policies support sustainable development and efficient service delivery.

Given the limited uptake of voluntary joint planning agreements under Law 5/2024 and the capacity constraints facing many small municipalities, Campania could take a more proactive role in enabling and co-ordinating inter-municipal planning. These efforts could be tied to EU Cohesion Policy Objective 5 (“a Europe closer to its citizens”) as well as actions related to strengthening administrative capacity of local public stakeholders in 5.1 and 5.2 of the ERDF ROP 2021-2027. Increased support for inter-municipal planning would be particularly relevant for ROP Action 5.1.1 aimed at creating local service centres with populations over 30 000. Increased access to services through polycentrism in the more stable population centres of rural areas could help retain local young talent. Key actions include:

• Developing formal inter-municipal planning instruments to support small municipalities. To address delayed adoption of PUCs, Campania can go beyond voluntary joint planning agreements to explore the creation of a formal planning instrument that covers multiple small municipalities with similar demographics, and which lack the resources to update or enforce their own local plans. Successful inter-municipal Masterplans can serve as a basis. To promote uptake, the region could introduce a mix of increased financial and procedural incentives, such as higher co-financing rates, and targeted technical assistance, It could also condition access to specific EU-funded project calls based on participation in planning agreements, and direct EU Cohesion Policy funds to investment proposals backed by inter-municipal spatial plans. These measures could be incorporated during the 2025 mid-term review of the ERDF ROP 2021-2027. Facilitating inter-municipal co-ordination across provincial lines could also help ensure that low-density development is not amassing just outside the boundaries of Provincial Territorial Co-ordination Plans.

• Assuming a more active role in joint planning at the regional level. This could include establishing a dedicated support unit, offering standardised legal and technical toolkits, and co-financing PUC updates contingent on inter-municipal co-operation. Pilot projects could be launched in shrinking areas with shared service needs, and best practices from Masterplans covering rural areas could be emulated. Strengthening the region’s role would help align local spatial plans with regional development priorities and could facilitate increased access to EU Cohesion Policy funding under Cohesion Policy Objective 5 (“a Europe closer to its citizens”).

Adapting multi-level governance and subnational finance in Campania

Establishing explicit strategies to co-ordinate regional policy initiatives on demographic change

Depopulation and ageing, as emerged during the assessment conducted with other European Regions, often coincide with socio-economic disparities, requiring a cross-sectoral and cross-territorial approach to economic development, essential services, healthcare and social protection. However, the existing policy initiatives to address demographic change in Campania may have faced challenges in strategic co-ordination. For example, EU funded programmes have at times been packaged into small project sizes, which may fragment programmes and limit their effectiveness in addressing demographic challenges. To strengthen co-ordination of policy initiatives, key actions include:

• Developing a regional policy strategy to address the challenges of youth outmigration and population ageing. Campania’s regional government could consider adopting a comprehensive overarching framework explicitly designed to address demographic change, including an assessment of youth outmigration and population ageing along with tailored interventions, integrated co-ordination across funds, sectors and stakeholders, joint-decision making bodies and rural-proofing mechanisms which ensure that all development plans assess demographic impacts. The experience of Castilla-La Mancha may offer important insights into how such a strategy could work in practice. Such a strategy would unify and give lasting structure to existing efforts, such as the National Strategy for Inner Areas which established the Tavolo Aree Interne to co-ordinate its investment initiatives among regional and local stakeholders and the Regional Strategic Guidance Document which promotes cross-sectoral investments for the EU 2021-27 programming period, while anchoring them more firmly in regional priorities rather than being solely shaped by EU frameworks.

• Increasing support for implementing integrated territorial tools in cohesion policy through promoting peer-learning. Integrated territorial tools such as the EU’s Integrated Territorial Investments (ITI) and Community-Led Local Development (CLLD) foster co-ordination across and between levels of government, enabling a holistic, cross-sectoral approach to addressing key issues such as demographic change. Local stakeholders in Campania, especially those engaged in the SNAI pilot areas, have accumulated valuable experience in deploying these tools. To leverage this momentum, the regional government could establish a dedicated peer-learning platform, complemented by regular thematic workshops, to facilitate the exchange of best practices and shared learning from both successes and challenges of using these tools. Similar to the European Common Agricultural Policy (CAP) Network which supports rural development strategies, the peer learning platform could eventually act as a one-stop shop that provides technical assistance, interactive tools and data that monitor and assess the impact of integrated investments and guidance handbooks. This platform would directly support upcoming phases of SNAI roll‑out and align with planned administrative capacity measures under ROP objective 5.2 (“promoting locally integrated and inclusive development”) of ERDF 2021-27. Similar initiatives may be put in place for integrated strategies aimed at urban areas that face different challenges from rural areas which could support urban development in Naples.

