Leadership competencies among male health professionals in a Western Balkan country

Aim: Our objective was to assess the current and the required level of leadership competencies among male health professionals in Albania, a country which is characterized by an intensive process of emigration of the health workforce in the past few decades. Methods: This was a cross-sectional study carried out in Albania in June-November 2018 including a nationwide representative sample of 132 male health professionals working at different health institutions at both central and local level in Albania (mean age: 41.4±10.1 years; overall response rate: 88%). A structured 52-item questionnaire was administered to all male health professionals aiming at self-assessing the current level and the required (necessary) level of leadership competencies for their actual job positions. Answers for each item of the instrument ranged from 1 (“minimal competency level”) to 5 (“maximal competency level”). An overall summary score (range: 52-260) and a subscale summary score for each domain were calculated for both the current and the required leadership competency levels. Paired sample t-test was used to compare the overall mean scores and the subscale mean scores of the current level and the required level of leadership competencies among male health professionals. Results: Mean value of the overall summary score of the instrument was lower for the current leadership competency level compared with the required leadership competency level (137.6±8.7 vs. 140.7±21.2, respectively; P=0.02). Mean difference between the required and the current level of leadership competencies was higher for male health professionals working in top managerial positions and those working in urban areas of Albania.     Conclusion: This study informs about the current and the required level of leadership competencies among male health professionals in Albania, a transitional country in the Western Balkans. Policymakers and decision-makers in Albania and other countries in the European region should be aware of the existing gap between the required and the current level of leadership competencies among health professionals operating at all levels

Enhancing health system’s governance through demographic and health surveys in transitional European countries: The example of Albania

To inform policymakers well, there is a need to promote different types of health examination surveys as additional sources of valuable information which, otherwise, would not be available through routine/administrative statistics. This is especially important for former communist countries of South Eastern Europe including Albania, where the existing health information system (HIS) is weak. Among many efforts to strengthen the HIS in Albania, there is currently a commitment to undertake a second round of a nationwide Demographic and Health Survey (DHS). This survey will involve a nationwide representative sample of about 17,000 private households, where all women aged 15-59 years and their respective partners will be interviewed and examined. Externally, the upcoming Albanian DHS will contribute to the European Union accession requirements regarding provision of standardized and valid health information. Furthermore, the DHS will considerably enhance the core functions of the Albanian health system in line with the WHO recommendations. Internally, the DHS will promote societal participation and responsibility in transitional Albania. Importantly, the forthcoming survey will promote good governance including transparency, accountability and health system responsiveness. Also, the DHS will allow for collection of internationally valid and standardized baseline socio-demographic and health information for: assessment of future national trends; monitoring and evaluation of health programs and interventions; evidencing health disparities and inequities; and cross-national comparisons between Albania and different countries of the European Region. Ultimately, findings of the DHS will enable rational decision-making and evidence-based policy formulation in Albania including appropriate planning, prioritization and sound resource allocation. However, transfer of the information collected and implementation in public health policies and interventional programs is rather challenging for most of the countries, particularly for transitional post-communist countries of South Eastern Europe including Albania.   &nbsp

Enhancing health system’s governance through demographic and health surveys in transitional European countries: The example of Albania

To inform policymakers well, there is a need to promote different types of health examination surveys as additional sources of valuable information which, otherwise, would not be available through routine/administrative statistics. This is especially important for former communist countries of South Eastern Europe including Albania, where the existing health information system (HIS) is weak.Among many efforts to strengthen the HIS in Albania, there is currently a commitment to undertake a second round of a nationwide Demographic and Health Survey (DHS). This survey will involve a nationwide representative sample of about 17,000 private households, where all women aged 15-59 years and their respective partners will be interviewed and examined.Externally, the upcoming Albanian DHS will contribute to the European Union accession requirements regarding provision of standardized and valid health information. Furthermore, the DHS will considerably enhance the core functions of the Albanian health system in line with the WHO recommendations. Internally, the DHS will promote societal participation and responsibility in transitional Albania. Importantly, the forthcoming survey will promote good governance including transparency, accountability and health system responsiveness. Also, the DHS will allow for collection of internationally valid and standardized baseline socio-demographic and health information for: assessment of future national trends; monitoring and evaluation of health programs and interventions; evidencing health disparities and inequities; and cross-national comparisons between Albania and different countries of the European Region. Ultimately, findings of the DHS will enable rational decision-making and evidence-based policy formulation in Albania including appropriate planning, prioritization and sound resource allocation. However, transfer of the information collected and implementation in public health policies and interventional programs is rather challenging for most of the countries, particularly for transitional post-communist countries of South Eastern Europe including Albania. 

