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Albania: Albania Health Profile 2012

2012/02/15

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Afghanistan Health Profile 2012

Life expectancy. The Albanian population enjoys a reasonably long life expectancy, which seems paradoxical when one takes into consideration the country’s high infant mortality rate, low incomes, very limited health services and frequent outbreaks of infectious diseases. Evidence shows an increase of life expectancy during the last decade to 75.7 years (73.8 years for men and 78.4 years for women) (2003 estimate by INSTAT).


General mortality. The death rate in Albania is slightly higher than 5 per 1000, and this indicator has been stable for the last ten years. There are, however, changes in the structure of causes of mortality. According to the Ministry of Health, mortality per 100 000 inhabitants is 92.8 from cancers, 285.4 from diseases of the circulatory system, 30.5 from diseases of the respiratory system, 13.8 from diseases of the nervous system, 3.1 from infectious diseases, and 38.9 fromaccidents and injuries.


Infant and maternal mortality. The health of women and children continues to be a concern. According to Ministry of Health figures, infant mortality per 1000 live births dropped from 28.3 in 1990 to 17.5 in 2004. These rates are still among the highest in south-east Europe and in Europe in general. The mortality rate for children under five for the year 2006 was reported as 19 per 1000 live births. Maternal mortality is still high in comparison to western Europe though the rate decreased from 28 to 17 per 100 000 live births between the early 1990s and 2003. This decrease was due to the introduction of a new reproductive health policy. Abortion was illegal before 1992. The rate of abortion increased dramatically during the period 1992-1996, with over 40 abortions for every 100 live births. However, a decreasing trend has been seen of late. Despite this, health services still do not offer all women family planning that includes alternative methods of birth control.


Communicable diseases. According to the Ministry of Health in 2005, the significant infectious diseases in  Albania, including those preventable by vaccine, were viral hepatitis (44.3 cases per 100 000), tuberculosis (16 cases per 100 000), measles (0.03 cases per 100 000), and mumps (63.5 cases per 100 000). In addition, the incidence of epizootic diseases is increasing in the country, mainly due to deficient veterinary control of domestic animals. The rates for mortality rates from infectious diseases, including epizootic, parasitic and respiratory diseases, are high for infants and young people. This reflects unhygienic living conditions, movement of the population and poor sterilization procedures.


Though mortality rates from HIV/AIDS and sexually transmitted diseases are still low, they might become a problem in the future if appropriate health promotion and disease preventive measures are not taken. The National HIV Strategy has been approved by both the Ministry of Health and The Global Fund to fight AIDS, Tuberculosis and Malaria.
Chronic noncommunicable diseases. As described above, the structure of causes of mortality has changed with noncommunicable diseases topping the list. The country reports comparatively low levels of alcohol consumption. Drug and tobacco use are increasing constantly mainly due to their low purchase cost, although recent trends show an increase in prices. Cigarette smuggling in Albania has increased, which makes it difficult to estimate cigarette consumption accurately. The shift to chronic noncommunicable diseases is a concern as this epidemiological transition will present the health care delivery system with a double burden.


Environment and health. Air pollution emissions decreased sharply in 1998. Particularly high concentrations of total suspended particulates and black smoke have been measured in several large cities with industrial production and intensive traffic. Recent measurements of air pollution in Tirana, carried out with WHO support, show one of the highest levels of pollution in Europe, 5–10 times higher than in western European countries. This is due to a dramatic increase in the number of cars. Contamination of drinking water with chemicals (pesticides) and bacteriological substances is also a problem. International experts have defined food quality as the country’s most serious environmental health problem. The incidence of brucellosis has increased because of the illegal sale of food on the streets. Three outbreaks of lead intoxication occurred in some rural zones (in 1992, 1996 and 1997). Occupational health problems have decreased with the collapse of industry. During the past 10 years, noise pollution from traffic has increased. There is also an increasing trend in the traffic fatality rate.

OPPORTUNITIES

  • The National Strategy for Socioeconomic Development came into force in 2002 as the frame for sustainable development. In 2005, it was changed to the National Strategy for Development and Integration and aligned with the European Union (EU) agenda and the Millennium Development Goals.
  • The Long-Term Strategy on the Development of the Health System, approved and endorsed in 2004, is under revision with focus on the core functions of the health system.
  • Health legislation is being thoroughly revised with focus  on the laws related to financing of health services.
  • The Health Insurance Fund established in 1995 is growing rapidly in terms of service packages provided.
  • The Ministry of Heath recognizes the need to reorganize health services on a cost-efficiency basis.

CHALLENGES

  • The serious threat to the health infrastructure and the resources caused by three major crises in one decade.
  • The brain drain of qualified health professionals.
  • The high turnover of governmental health officials (ministers of health and deputies).
  • Fragmented subsidization of the health needs of the population (funds are divided between the Ministry of Health, the Health Insurance Fund and the Ministry of Labour Social Fund).
  • Outdated, weak and inefficient public health services, which are still unable to meet the challenges of the new double epidemiological diseases pattern related to socioeconomic, lifestyle and environmental determinants and risks.
  • Fragmented education for different health professional profiles; continuing medical education.