Strengthening subnational fiscal capacity to respond to demographic pressures

Demographic change poses a significant challenge to the long-term fiscal sustainability of Campania. Although it is currently Italy’s youngest region, this demographic advantage is rapidly diminishing due to youth outmigration and persistently low fertility rates with the inner provinces of Avellino and Benevento expected to be particularly affected. In Avellino, for instance, the proportion of the population aged 65 and over relative to those aged 15-64 is projected to increase significantly from 36% in 2023 to 67% by 2050, compared to 50% in the EU. The region’s ageing and shrinking population is expected to drive up already-high healthcare expenditure while limiting revenue growth. Under certain assumptions, increasing healthcare costs is expected to worsen the fiscal balance by 3.5 percentage points of regional GDP in 2050. Enhancing the region’s fiscal capacity will be critical to ensuring the continued delivery of essential public services and preserving financial stability amid demographic pressures. Key actions include:

• Consider reviewing fiscal equalisation mechanisms to better account for the challenges in sparsely populated and shrinking areas. In the long term, the national government could enhance the design of the National Equalisation Fund by more explicitly considering the rising per capita costs associated with shrinking populations and the loss of economies of scale. A more transparent and needs-based allocation model could enhance predictability and reduce reliance on ad hoc adjustments through the State-Regions Conference. Similarly, the higher per capita spending needs and limited fiscal capacity of small municipalities could be more systematically reflected in the calculation of standard requirements within the Municipal Solidarity Fund. While this may not be a pressing issue for many municipalities in Campania, given its relatively larger municipalities and younger average populations, it will likely become increasingly important as populations decline and age in the future.

• Consider introducing a vacant property tax. National legislation for a specific IMU tax category for vacant properties could encourage more efficient land use and generate additional municipal revenue. Greater tax autonomy would enable subnational governments to respond more flexibly to evolving demographic needs, while supporting the broader fiscal federalism objectives outlined in the National Recovery and Resilience Plan (PNRR). However, any such measure should carefully weigh the administrative costs of implementation and enforcement.

• Consider adopting participatory budgeting as a tool to build trust in public institutions and ultimately improve tax compliance. Uncollected tax revenue represents a significant source of untapped funding for Campania. By involving citizens in spending decisions, local authorities could strengthen the perceived link between taxes and local development and nurture tax morale. Such local efforts can complement national enforcement measures planned in the PNRR. Moreover, increased civic participation can also improve the quality of public investment decisions and reduce the risks of corruption and political capture. Experiences from northern regions such as Lombardy and Emilia-Romagna, where participatory budgeting has been used to engage communities and enhance transparency, may offer useful guidance for designing effective approaches.

Encouraging higher labour force participation and increased digitalisation for greater economic output and tax revenue

In addition to enhancing subnational fiscal capacity through equalisation mechanisms and new tax powers, it will also be important to strengthen the existing tax base by boosting economic output. This can be supported by measures to strengthen the labour market, such as training and upskilling workers, expanding access to childcare to enable caregivers to return to work and further leveraging digitalisation to enhance productivity. By creating greater employment opportunities and fostering more productive firms, these efforts can also help attract and retain young people. Indeed, many policy initiatives are already in place – for example, EUR 1.1 billion from the ERDF and EUR 160 million from the PNRR are allocated to digitalisation and innovation. Policy efforts from the region could focus on fine-tuning, repurposing, accelerating deployment and better promoting these measures, beyond any increases in funding. Successfully boosting productivity and labour force participation through these initiatives is expected to improve the long-term fiscal balance by over 2 percentage points of GDP by 2050, offsetting more than half of the fiscal pressure resulting from population ageing and decline. Further details are provided below.