Leadership competencies among male health professionals in a Western Balkan country

Aim: Our objective was to assess the current and the required level of leadership competencies among male health professionals in Albania, a country which is characterized by an intensive process of emigration of the health workforce in the past few decades.Methods: This was a cross-sectional study carried out in Albania in June-November 2018 including a nationwide representative sample of 132 male health professionals working at different health institutions at both central and local level in Albania (mean age: 41.4±10.1 years; overall response rate: 88%). A structured 52-item questionnaire was administered to all male health professionals aiming at self-assessing the current level and the required (necessary) level of leadership competencies for their actual job positions. Answers for each item of the instrument ranged from 1 (“minimal competency level”) to 5 (“maximal competency level”). An overall summary score (range: 52-260) and a subscale summary score for each domain were calculated for both the current and the required leadership competency levels. Paired sample t-test was used to compare the overall mean scores and the subscale mean scores of the current level and the required level of leadership competencies among male health professionals.Results: Mean value of the overall summary score of the instrument was lower for the current leadership competency level compared with the required leadership competency level (137.6±8.7 vs. 140.7±21.2, respectively; P=0.02). Mean difference between the required and the current level of leadership competencies was higher for male health professionals working in top managerial positions and those working in urban areas of Albania.    Conclusion: This study informs about the current and the required level of leadership competencies among male health professionals in Albania, a transitional country in the Western Balkans. Policymakers and decision-makers in Albania and other countries in the European region should be aware of the existing gap between the required and the current level of leadership competencies among health professionals operating at all levels. Conflicts of interest: None

Trend and Correlates of Leadership Competencies Among Female Health Professionals in Albania

Aim: Our aim was to assess the trends and correlates of the leadership competency level of female health professionals in Albania, a transitional country in the Western Balkans, based on a standardized international instrument.Methods: Two nationwide cross-sectional studies were conducted in Albania in 2014 (first wave; n = 105 women) and subsequently in 2018 (second wave; n = 121 women). A structured questionnaire was administered to all female participants aiming at self-assessing the current level of leadership competencies and the required (desirable) level of leadership competencies for their current job position. The questionnaire consisted of 52 items pertinent to eight domains. Answers for each item of the instrument ranged from 1 (“minimal competency level”) to 5 (“maximal competency level”). Overall summary scores (range: 52–260) were calculated for both the current and the required leadership competency levels in both survey rounds, based on which the gap in leadership competency level was also computed (required minus current competency level). Binary logistic regression was used to assess the correlates of the gap in leadership competency level among study participants.Results: In multivariable-adjusted logistic regression models, there was evidence of a positive association between the gap in leadership competency level and: workplace in urban areas (OR = 3.2, 95%CI = 1.6–6.6); work experience (OR[for 1 year increment] = 1.1, 95%CI = 1.0–1.2); first round of the survey conducted in 2014 (OR = 2.1, 95%CI = 1.0–4.3); and, particularly, a high managerial job position/level (OR = 3.8, 95%CI = 1.6–9.3). Conversely, there was an inverse relationship with the age of women (OR[for 1 year increment] = 0.9, 95%CI = 0.8–1.0).Conclusion: Our study provides useful evidence about trends over time and selected correlates of the gap in leadership competencies among female health professionals in Albania. Policymakers and decision-makers in Albania and other countries should be aware of the unmet need for leadership training of female health professionals at all levels

