Correlates of level of satisfaction among primary health care workers in Albania

Aim: The aim of this study was to explore the level of satisfaction of primary health care staff in Albania and the factors associated with it. Methods: A cross-sectional study was conducted in Tirana city, the Albanian capital, from 11 November 2020 until 25 November 2020. Among all health centers (HCs) and health centers of specialties (HCSs) of Tirana Municipality, there were selected randomly a HC in rural areas, a HC in urban areas and one HCS. All the staff (doctors and nurses) being present at the time of data collection was interviewed, using an international standardized tool (the Dartmouth-Hitchcock Medical Center instrument) assessing the satisfaction with various elements of the work in PHC, validated in Albanian. A total of 102 PHC staff were included in the study. Binary logistic regression was used to assess the association of staff satisfaction with independent factors. Results: The aspects of work most appreciated by PHC staff (% satisfied or very satisfied) were: respectful treatment by colleagues (78.2%), staff morale and their positive attitude towards work (73.2%). The most disliked aspects of work by PHC staff (% dissatisfied or very dissatisfied) were: current salary (60.8%), stress at work (38.3%), physical and medical infrastructure in the institution (27%). Staff in rural HCs, older staff, females and nurses and family doctors are more likely to be satisfied compared to their respective colleagues. Conclusion: Our findings suggest various factors associated with the satisfaction of PHC staff in Albania. These findings could be guiding future efforts aiming to improve the work conditions of the professionals working in primary health care in Albania

Application of EASY-Care Standard 2010 instrument in a population-based survey in transitional Kosovo

Background The aim of this study was to assess the health needs and priorities of older people in Kosovo, the newest state in Europe striving for a functional democracy after the breakdown of former Yugoslavia and the following war in the region. Methods A cross-sectional study was conducted in Kosovo in 2011 including a nationwide representative sample of 1890 individuals aged ≥65 years (949 men, mean age: 73 ± 6 years; 941 women, mean age: 74 ± 7 years; overall response rate: 84%). All individuals were administered the full version of EASY-Care Standard 2010 instrument, inquiring about the need for support in activities of daily living (‘independence’), the ‘risk of breakdown in care’ (leading to emergency admission to hospital) and the ‘risk of falls’. Results The degree of ‘independence’ was lower, whereas the ‘risk of breakdown in care’ and the ‘risk of falls’ were significantly higher in: older women; the oldest individuals (≥85 years); rural residents; participants living alone; those perceiving themselves as poor; participants who could not access medical care; those who perceived their general health status as poor; and older people who reported at least one chronic condition. Conclusions This is one of the very few reports from Southeast European region informing about the health needs and priorities of older people in a large and representative population-based sample of older men and women. The poor health status of older people, especially evident in the socio-demographic disadvantaged categories, should raise the awareness of policymakers and decision-makers for appropriate health and social care of elderly in Kosovo and in other European countries

Health literacy and body mass index:a population-based study in a South-Eastern European country

BACKGROUND: The relationship of health literacy (HL) with objective measures including anthropometric measurements remains an under-researched topic to date. OBJECTIVE: To assess the association between body mass index (BMI) and HL among Albanian adults. METHODS: A cross-sectional study was conducted in Tirana, Albania, in 2012-2014 including a population-based sample of 1154 individuals aged ≥18 years. HL was assessed by the use of HLS-EU-Q instrument. Anthropometrics included measurement of weight and height based on which BMI was calculated. Information on socio-demographic characteristics was also collected. Logistic regression was employed to assess the independent association of BMI and HL controlling all socio-demographic factors. RESULTS: One-fifth of the participants reported an inadequate HL level, whereas almost one-third (31%) reported an excellent HL level. About 41% of study participants were overweight and further 22% were obese. In multivariate analysis, there was evidence of a strong and significant association between BMI and HL: the odds of overweight/obesity were two times higher (OR = 2.0, 95% CI = 1.3-3.1) among inadequate HL individuals compared with excellent HL participants. CONCLUSION: Our findings, pertinent to a transitional country in the South East Europe, point to a strong, consistent and highly significant association between BMI and HL, irrespective of a wide array of socio-demographic characteristics

Implementation of a neonatal hearing screening programme in three provinces in Albania