• Increasing spending on job placement services, training, and upskilling programmes to boost overall labour force participation. While Italy allocates a relatively high 3.0% of GDP to labour market policies, above the OECD average of 2.2%, only 7% of this spending goes toward active measures such as job placement, training and upskilling, compared to an OECD average of 31%. Campania’s regional government could redirect a greater share of resources toward active labour market policies, representing a strategic shift toward more sustainable, inclusive employment growth in the region. The region may also leverage the EU Cohesion Policy mid-term review’s prioritisation on innovation and competitiveness to frontload EU funds, such as ROP objective 1.4 (“developing skills for smart specialisation, industrial transition and entrepreneurship”) of ERDF to support skills developments in the region.

• Reskilling older workers. Campania’s regional government could invest in equipping older adults with the skills needed to perform non-routine tasks and meet the demands of technology-intensive occupations in the digital economy. These efforts could include expanding the eligibility of the National Programme for the Guaranteed Employability of Workers (GOL) – supported by the EU through its contributions to the PNRR – for those above 65. Programmes targeting this group could prioritise short, practical training courses tailored to specific tasks rather than focusing primarily on foundational skills. The EU Cohesion Policy mid-term review’s prioritisation of skills development also provides an important opportunity to frontload EU funding, such as ROP objective 1.4 and 4.2 of the ERDF related to innovation and competitiveness and lifelong learning to reskill older workers. Such measures not only support labour participation, but also facilitate better access to digital services, such as telemedicine.

• Expanding access to childcare to empower more women to enter the labour market. In 2022, less than 12% of children under the age of three in Campania were in formal childcare, compared to the EU average of 36%. Expanding the availability of childcare facilities will be crucial to allow caregivers, primarily women, to participate in the labour force, and thus increasing economic activity and tax revenue. The Campania ESF+ has allocated funds to increase nursery school enrolment by providing vouchers to finance nursery attendance, alongside work-life balance measures to support women returning to the labour market. Campania’s regional government could additionally utilise the resources available through the PNRR, which identifies the expansion of early childhood education and care, particularly crèches, as a key priority. Currently, no investments have yet been planned for Campania in the relevant PNRR “Education and Research” programming area.

• Strengthening awareness of programmes to support labour participation of youth. Supporting youth employment has been a key priority for Campania, allocating over EUR 200 million through the ESF+ 2021-27. Campania’s regional government could additionally facilitate easier access to and enrolment in programmes like the National Programme for Youth, Women and Work, which have comparatively low enrolment rates in the region despite having allocated substantial funding of EUR 2.8 billion to support young people’s transition into the workforce. Participation in the previous Programme relied on word of mouth, suggesting the importance of strengthening awareness-raising through active and continuous outreach initiatives – for example in schools, churches, community centres and social media platforms. Actively supporting youth employment could contribute to retaining and attracting young talent by fostering a more visible, supportive and attractive employment environment in the region.

• Supporting small businesses and leverage digitalisation to boost productivity. Campania’s regional government could consider increasing investments to help small firms adopt digital technologies, particularly those lagging in productivity. Greater digitalisation can improve efficiency, drive economic growth and ultimately expand the tax base by increasing overall output. Whilst significant investments are already planned in the PNRR, Campania could consider shifting the allocation of the budget more towards small local firms since Italian microbusinesses are about 30% less productive than European peers, whereas large Italian businesses tend to already be more productive than their counterparts.

Enhancing public service efficiency through strengthening the role of metropolitan cities and promoting inter-municipal co-operation and municipal mergers

Campania’s local administrative landscape is fragmented, with 37% of its 550 municipalities smaller than 2 000 inhabitants compared to 19% for OECD unitary countries on average. Despite this, inter-municipal co-operation remains underutilised. The region has one of the lowest uptakes of the Union of Municipalities per municipality among Italy’s ordinary statute regions and has seen only one municipal merger since 2008 – significantly fewer than in other Italian regions. Among the various factors contributing to this low uptake, a major factor may be limited awareness of the benefits of inter-municipal co-operation. This fragmentation makes it challenging to maintain high-quality, cost-effective, accessible and equitable services, particularly in rural inland areas facing rapid population decline, due to lack of economies of scale and weak capacity. Key actions include:

• Strengthening the capacity and governance of metropolitan cities. The Metropolitan City of Naples has yet to fully harness the agglomeration potential of its surrounding municipalities. A more empowered Naples could serve as a catalyst for broader regional growth, reinforcing the economic vitality of the entire area. Achieving this would require national legislation for a clearer delineation of responsibilities across levels of government, the direct election of metropolitan mayors to enhance legitimacy and accountability and stronger fiscal capacity supported by well-designed equalisation mechanisms. The regional government could also establish capacity-building and peer-learning platforms to facilitate the exchange of best practices to better utilise urban-oriented Integrated Territorial Investments.