DETERMINANȚII NAȘTERILOR PREMATURE ÎN SHKODER, PRINCIPALA REGIUNE DIN NORDUL ALBANIEI

BACKGROUND: Premature birth is a major public health problem worldwide. Our aim was to assess maternal socio-demographic and behavioral determinants of premature birth in Shkoder, which is one of the main regions in Albania. METHODS: This was a case-control study including all premature births (cases: N=343) and a representative sample of full-term births (controls: N=372) pertinent to the Regional Hospital of Shkoder during the period January 2014 – December 2015. Information on maternal socio-demographic characteristics and behavioral factors was collected for all study participants. Binary logistic regression was used to assess the association of premature births with maternal socio-demographic characteristics and lifestyle factors.   RESULTS: In multivariable-adjusted logistic regression models, independent “predictors” of premature births were maternal older age (OR=4.7, 95%CI=2.7-8.0), a lower educational level (OR=5.9, 95%CI=3.2-8.7), unemployment (OR=1.6, 95%CI=1.1-2.2), smoking and alcohol consumption (OR=1.9, 95%CI=1.1-3.3 and OR=2.0, 95%CI=1.1-3.7, respectively) and overweight and obesity (OR=1.8, 95%CI=1.2-2.7 and OR=2.3, 95%CI=1.6-3.3, respectively).    CONCLUSION: This study provides useful information about several maternal socio-demographic and behavioral correlates of premature births in Shkoder, which constitutes the main region in north Albania. Findings from this study indicate the need for active preventive and health promotion programs in order to avoid premature births in transitional Albania.      Keywords: Albania, alcohol consumption, body mass index, full-term birth, pregnant women, premature birth, Shkoder, smoking.   CONTEXT: nașterea prematuă reprezintă o problemă majoră de sănătate publică în întreaga lume. Scopul nostru a fost evaluarea factorilor determinanți socio-demografici și comportamentali materni ai nașterilor premature în Shkoder, care este una dintre principalele regiuni ale Albaniei. METODĂ: S-a realizat un studiu caz control, incluzând toate nașterile premature (un număr de 343 cazuri) și un eșantion reprezentativ de nașteri la termen (lotul control cu 372 cazuri), internate în Spitalul Regional din Shkoder, în perioada ianuarie 2014 - decembrie 2015. Informații cu privire la caracteristicile socio-demografice materne și factorii comportamentali au fost colectate pentru toți participanții la studiu. S-a folosit regresia logistică binară pentru a evalua asocierea nașterilor premature cu caracteristicile socio-demografice materne și stilul de viață. REZULTATE: În modelele de regresie logistică multivariabil-ajustate, ! ”predictorii"” independenți ai nașterilor premature au fost vârsta maternă mai mare (OR = 4,7, 95% CI = 2,7-8,0), un nivel educational mai redus (OR = 5,9, 95% CI = 3,2- 8,7), șomajul (OR = 1,6, 95% CI = 1,1-2,2), fumatul și consumul de alcool (OR = 1,9, 95% CI = 1,1-3,3 și respectiv OR = 2,0, 95% CI = 1,1-3,7), excesul ponderal și obezitatea (OR = 1,8, 95% CI = 1,2-2,7 și respectiv OR = 2,3, 95% CI = 1,6-3,3). CONCLUZII: Acest studiu oferă informații utile despre mai multe corelații între factorii socio-demografici și comportamentali materni și nașterile premature în Shkoder, care constituie principala regiune din nordul Albaniei. Rezultatele acestui studiu indică necesitatea unor programe active de prevenire și de promovare a sănătății, în scopul de a evita nașterile premature în Albania de tranziție. Cuvinte-cheie: Albania, consum de alcool, indice de masă corporală, naștere la termen, femeile gravide, naștere prematură, Shkoder, fuma

Enhancing health system’s governance through demographic and health surveys in transitional European countries: The example of Albania

