Health Systems of the World - Albania

Abstract

Abstract
Profiling a health system in transition is a time sensitive undertaking. Studying the past may provide guidance but is not necessarily helpful in projecting the future. Examples include countries ravished by war, major environmental disasters that wipe out an existing infrastructure or a change in the political landscape that improves or reshapes, for good or bad, an existing health care system. Albania is a perfect example of the unpredictability of foreseeing the future through historical perspective. Moreover, planning in a present tense requires more contingencies than certainties. It is in this vortex of change that Albanian health officials are attempting to develop a strategic plan that will enhance and improve health care access by adopting the principles of scientific medicine and technologies and bringing modern management techniques to a newly emerging health care system.
In this article we attempt to view health care in Albania as seen through the eyes of its Minister of Health (MoH). Challenges include the tumultuous history of Albania – a country that traces its roots from the Illyrians (2d Century, AD), through several occupying armies and countries to post World War ll communism and finally to today’s democratic government. The economy is fragile, and while expanding, is still adjusting to decentralization of control from the state to the private sector. Many of Albania’s physicians and other professionals – including managers - left the country during the Kosovo crisis in 1998-99 and are just beginning to return.
The tools the MoH must work with are important – particularly the new Constitution of The Republic of Albania. In several sections of the Constitution, health issues are addressed and this framework provides the genesis for expanding health services, improving maternal and child health and extending services to the aged and disabled. A health insurance program is included, although its implementation is dependent on financing.
The MoH has developed a strategic plan to enhance and improve health. This article reviews the plan and attempts to assess its likelihood of success. The plan, entitled The Long-Term Strategy for the Development of the Albanian Health System was developed in 2004 and lays out for the next five year period strategies in the following areas:
• Stewardship – including: Accreditation, Partner Organizations, Private Sector Activity, and The Role of the Patient.
• Organization and Decentralization
• Human Resources
• Financing
• Management
• Health Services – (public health, primary healthcare, hospital health care and services, dental service and pharmaceutical service).
• The Success of Reform
What is guaranteed to the people as specified in the Constitution is developed in the list of objectives the MoH hopes to accomplish. Much will depend on two important factors. First, the economy of Albania must continue to move forward and improve, hopefully in a stable political environment. Secondly, partner organizations, including more prosperous countries and Non-Governmental Organizations (NGO’s) such as the World Bank must continue to provide needed financial resources until self determination and self sufficiency coincide.