• Promoting the formation of Unions of Municipalities through enhancing communication of their costs and benefits. Whilst fiscal incentives are important to promote inter-municipal co-operation, these already exist at the national and regional level, suggesting the presence of other barriers such as a lack of awareness of the benefits of co-operation. For example, studies have pointed to reluctance stemming from scepticism towards nationally led efforts to promote co-operation and historically weaker collaboration between neighbouring municipalities. Campania’s regional government should aim to increase use of this mechanism by municipalities through seminars and resources that explain the benefits and procedures, as well as a dedicated website that shares key information and the impacts of Unions, similar to the approach in Emilia Romagna.

• Promoting municipal mergers for small municipalities. Voluntary amalgamations, such as those currently practised in Italy, tend to result in significantly fewer mergers compared to more directive approaches. Among softer policy tools, information-based measures like impact assessments and guidance often have limited effect unless combined with tangible fiscal incentives. Therefore, the national government could consider increasing fiscal incentives for municipal mergers or encourage amalgamations by setting targets and applying implicit pressure.

Adapting service provision and accessibility in Campania

Leveraging existing resources and expanding physical and digital access to services

Despite strategic investments by Campania in service provision, including in public transport, education, and healthcare, many parts of the region still struggle with gaps in access to and quality of services. These gaps are likely to grow due to depopulation and ageing as residents are spread more sparsely over the territory and demand increases among older residents, leading to rising costs for service delivery per capita. Local governments have limited capacity to manage public funds effectively, as well as to implement and evaluate public services. At the same time, the region has assets that can be leveraged to help close gaps in service provision and access, such as strong community networks and electric buses recently provided to many small municipalities. The expansion of digital infrastructure can narrow these gaps as well. Key actions include:

• Upskilling public sector staff in data use and analytical methods. This can leverage ERDF and ESF+ funds dedicated to technical assistance and lead to more effective short-term policies, targeting investments with higher returns in light of limited resources. Training for professionals hired under the National Recovery and Resilience Plan (PNRR) can help build administrative capacity in municipalities. Campania can also request the inclusion of cost-benefit analysis, measurement methods and forecasting within the EC’s training portfolio and leverage the support of the National Technical Assistance Programme “Capacities for Cohesion” (CapCoe) 2021-2027 to strengthen administrative capacity. As part of CapCoe a recruitment plan has been launched to reinforce municipalities, municipal unions, regional administrations, provinces, and metropolitan cities in less developed regions such as Campania for the 2021–2027 programming period.

• Maintaining roads and decongesting car traffic to improve physical access to services. Campania should continue to invest in maintaining its most-used roads and in strengthening its public transport network. Carpooling incentives, taxes on single-occupancy vehicles accessing designated urban centres and congestion charges could also help decongest urban areas and improve accessibility.

• Leveraging existing resources in areas with limited physical accessibility. Campania could help small municipalities to repurpose recently obtained electric school buses for broader transport needs during non-school hours to expand accessibility for residents, e.g. through piloting on-demand transport services that connect small municipalities with nearby regional service centres. Campania should monitor performance and gather feedback to refine on-demand pilots.

• Complementing public service provision through social economy and bottom-up initiatives. Campania can continue to encourage local development projects receiving funds to include components that complement traditional service delivery, such as childcare. For example, the MaTer agricultural co-operative in Pietraroja not only supported local young entrepreneurs but included an educational programme for young children during school holidays.

• Supporting digital service provision and increasing investment in digital infrastructure. To support digital service provision, Campania can continue to expand internet connectivity and offer digital literacy trainings, building on its ESF+ regional programme that includes provisions for those in formal education and a component on lifelong learning, and focusing on rural areas with weaker digitalisation and rapid ageing. The national government can continue to expand and improve digital infrastructure as well, especially in rural provinces where internet speed is lowest.

