Health System Strengthening

Health System Strengthening

Early Childhood Development and Quality Education

Early Childhood Development and Quality Education

Prevention from Abuse, Violence and Exploitation

Prevention from Abuse, Violence and Exploitation

 

Health System Strengthening

Mother and child in the village Studenicani during a visit from the local patronage nurse

In the initial years after its independence in 1991, the country’s rapid growth was matched by major strides in mother and child health care. Mortality rates fell and immunization rates rose, to name just two positive indicators. Yet the pace of improvement has slowed in recent years and failed to keep up with the country’s broader economic gains. UNICEF has been working with the Ministry of Health, non-governmental agencies and others to develop strategies and action plans to help the country make additional gains.

As the country moved away from its socialist past and through its economic and political transition, health initiatives helped prevent hundreds of unnecessary deaths of children. The country achieved the impressive results in reducing under-five mortality, from 36 per 1,000 live births in 1990 to 11 per 1,000 live births in 2008. Skilled birth deliveries are almost universal outside of the Roma community. Immunization rates have been steady at around 95 percent for the past decade. In 2003, the country became the first in the region to be certified as iodine-deficiency free. HIV/AIDS rates are at less than 0.1 percent.

But more work is needed. Perinatal mortality is three times higher than the EU average and immunization coverage is far lower in rural areas and among some ethnic groups. The World Health Organization recommends that women have at least four health checks during pregnancy, yet the national average is 2.8 health checkups. Only four in ten pregnant women go for regular check-ups during first three months, a critical time to prevent complications. Pockets of unimmunized children do exist, with significant disparities among the Roma and Albanian communities, and those living in rural areas.

To overcome these deficiencies, UNICEF has developed the Health System Strengthening Project to help the Ministry of Health and other relevant public health groups improve their planning, budgeting and implementing of public health programs for mothers and their children. This includes the creation of long-term policies with clear and integrated targets, instead of continuing to rely on short-term projects that are updated from year to year, or scrapped.

In practical terms, this means that as part of a broader plan to improve  mother and child health care, medical equipment must be kept up to standards, and outreach services expanded. Health professionals must be adequately trained to provide high quality and newly recommended vaccines, and curricula at medical and nursing colleges meet the latest international guidelines. Regional differences must also be recognized so that medical resources are divided in a way that ensures the neediest parts of the country get adequate resources.

UNICEF is also undertaking a broad nutrition plan to tackle anemia, one of the biggest causes of complications during pregnancies. One part of this strategy includes surveying about 8,000 households to assess the quality of their diets. The results of the survey will help determine the scope of an anticipated UNICEF-supported flour fortification program which will ensure stable foods contain adequate mineral and vitamins to improve the health of the mothers and decrease the number of complications at birth.