An Insight into the Immunization Coverage for Combined Vaccines in Albania

We aim to Provide facts about the vaccination coverage for combined vaccines such as MMR (Measles, Mumps and Rubella) and DTP (Diphtheria, Tetanus, Pertussis) containing vaccines in use in Albania during the last 10 years, in order to confirm the stability of immunization program. One of the reasons for coverage improvement is the use of one or two-dose vials for the administration of MMR vaccine, enabling the vaccination of children at any time, without the need of gathering them on certain days when the multi-dose vaccine vials are opened. In the last three years, according to WHO recommendations, it was noted that vaccination coverage with three doses containing DTP is at sustainable levels, always above 95%, but for our country this value goes sometimes above 98%. As for the use of pentavalent vaccine, from 2008, DTP-HepB-Hib, also the coverage of Hepatitis b vaccine is always at upper levels due to its use on 5 in 1 combination. The application of this vaccine was associated with the use of one dose vial administration, therefore one vaccine to a child. Immunization coverage for vaccines with measles component remains at very high levels for both doses of vaccine, more then 95%. Immunization coverage for vaccines with DTP component exceeds 95% rate at country level, for each district it exceeds 95% and it reaches the value of 98.5% for the last two years. During the last years the vaccine coverage is increased significantly as a result of using combined vaccine of DTP-HepB -Hib. The use of one dose vials has played an important role on sustaininig and increasing vaccination coverage

Preventive check-up programme for strengthening people-centred primary health care services in Albania: Case study and lessons learnt

Non-communicable Diseases (NCDs) in Albania are increasing, yet the country has a low number of outpatient visits per inhabitant per year. A primary health care (PHC) based programme of medical check-ups, with a focus on prevention, was set up in the country in 2015 aiming to address this issue, among others. This manuscript describes the development and status of the programme at key time points after its implementation, and considers some of its outcomes.The current analysis was based on data gathered from the check-up programme information system and the registry of diseases at PHC centres, and guided by the European Framework for Action on Integrated Health Services Delivery.Based on PHC registered cases, a 13% and 34% increase in the prevalence of elevated blood pres-sure and diabetes were observed in 2015 respectively, following the introduction of the check-up programme compared to the previous year. Three years after implementation, about 60% of the population aged 35–70 years old had used the programme at least once, with 61% of the total 954 667 visits provided to women.Overall, the check-up programme in Albania has identified a substantial number of new cases of NCD as well as their associated risk factors in its population. The early detection of NCDs is expected to contribute to the prevention of complications, premature mortality and their associated costs. Albanian politicians and decision-makers should regularly revise and introduce appropriate changes to the check-up programme in the future. In particular, the issue of sustainability and long-term resource mobilization is of particular concern and warrants careful consideration.   Conflict of interests: None declared

Preventive check-up programme for strengthening people-centred primary health care services in Albania: Case study and lessons learnt

Non-communicable Diseases (NCDs) in Albania are increasing, yet the country has a low number of outpatient visits per inhabitant per year. A primary health care (PHC) based programme of medical check-ups, with a focus on prevention, was set up in the country in 2015 aiming to address this issue, among others. This manuscript describes the development and status of the programme at key time points after its implementation, and considers some of its outcomes.The current analysis was based on data gathered from the check-up programme information system and the registry of diseases at PHC centres, and guided by the European Framework for Action on Integrated Health Services Delivery.Based on PHC registered cases, a 13% and 34% increase in the prevalence of elevated blood pres-sure and diabetes were observed in 2015 respectively, following the introduction of the check-up programme compared to the previous year. Three years after implementation, about 60% of the population aged 35–70 years old had used the programme at least once, with 61% of the total 954 667 visits provided to women.Overall, the check-up programme in Albania has identified a substantial number of new cases of NCD as well as their associated risk factors in its population. The early detection of NCDs is expected to contribute to the prevention of complications, premature mortality and their associated costs. Albanian politicians and decision-makers should regularly revise and introduce appropriate changes to the check-up programme in the future. In particular, the issue of sustainability and long-term resource mobilization is of particular concern and warrants careful consideration.   Conflict of interests: None declared