Adapting healthcare to meet increased demand and promote preventative care

The projected acceleration of population ageing is expected to increase the demand for healthcare services, leading to higher per person treatment costs and additional pressure on the healthcare infrastructure, putting short- and medium-term fiscal sustainability at risk. In response, Campania has undertaken initiatives like the New Territorial Health Plan, which enhances preventive and digital healthcare provision. The Region is also making use of the resources made available under the National Programme “Health Equity” 2021-2027, which aims to address the challenges identified in the Country-Specific Recommendations and to improve access to healthcare services. The programme focuses on four priority thematic areas: mental health, cancer screening, gender health, and health-related poverty. It operates through a national initiative supporting the regional and local organisation of health and social care services, with the goal of enhancing the capacity of healthcare systems and ensuring better access to services for populations facing socio-economic vulnerability. Additional key actions include:

• Addressing the shortage of medical professionals. Campania could incentivise medical professionals to work in underserved areas, e.g. through bonuses or housing support. National government can augment these efforts by incentivising doctors to remain in the workforce longer to meet increasing demand, reforming education and training to increase the number of students in medical programmes, shifting some responsibilities from doctors to nurses and assistants to allow all to optimise their training and expertise, and recruiting foreign professionals.

• Continued monitoring of medical infrastructure to ensure capacity aligns with demand. Campania should assess whether ongoing investments in medical infrastructure occurring under the New Territorial Health Plan will be sufficient to meet expected demand in different parts of the region. Campania should also assess whether current medical staff in the region will be able to meet projected increases in demand for healthcare, especially in rapidly ageing areas.

• Leveraging available data to identify gaps in telemedicine provision. Analysing the demographics and locations of users, as well as the types of teleconsultations accessed, could help support targeted interventions by revealing where access remains low and which barriers prevent wider adoption. Telemedicine pilots in areas with high internet connectivity could help evaluate impacts and limits. If remote monitoring for older adults via wearable devices proves successful, Campania could explore its scalability.

• Promoting healthy ageing through preventive care and early intervention. Campania should encourage physical, mental, and social activity for ageing residents and expand screening programmes to ensure early detection, which can reduce long-term costs and ease pressure on the healthcare system. Campania can build on the interventions that are already underway, including those implemented with joint funding from the PR Campania ESF+ 2021-2027 and the PR Campania ERDF 2021-2027 that aim is to carry out structured and coordinated actions to promote adequate physical activity among older people and persons with disabilities living in conditions of socio-economic disadvantage and vulnerability. Digital tools can support healthy habits through positive messaging and educational content that promotes activity and mental well-being.

Optimising resources in the education sector

The number of school-age children in Campania is expected to decline, which may lead to school closures and shifts in infrastructure needs. Low nursery coverage rates and over-enrolment in kindergartens reflect high and unmet demand for early childhood education (ECE) services. While the share of young individuals (18-24 years) who at most completed lower secondary education and are not engaged in further education decreased by 13 percentage points in the last two decades, it remains above Italian and EU averages. Ensuring equitable access to digital tools across the education system remains a key challenge. In response and as part of its effort to build the human capital needed to sustain economic growth, the region is subsidising ECE for low-income households, providing guidance to students in low-income neighbourhoods affected by crime and improving accessibility to schools by providing electric school buses to small municipalities. Key additional actions include:

• Strategically consolidating school networks. Local and regional governments can create school clusters (e.g. a shared administration across schools) and co-locate grades (e.g. integrating primary and secondary education within one building) to help maintain levels of accessibility and improve cost efficiency. Where closure is necessary, Campania should prioritise closing secondary over primary schools, considering that the latter influences parents’ residential choices.

• Diversifying learning models. With the support from the Ministry of Education and Merit, Campania could pilot blended learning models that combine in-person and online education to support students where access to schools is severely limited. Such efforts require increased investment in internet connectivity, digital devices and conducive learning environments in rural and depopulating areas.

• Increasing the coverage rates in nurseries and supporting ECE. Campania should support municipalities in increasing the coverage rate of nurseries. Campania could also offer training for additional childcare workers and incentivise surplus kindergarten and primary school teachers to transition to ECE. Once more spaces are available, continued use of mechanisms such as the 916 vouchers funded as part of the PR Campania ESF+ 2021–2027 can encourage greater use of nurseries, particularly among low-income households. In small municipalities, Campania could support piloting inter-generational facilities offering both childcare and elderly care.

