Alban Ylli1,2, Genc Burazeri2, Albana Fico1,2
1 Institute of Public Health, Tirana, Albania;
2 Faculty of Medicine, University of Medicine, Tirana, Albania.
Background: Primary Health Care (PHC) is considered central in Albanian Health System efforts to control diseases and protect the health of all citizens. The first national strategy for PHC is in final stages and aims to lay the path for preparing the health system to better address the changing health needs of all communities and population categories. In this context we analyse challenges PHC faces and some of its recent achievements.
Methodology: For this work there are used two different methodologies; First, indicators about utilisation of services are systematically retrieved from Institute of Public Health, INSTAT and World Health Organization’s (WHO) databases. They are combined with population data about risk factors and mortality data. The second source of data was the assessment of primary health care services in Albania carried out in 2018, which methodology was guided by the WHO European Framework for Action on Integrated Health Service Delivery and its monitoring tool.
Results: The number of visits in PHC services has been on increase, reaching recently 7,942,742. Still the indicator of average number of contacts with PHC per inhabitant per year (2.7) remains relatively low compared to other European countries. Introduction of check-up program for people 35-70 years old seems to have improved the early detection of hypertension and diabetes; there are 12% more cases of hypertension and 30% more cases of diabetes identified in PHC in the second year of the program. Data show that although hospitalisation rate for hypertension in Albania remains comparatively high, it has been decreasing with 5% during 2015-2017. Nevertheless, the trend is on increase for diabetes. There is an improvement of hypertension control between 2014 and 2016 with 50% less cases of grade 2 and 3 among people over 65 years old. PHC utilisation rate for mental conditions is very low in Albania, while population prevalence rate indicate stigma and barriers in
Conclusions: There are some positive trends related to utilisation rate and early detection of diseases at PHC services in Albania. Still, they need to continuously cope with increasing needs of the population, while aiming at universal coverage with quality health services and lowering the burden of hospitals.
Keywords: challenges, primary health care, Albania.