Data gaps in adolescent fertility surveillance in middle-income countries in Latin America and South Eastern Europe: Barriers to evidence-based health promotion

Adolescent health is a major global priority. Yet, as recently described by the World Health Organization (WHO), increased recognition of the importance of adolescent health rarely transforms into action. One challenge is lack of data, particularly on adolescent fertility. Adolescent pregnancy and childbirth are widespread and affect lifetime health and social outcomes of women, men, and families. Other important components of adolescent fertility include abortion, miscarriage, and stillbirth. Access to reliable, consistently-collected data to understand the scope and complexity of adolescent fertility is critical for designing strong research, developing meaningful policies, building effective programs, and evaluating success in these domains. Vital surveillance data can be challenging to obtain in general, and particularly in low- and middle-income countries and other under-resourced settings (including rural and indigenous communities in high-income countries). Definitions also vary, making comparisons over time and across locations challenging. Informed by the Adolescence and Motherhood Research project in Brazil and considering relevance to the Southern Eastern European (SEE) context, this article focuses on challenges in surveillance data for adolescent fertility for middle-income countries. Specifically, we review the literature to: (1) discuss the importance of understanding adolescent fertility generally, and (2) highlight relevant challenges and complexity in collecting adolescent fertility data, then we (3) consider implications of data gaps on this topic for selected middle-income countries in Latin America and SEE, and (4) propose next steps to improve adolescent fertility data for evidence-based health promotion in the middle-income country context

Data gaps in adolescent fertility surveillance in middle-income countries in Latin America and South Eastern Europe: Barriers to evidence-based health promotion

Adolescent health is a major global priority. Yet, as recently described by the World Health Organization (WHO), increased recognition of the importance of adolescent health rarely transforms into action. One challenge is lack of data, particularly on adolescent fertility. Adolescent pregnancy and childbirth are widespread and affect lifetime health and social outcomes of women, men, and families. Other important components of adolescent fertility include abortion, miscarriage, and stillbirth. Access to reliable, consistently-collected data to understand the scope and complexity of adolescent fertility is critical for designing strong research, developing meaningful policies, building effective programs, and evaluating success in these domains. Vital surveillance data can be challenging to obtain in general, and particularly in low- and middle-income countries and other under-resourced settings (including rural and indigenous communities in high-income countries). Definitions also vary, making comparisons over time and across locations challenging. Informed by the Adolescence and Motherhood Research project in Brazil and considering relevance to the Southern Eastern European (SEE) context, this article focuses on challenges in surveillance data for adolescent fertility for middle-income countries. Specifically, we review the literature to: (1) discuss the importance of understanding adolescent fertility generally, and (2) highlight relevant challenges and complexity in collecting adolescent fertility data, then we (3) consider implications of data gaps on this topic for selected middle-income countries in Latin America and SEE, and (4) propose next steps to improve adolescent fertility data for evidence-based health promotion in the middle-income country context.Conflicts of interest: None

Demographic and health challenges facing Albania in the 21st century

Detailed in-depth analysis of Demographic and Health Challenges facing Albania in the 21st Century prepared by a group of experts in the fields of demography and public health. From a scientific perspective, this report is very important as it highlights the urgent challenges Albania faces today, as well as provides recommendations for integrated policies as a tool to address such challenges, policies not just for the health of young children, but their mothers’ as well. The report highlights the need to focus on the potential of young people in the country through development of policies, not only to stop migration, but also to slow down the aging process. The report also emphasizes that the focus on the elderly should be a new agenda for health and social care, as Albanian population is aging at a very high rate. The report does not leave aside focus on human rights and reproductive health rights. Addressing the regulation of abortion, sex-bias abortion, as well as the empowerment of women in decision-making in all aspects of life, this report underlines the importance of reproductive health rights as part of human rights