Action plan

This action plan outlines a series of targeted actions linked to the policy recommendations developed for each policy sector in the report. These reflect the levers available to national, regional and local authorities in adapting to demographic change. Each recommendation is broken down into concrete actions, specifying the relevant actors and indicative timelines. The proposed lead actor, typically the institution with legal authority or technical competence, is listed first, followed by key partners involved in the delivery of the action. Timelines are classified as short-term (1-2 years), medium-term (3-5 years), or long-term (beyond 5 years), which have been determined based on a judgement of the regulatory, financial, and institutional requirements of the action. Where possible and relevant a mix of short- and long-term actions have been identified across different levels of government, allowing smaller actions to be taken in the absence of larger reforms. Recommendations that have a strong link to the priority topic of youth have also been explicitly identified.

Given the breadth and complexity of the proposed actions, it is recommended that the region organises a forum with relevant stakeholders and develops an implementation roadmap. This roadmap should set out a prioritisation matrix based on each action’s expected impact (low, medium, high) and feasibility, including political will, administrative capacity, and financing availability. It should also identify funding sources, such as own-source revenue or EU funds, designate a clear lead institution for each action, and provide a realistic timeline for implementation. Establishing such a roadmap would support effective sequencing, foster alignment across government levels, and enhance transparency and accountability in implementation.

Table 1.1. Action plan for addressing demographic change in the Region of Campania