Objectives: The EUSCREEN study compares the cost-effectiveness of paediatric hearing screening programmes and aims to develop a cost-effectiveness model for this purpose. Alongside and informed by the development of the model, neonatal hearing screening (NHS) is implemented in Albania. We report on the first year. Methods: An implementation plan was made addressing objectives, target population, screening protocol, screener training, screening devices, care pathways and follow up. NHS started January 1st, 2018 in four maternity hospitals: two in Tirana, one in Pogradec and one in Kukës, representing both urban and rural areas. OAE-OAE-aABR was used to screen well infants in maternity hospitals, whereas aABR-aABR was used in neonatal intensive care units and in mountainous Kukës for all infants. Screeners’ uptake and attitudes towards screening and quality of screening were assessed by distributing questionnaires and visiting the maternity hospitals. The result of screening, diagnostics, follow up and entry into early intervention were registered in a database and monitored. Results: Screeners were keen to improve their skills in screening and considered NHS valuable for Albanian health care. The number of “fail” outcomes after the first screen was high initially but decreased to less than 10% after eight months. In 2018, 11,507 infants were born in the four participating maternity hospitals, 10,925 (94.9%) of whom were screened in the first step. For 486 infants the result of screening was not registered. For the first screen, ten parents declined, eight infants died and one infant was discharged before screening could be performed. In 1115 (10.2%) infants the test either could not be performed or the threshold was not reached; 361 (32,4%) of these did not attend the second screen. For the third screen 31 (34.4%) out of 90 did not attend. Reasons given were: parents declined (124), lived too far from screening location (95), their infant died (11), had other health issues (7), or was screened in private clinic (17), no reason given (138). Conclusions: Implementation of NHS in Albania is feasible despite continuing challenges. Acceptance was high for the first screen. However, 32.4% of 1115 infants did not attend the second screen, after a “fail” outcome for the first test

ETAPELE PRELIMINARE PENTRU IMPLEMENTAREA SCREENING-ULUI AUDITIV GENERAL NEONATAL, ÎN ALBANIA

BACKGROUND: Delayed diagnosis and/or treatment of the hearing impairment could jeopardize the future personal and social development of affected infants. Universal newborn hearing screening is an important instrument that enables the detection of most babies born with hearing impairment, but this practice needs to meet certain criteria in order to be implementable. The EUSCREEN project in Albania offers an opportunity to determine a cost-optimized model of childhood hearing screening that could be implemented in different low-to-middle income countries. In this context, the present study focuses on describing the current state of affairs of this project in Albania. METHODS: We provide the readers with a general description of activities that have been carried out in the framework of the preparatory phase and the implementation of EUSCREEN project activities in Albania. In addition, screening tests and procedure is explained and the preliminary prevalence of hearing impairment among newborns is calculated. RESULTS: EUSCREEN project in Albania has gone through multiple meetings among local partners. It is being implemented in three socio-economically diverse districts of the country. Various theoretical and practical sessions have taken place and a large number of informative materials are produced. The screening covered about 95% of all targeted newborns in selected project sites. Conclusion: So far, the EUSCREEN project in Albania is providing valuable information about the newborn hearing screening procedures, which will be used by the international team of experts to determine a cost-optimized model of childhood hearing screening.   Keywords: Albania, EUSCREEN, hearing impairment, horizon 2020, screening.CONTEXT: Întârzierea diagnosticului și/sau a tratamentului la nou-născuții cu afectări ale auzului ar putea pune în pericol dezvoltare personală și socială viitoare a acestora. Screening-ul auditiv general pentru nou-născuți este un instrument important care permite depistarea majorității copiilor născuți cu deficiențe de auz, dar această metodă trebuie să îndeplinească anumite criterii pentru a putea fi implementată. Proiectul EUSCREEN din Albania oferă posibilitatea de a stabili un model cost optim al screening-ului auditiv al copilului, care ar putea fi implementat în diferite țări cu venituri mici sau medii. În acest context, studiul de față se concentrează pe descrierea situației actuale a acestui proiect în Albania. METODE: Studiul oferă cititorilor o descriere generală a activităților care au fost efectuate în cadrul fazei pregătitoare și implementarea activităților proiectului EUSCREEN în Albania. În plus, sunt explicate testele și metoda de screening și este calculată prevalența afecțiunilor auditive în rândul nou-născuților. Rezultate: Proiectul EUSCREEN din Albania a presupus mai multe întâlniri între partenerii locali. Proiectul s-a implementat în trei zone socio-economice diferite ale țării. S-au desfășurat diferite sesiuni teoretice și practice și s-a realizat un număr mare de materiale informative. Screening-ul a acoperit aproximativ 95% din totalitatea nou-născuților vizați din locurile selectate în proiect. CONCLUZII: Până în prezent, proiectul EUSCREEN din Albania a oferit informații importante despre metodele de screening auditiv la nou-născut, care vor fi utilizate de către echipa internațională de experți pentru a stabili un model optim din punct de vedere al costului pentru screening-ul auditiv al copilului.   Cuvinte cheie: Albania, EUSCREEN, tulburări de auz, Orizont 2020,  screenin

