Socio-Demographic Correlates of Barriers to Access Healthcare Services among Children in Post-Communist Albania

Access to healthcare services is an essential component of promoting public health and sustainable development. Our aim was to assess socio-demographic correlates of barriers to accessing healthcare services among children in Albania, a post-communist country in Europe. An online survey was conducted in September 2022, including a nationwide representative sample of 7831 school children (approximate to 54% girls) ranging from grades six to nine from all regions of Albania. A structured and anonymous questionnaire was administered to all children inquiring about a range of potential barriers to accessing healthcare services. Overall, about 42% of the children reported that they had barriers to accessing healthcare services. There were no gender differences, but there were significant ethnic differences (51% among Roma/Egyptian children vs. 42% among the general sample of the children); urban/rural differences (46% rural vs. 39% urban); and socio-economic differences (52% among children with a lower maternal education vs. 31% among children with a higher maternal education; 66% among children from poor families vs. 35% among children with a higher family income). In transitional Albania, children residing in rural areas, children from Roma and/or Egyptian communities, and especially those pertinent to low socio-economic families report considerably more barriers to accessing healthcare services, which is a cause of concern

Digital applications as a means for promotion of healthy behaviours among Albanian children

Digital applications can be effective tools for strengthening school-based health education programs as they can provide valuable health information to children through interactive videos, quizzes and games. We aimed at assessing the change in the prevalence of healthy behaviours among children exposed to digital applications (intervention) employed for promoting healthy behaviours. We conducted a cross-sectional study before the intervention in March 2022 including a representative sample of 1500 Albanian schoolchildren (˜54% girls) aged 12-15 years. In June 2022, after 4-month exposure to digital applications aimed at promoting healthy behaviours (intervention), we carried out a second cross-sectional study in the same sample of schoolchildren. In both survey rounds, an anonymous and structured self-administered questionnaire inquired children about a range of behavioural practices including nutrition, oral health, physical activity and hygiene practices. After the intervention, overall, there was evidence of a significant increase in the prevalence of all healthy behavioural practices measured: ~9% for breakfast consumption and/or environmental protection, 12% for toothbrushing, 14% for handwashing, 15% for leisure time physical exercise and 24% for adequate fruit and vegetable intake (all p < 0.001). Engagement in healthy behaviours only after the intervention was higher among rural children (from 18% for breakfast consumption to 37% for handwashing and/or adequate fruit and vegetable intake) and especially those pertinent to Roma/Egyptian communities (from 18% for breakfast consumption to 46% for adequate fruit and vegetable intake), except for engagement in safe environmental protection which was more prevalent among urban residents (28% vs. 15% among rural children) and ethnic Albanian children (24% vs. 13% among Roma/Egyptian children). Our findings from Albania indicate that digital applications can be useful for strengthening school-based health promotion programs