Recommendation	Action	Actors	Timeline	Priority
Land use and spatial planning
Update local plans to increase land use efficiency and attractiveness	Updating the PTR to reflect demographic trends and projections, and consider stronger incentives, support and penalties to encourage municipalities to do the same	Assessorato for Territorial Governance Directorate General for Territorial Governance	Medium-term Long-term
	Ensuring all municipalities have updated local land-use plans	Assessorato for Territorial Governance Directorate General for Territorial Governance Municipalities	Short-term Medium-term
	Zoning the region for place-based planning policies by adopting Masterplans	Assessorato for Territorial Governance	Medium-term Long-term
Support smart densification	Incentivising urban regeneration	Assessorato for Territorial Governance Directorate General for Territorial Governance	Short-term Medium-term	Talent –increasing attractiveness
	Facilitating land adjustment, transfer of development rights, and the regeneration process of rural areas	Assessorato for Territorial Governance Directorate General for Territorial Governance Municipalities	Medium-term Long-term
Match housing supply with demand	Evaluating housing permits based on current and future trends	Municipal planning departments	Short-term
	Deploying incentives and mechanisms to reduce and manage vacant properties	Assessorato for Territorial Governance Directorate General for Territorial Governance Municipalities	Short-term Medium-term	Talent –increasing attractiveness
	Boosting provision of affordable and social housing	Assessorato for Territorial Governance Directorate General for Territorial Governance Municipalities ACER PRUACS	Short-term Medium-term	Talent – providing accessible and affordable housing
Promote intermunicipal spatial planning	Developing formal inter-municipal planning instruments to support small municipalities	Assessorato for Territorial Governance Directorate General for Territorial Governance Municipalities	Short-term Medium-term Long-term	Talent – improving service delivery and sustainable planning
	Assuming a more active role in joint planning at the regional level	Assessorato for Territorial Governance Directorate General for Territorial Governance	Short-term Medium-term Long-term
Multi-level governance and subnational finance
Establish explicit strategies to co-ordinate regional policy initiatives on demo-graphic change	Developing a regional policy strategy to address demographic change	National government (Department for cohesion policies) Regional government (Regional Council, Directorate General for Territorial Governance) ANCI Campania	Long-term
	Increasing support for implementing integrated territorial tools through promoting peer-learning	Regional government (Managing authorities of EU cohesion policies, Directorate General for Territorial Governance) Municipal government (Local Councils)	Medium-term Long-term
Strengthen subnational fiscal capacity to respond to demographic pressures	Considering reviewing fiscal equalisation mechanisms to better reflect challenges in sparsely populated and shrinking areas	National government (Ministry of Economy and Finance, Ministry of the Interior, Department for Cohesion Policies) Parliamentary committees ANCI	Long-term
	Considering introducing a vacant property tax	National government (Ministry of Economy and Finance, Ministry of the Interior, Department for Cohesion Policies) Parliamentary committees ANCI	Long-term
	Considering adopting participatory budgeting	Municipal government councils ANCI	Medium-term
Encourag higher labour force participation and increased digitalisation for greater economic output and tax revenue	Increasing spending on job placement services, training, and upskilling programmes	Regional government (Directorate General for Education, Training, Employment and Youth Policies)	Medium-term	Talent – improving employment prospects
	Reskilling older workers	National government (Ministry of Labour and Social Policies) Regional government (Directorate General for Education, Training, Employment and Youth Policies)	Medium-term Long-term
	Expanding access to childcare to empower more women to enter the labour market	National government (Ministry of Education and Merit, Department of Family Policies) Regional government (Directorate General for Social and Socio Health Policies)	Medium-term Long-term	Talent – supporting working-age women
	Strengthening awareness of programmes to support labour participation of youth	Regional government (Directorate General for Education, Training, Employment and Youth Policies) Employment offices	Short-term	Talent – improving youth employment prospects
	Supporting small businesses and leverage digitalisation to boost productivity	National government (Ministry of Enterprises and Made in Italy, Agency for Digital Italy) Regional government (Directorate General for Economic Development and Productive Activities)	Long-term	Talent – increasing attractive small and micro businesses
Enhance public service efficiency through strengthening the role of metropolitan cities, and promoting inter-municipal co-operation and municipal mergers	Strengthening the capacity and governance of metropolitan cities	National government (Ministry of Economy and Finance, Ministry of the Interior, Department for Cohesion Policies) Parliamentary committees Regional government (Directorate General for Territorial Governance) ANCI	Long-term
	Promoting the formation of Unions of Municipalities through enhancing communication of their costs and benefits	Regional government (Directorate General for Territorial Governance)	Short-term Medium-term
	Promoting municipal mergers	National government (Ministry of the Interior, Department for Cohesion Policies) Regional government (Regional Council, Directorate General for Territorial Governance) Municipal government (Local Councils) ANCI Campania	Long-term
Service provision and accessibility
Leverage existing resources and expanding physical and digital access to services	Upskilling public sector staff in data use and analytical methods	Regional government European Commission	Short-term Medium-term
	Maintaining roads and decongesting car traffic to improve physical access to services	Regional government	Short-term Medium-term
	Leveraging existing resources in areas with limited physical accessibility	Regional government Municipalities	Short-term Medium-term
	Complementing public service provision through the social economy and bottom-up initiatives	Regional government	Short-term Medium-term	Talent – bolstering local service provision through community networks
	Supporting digital public service provision and increasing investment in digital infrastructure	National government (Ministry of Economic Development) Regional government	Short-term Medium-term
Adapt healthcare to meet increased demand and promote preventative care	Addressing the shortage of medical professionals	Regional government (General Directorate for Health Protection) National government	Short-term Medium-term Long-term
	Continued monitoring of medical infrastructure capacity to ensure it aligns with increasing demand	Regional government (General Directorate for Health Protection)	Medium-term Long-term
	Leveraging available data to identify gaps in telemedicine provision	Regional government (General Directorate for Health Protection)	Short-term Medium-term
	Promoting healthy ageing through preventive care and early intervention	Regional government (General Directorate for Health Protection)	Short-term Medium-term
Optimise resources in the education sector	Strategically consolidating school networks	Regional government (Directorate General for Education, Training, Employment and Youth Policies) Municipal governments	Short-term Medium-term	Talent – maintaining accessibility for students
	Diversifying learning models	National government (Ministry of Education and Merit) Regional government (Directorate General for Education, Training, Employment and Youth Policies) Municipal government	Medium-term Long-term	Talent – maintaining accessibility for students
	Increasing the coverage rates in nurseries and continuing to support the provision of ECE	Regional government (Directorate General for Education, Training, Employment and Youth Policies, Directorate General for Social and Social Health Policies) Municipal governments	Short-term Medium-term	Talent – ensuring parents have access to childcare

Note

← 1.  The Nomenclature of Territorial Units for Statistics or NUTS (Nomenclature des unités territoriales statistiques in French) is a geographical nomenclature subdividing the economic territory of the European Union (EU) into regions at three different levels (NUTS 1, 2 and 3 respectively, moving from larger to smaller territorial units). Above NUTS 1, there is the 'national' level of the Member States. The NUTS is instrumental in the EU’s Structural Funds and Cohesion Fund delivery mechanisms and for locating the area where goods and services subject to European public procurement legislation are to be delivered.