The lower COVID-19 related mortality and incidence rates in Eastern European countries are associated with delayed start of community circulation

BackgroundThe purpose of this analysis was to assess the variations in COVID-19 related mortality in relation to the time differences in the commencement of virus circulation and containment measures in the European Region.MethodsThe data for the current analysis (N = 50 countries) were retrieved from the John Hopkins University dataset on the 7th of May 2020, with countries as study units. A piecewise regression analysis was conducted with mortality and cumulative incidence rates introduced as dependent variables and time interval (days from the 22nd of January to the date when 100 first cases were reported) as the main predictor. The country average life expectancy at birth and outpatient contacts per person per year were statistically adjusted for in the regression model.ResultsMortality and incidence were strongly and inversely intercorrelated with days from January 22, respectively -0.83 (pConclusionCountries in Europe that had the earliest COVID-19 circulation suffered the worst consequences in terms of health outcomes, specifically mortality. The drastic social isolation measures, quickly undertaken in response to those initial outbreaks appear effective, especially in Eastern European countries, where community circulation started after March 11th. The study demonstrates that efforts to delay the early spread of the virus may have saved an average 30 deaths daily per one million inhabitants

Prevalence and sociodemographic correlates of medication intake adherence among primary health-care users in Albania

Background: Evidence about the magnitude and determinants of medication intake adherence among patients and the general population in Southeastern Europe is scant. Aims: To assess the prevalence and sociodemographic correlates of medication intake adherence among adult primary health-care (PHC) users in Albania. Methods: A cross-sectional study was conducted in 2018-2019 in a representative sample of 1553 adult PHC users (response: 94%) selected probabilistically from 5 major regions of Albania. There were 849 (55%) women and 704 (45%) men, with a mean age 54.6 (16.4) years. A structured interviewer-administered questionnaire inquired about medication intake adherence prescribed by family physicians, and sociodemographic characteristics. Binary logistic regression was used to assess the sociodemographic correlates of medication intake adherence. Results: Three hundred (19.8%) participants did not take the prescribed medication. In multivariable-adjusted logistic model, significant correlates of nonintake of medication included rural residence, low educational level, unemployment and low economic level. Among these 300 participants, 273 (91%) considered the high cost of the drugs as a reason for not taking the medication. Conclusion: We found a high prevalence of nonintake of medication prescribed by family physicians. Decision-makers and policy-makers in Albania and elsewhere should consider the provision of essential drugs free of charge or at low cost to low socioeconomic groups and other vulnerable and marginalized population categories, because the costs of noncompliance will eventually be higher

Understanding of Medication Information in Primary Health Care:A Cross-Sectional Study in a South Eastern European Population

Aim:We aimed to assess adult primary health care (PHC) users' understanding of their medication information in a transitional South Eastern European population across seven domains. Methods:A cross-sectional study, carried out in Albania in 2018-19, included a representative sample of 1,553 PHC users aged >= 18 years (55% women; overall mean age: 54.6 +/- 16.4 years; overall response rate: 94%). Participants were asked about their understanding of information they received from their respective family physicians about prescribed medicines in terms of factors like cost, dosage, and side-effects. Socio-demographic data were also gathered. Binary logistic regression was employed to assess the socio-demographic predictors of information about medication use and administration. Results:Across different aspects of use and administration, 21-60% of participants did not understand their medications. Less understanding of medication use was particularly high among the poor and those with low education and among urban residents, irrespective of socioeconomic status. Conclusion:This study provides important evidence about the level and socio-demographic determinants on understanding of information about medication use and administration among adult PHC users in a transitional former communist country in South Eastern Europe. Policymakers should be aware of the joint role and interplay between health literacy (demand side) and information provision (supply side), which both significantly influence the understanding of medication use by the general population