To inform policymakers well, there is a need to promote different types of health examination surveys as additional sources of valuable information which, otherwise, would not be available through routine/administrative statistics. This is especially important for former communist countries of South Eastern Europe including Albania, where the existing health information system (HIS) is weak.Among many efforts to strengthen the HIS in Albania, there is currently a commitment to undertake a second round of a nationwide Demographic and Health Survey (DHS). This survey will involve a nationwide representative sample of about 17,000 private households, where all women aged 15-59 years and their respective partners will be interviewed and examined.Externally, the upcoming Albanian DHS will contribute to the European Union accession requirements regarding provision of standardized and valid health information. Furthermore, the DHS will considerably enhance the core functions of the Albanian health system in line with the WHO recommendations. Internally, the DHS will promote societal participation and responsibility in transitional Albania. Importantly, the forthcoming survey will promote good governance including transparency, accountability and health system responsiveness. Also, the DHS will allow for collection of internationally valid and standardized baseline socio-demographic and health information for: assessment of future national trends; monitoring and evaluation of health programs and interventions; evidencing health disparities and inequities; and cross-national comparisons between Albania and different countries of the European Region. Ultimately, findings of the DHS will enable rational decision-making and evidence-based policy formulation in Albania including appropriate planning, prioritization and sound resource allocation. However, transfer of the information collected and implementation in public health policies and interventional programs is rather challenging for most of the countries, particularly for transitional post-communist countries of South Eastern Europe including Albania. 

Trend and Correlates of Leadership Competencies Among Female Health Professionals in Albania

Aim: Our aim was to assess the trends and correlates of the leadership competency level of female health professionals in Albania, a transitional country in the Western Balkans, based on a standardized international instrument. Methods: Two nationwide cross-sectional studies were conducted in Albania in 2014 (first wave; n = 105 women) and subsequently in 2018 (second wave; n = 121 women). A structured questionnaire was administered to all female participants aiming at self-assessing the current level of leadership competencies and the required (desirable) level of leadership competencies for their current job position. The questionnaire consisted of 52 items pertinent to eight domains. Answers for each item of the instrument ranged from 1 (“minimal competency level”) to 5 (“maximal competency level”). Overall summary scores (range: 52-260) were calculated for both the current and the required leadership competency levels in both survey rounds, based on which the gap in leadership competency level was also computed (required minus current competency level). Binary logistic regression was used to assess the correlates of the gap in leadership competency level among study participants. Results: In multivariable-adjusted logistic regression models, there was evidence of a positive association between the gap in leadership competency level and: workplace in urban areas (OR = 3.2, 95%CI = 1.6-6.6); work experience (OR[for 1 year increment] =1.1, 95%CI = 1.0-1.2); first round of the survey conducted in 2014 (OR = 2.1, 95%CI = 1.0-4.3); and, particularly, a high managerial job position/level (OR = 3.8, 95%CI = 1.6-9.3). Conversely, there was an inverse relationship with the age of women (OR[for 1 year increment] = 0.9, 95%CI = 0.8-1.0). Conclusion: Our study provides useful evidence about trends over time and selected correlates of the gap in leadership competencies among female health professionals in Albania. Policymakers and decision-makers in Albania and other countries should be aware of the unmet need for leadership training of female health professionals at all levels

Ability to Maintain and Improve Health and Socio-Demographic Correlates among Children in Albania

Our aim was to assess the level and socio-demographic correlates of the ability to maintain health among children in Albania, a post-communist country in the Western Balkans

Lifestyle Characteristics and Gastroesophageal Reflux Disease: A Population-Based Study in Albania

Aim. We aimed to assess the prevalence and lifestyle correlates of gastroesophageal reflux disease (GERD) in the adult population of Albania, a Mediterranean country in Southeast Europe which has experienced major behavioral changes in the past two decades. Methods. A cross-sectional study, conducted in 2012, included a population-representative sample of 845 individuals (≥18 years) residing in Tirana (345 men, mean age: ; 500 women, mean age: ; response rate: 84.5%). Assessment of GERD was based on Montreal definition. Covariates included socioeconomic characteristics, lifestyle factors, and body mass index. Logistic regression was used to assess the association of socioeconomic characteristics and lifestyle factors with GERD. Results. The overall prevalence of GERD was 11.9%. There were no significant sex differences, but a higher prevalence among the older participants. In fully adjusted models, there was a positive relationship of GERD with smoking, physical inactivity, fried food consumption, and obesity, but not so for alcohol intake and meat consumption. Conclusion. We obtained important evidence on the prevalence and lifestyle correlates of GERD in a Western Balkans' country. Smoking, physical inactivity, and obesity were strong “predictors” of GERD in this population. Findings from this study should be replicated in prospective studies in Albania and other transitional settings