Correlates of level of satisfaction among primary health care workers in Albania

Aim: The aim of this study was to explore the level of satisfaction of primary health care staff in Albania and the factors associated with it. Methods: A cross-sectional study was conducted in Tirana city, the Albanian capital, from 11 November 2020 until 25 November 2020. Among all health centers (HCs) and health centers of specialties (HCSs) of Tirana Municipality, there were selected randomly a HC in rural areas, a HC in urban areas and one HCS. All the staff (doctors and nurses) being present at the time of data collection was interviewed, using an international standardized tool (the Dartmouth-Hitchcock Medical Center instrument) assessing the satisfaction with various elements of the work in PHC, validated in Albanian. A total of 102 PHC staff were included in the study. Binary logistic regression was used to assess the association of staff satisfaction with independent factors. Results: The aspects of work most appreciated by PHC staff (% satisfied or very satisfied) were: respectful treatment by colleagues (78.2%), staff morale and their positive attitude towards work (73.2%). The most disliked aspects of work by PHC staff (% dissatisfied or very dissatisfied) were: current salary (60.8%), stress at work (38.3%), physical and medical infrastructure in the institution (27%). Staff in rural HCs, older staff, females and nurses and family doctors are more likely to be satisfied compared to their respective colleagues. Conclusion: Our findings suggest various factors associated with the satisfaction of PHC staff in Albania. These findings could be guiding future efforts aiming to improve the work conditions of the professionals working in primary health care in Albania. Conflicts of interest: None declared. Acknowledgment: This study was funded by the “Health for All Project” in Albania (hap.org.al), which is a project of the Swiss Agency for Development and Cooperation (SDC)

Socioeconomic conditions of elderly people in Kosovo: a cross-sectional study

Abstract Background Kosovo is the newest state in Europe facing a particularly difficult socioeconomic and political transition. The available evidence on socioeconomic conditions and quality of life of elderly people in Kosovo is scarce notwithstanding the ageing trend due to lowering of fertility rates and a higher life-expectancy. In this context, the aim of our study was to assess the socioeconomic conditions of elderly people in post-war Kosovo. Methods A cross-sectional study was conducted in Kosovo in January-March 2011 including an age- sex-and residence (urban vs. rural)-stratified sample of 1,890 individuals (83.5% response) aged 65 years and over. A structured questionnaire included assessment of socio-demographic and socioeconomic characteristics including educational level and self-perceived poverty. Binary logistic regression was used to assess the association of self-perceived poverty with socio-demographic and socioeconomic factors. Results The educational level in this representative sample of elderly people in Kosovo was quite low, particularly among women. About 47% of respondents perceived themselves as poor, or extremely poor (41% of men and 52% of women). In multivariable-adjusted models, self-perceived poverty was higher among older women, low educated individuals, urban residents, and elderly individuals living alone. Conclusions Findings from this study indicate that the socioeconomic situation of the elderly population in Kosovo is rather challenging. Demographic trends coupled with the economic and political transition raise serious concerns about increasing needs for socioeconomic support of elderly people in Kosovo. Specific policies and actions should be considered by a number of stakeholders, including government and civil society in transitional Kosovo.</p

Demographic and Social Correlates of Tobacco, Alcohol and Cannabis Use Among 15-16-Year-Old Students in Albania: Results of the ESPAD Survey

AIMS – Our aim was to assess the demographic and social factors associated with lifetime use of tobacco, alcohol and cannabis among school students aged 15–16 in Albania in order to make information and knowledge available for health promotion specialists working on substance use prevention. DESIGN – This cross-sectional study was conducted in March–May 2011 in the framework of the European School Survey Project on Alcohol and Other Drugs (ESPAD). In total, 3189 students born in 1995 participated in the survey. The standardised ESPAD questionnaire was used to collect data about substance use. RESULTS – Our multivariable adjustment analysis showed that being a male and having easy access to cigarettes were the only universal factors significantly increasing the likelihood of ever using tobacco, alcohol or cannabis. Own smoking was strongly and significantly associated with alcohol and cannabis use. The associations of own substance use with peer substance consumption were weak to moderate. CONCLUSIONS – Own smoking seems to be the most important single independent risk factor which strongly and significantly predicted alcohol and cannabis use among Albanian school students. Policy makers need to strengthen the rule of law whereas health promotion professionals should firmly address smoking in adolescence through target interventions

Users' Knowledge About Adverse Effects of Non-steroidal Anti-inflammatory Drugs in Tirana, Albania

AIM: To assess the level of knowledge of the adult users of non-steroidal anti-inflammatory drugs (NSAIDs) regarding their side effects and the socio-demographic factors associated with the use of these drugs in the adult population of Albania. METHODS: This was a cross-sectional study including a representative sample of 199 individuals aged ≥18 years (77% women; overall mean age: 30.3±10.0 years; overall response rate: 90%) who were users of NSAIDs recruited in ten different pharmacies in Tirana municipality during April-May 2015. A self-administered questionnaire contained basic socio-demographic information and questions about NSAIDs use, their types, participants' knowledge about NSAIDs side effects and their interaction with other drugs. RESULTS: In 56% of the cases, NSAIDs were taken by participants' own decisions, whereas in about 29% of the cases these drugs were prescribed by physicians. Acetaminophen, ketoprofen and ibuprofen were the most frequently used NSAIDs. Overall, 51% of participants thought NSAIDs could cause allergic reactions, whereas one third or fewer were aware of each of the following side effects: upper and lower gastrointestinal bleeding, hypertension, gastritis, kidney failure, myopathy, osteoporosis. About one third of participants were aware of NSAIDs-other drug interactions, whereas some of them were already taking contraindicated drugs. No significant differences were noticed regarding sex, age, educational level, employment status and marital status, with very few exceptions. CONCLUSION: Our findings indicate limited knowledge about NSAIDs side effects and their interaction with other drugs among the Albania adult population, which is a cause of concern