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Reproductive
Health for All
A contribution from the
Geneva WHO Collaborating Centre for Research in Human Reproduction
Study Tour in Geneva for the Reorganisation
of the
Reproductive Health Services in Albania
Self-Evaluation Report
Petrit Vassili and Nedime Ceka
During 15-23 October Dr Petrit VASILI, Director of Primary Health Care
in the Ministry of Health of Albania and Dr Nedime CEKA, Chief of the Reproductive
Health Sector in the Directory of Primary Health Care, had done a study
tour organised by WHO Collaborating Centre for Research in Human Reproduction,
Dept. of Obstetrics and Gynaecology Geneva University Hospital, Geneva.
The study tour was part of a project financed by the
Swiss National Science Foundation. In addition, a generous financial contribution
and valuable technical advice had been received from WHO Collaborating Centre
for Health Policies, Planning and Management, Dept. of Social Affairs, Canton
of T icino, Bellinzona.
Situation analysis of reproductive health in Albania
- a summary
Albania has high maternal and infant mortality and morbidity.
For the year 1997 the IMR was 22,5 per 1000 live births and the maternal
mortality was 25,7 per 100 000 live births. The main causes of infant deaths
are, ARI, diarrhoeal diseases and malnutrition. The principal causes of
maternal mortality are: 1) bleeding during and after delivery 2) already
existing pathologies during pregnancy 3) eclampsia.
The existing health structures for women and children
in Albania offer low quality services because of lack of training and retraining
(in medical and management terms) of the staff, who work in prenatal care
and puericulture, lack of equipment and financial resources.
According to the new national health policies and strategies,
based also upon the "Health for All Strategy of WHO", the Ministry of Health
is now in the phase of reorganising its services and integrating the reproductive
health services in the primary health care.
Overall objective of the study tour
The study tour was requested by our directory and the
principal goal of the study tour was to acquire foreign experience with
a view to improve, manage and integrate the reproductive health services
in Albania.
Specific objectives of the study tour
- To discuss and exchange information about the legislative aspects
for reorganising the reproductive health services in Albania.
- To search support for the national programmes for controlling and
monitoring child growth and development, nutrition, etc. in developing
national nutrition policies and plans of actions.
- To find contemporary literature for using in the modules for training
of health staff who work in the reproductive health services.
- To discuss about the different possible ways in managing and integrating
the different woman and child preventive health services based on the
Swiss experience.
Principal activities during our journey
- During our stay in Geneva we had meetings with WHO Programme of
Nutrition. In these meetings, we covered the following issues:
- Development of a national policy on nutrition in Albania for
the year of 1999. Upon request, technical assistance by WHO would
be granted during the phase of preparation and implementation.
- Technical discussions with a specialist of WHO, for finalising
our draft national law on the marketing of breastmilk substitutes.
In Albania, breastfeeding is a health priority, and its practices
are widely spread. Reliable data on breastfeeding rates of mothers
exists. However, now with the opening of the country and a new market
economy, a number of companies offering breastmilk substitutes,
are selling their product in Albania. In order to be protected from
the promotion of non-breastfeeding practices and to promote the
concept of breastfeeding, our directory had prepared a draft national
law for regulating the marketing of breastmilk substitutes. It is
hoped to pass this law in the Albanian Parliament by the end of
1998.
- Direct relation with WHO headquarters for using their rich bibliography
of different books and materials, which will help our work in the
future.
- Meetings with the Cantonal Directors in Geneva, who work in centres
for education of health staff and little children, in the Department
of Public Instruction, to:
- exchange information in training of health personnel, mainly
in primary health care;
- prepare the curricula for their training;
- find materials and modules for their training.
- Meeting with the Professor of the Institut de la Droit de la Santé,
University of Neuchâtel. The following issues were discussed:
- The preparation of an Albanian national law about reproductive
health, based on the existing model laws in different countries.
- The necessary legislative base for organising the work in the
reproductive health services.
- The Institute agreed to collaborate with our Directory in the
future to assist us in the different steps of preparation of this
law.
- Meeting with Prof. Aldo Campana, Head of Dept. OB/GYN, and Mrs Eva
Mathur, Management Consultant, WHO Collaborating Centre for Research
in Human Reproduction, University of Geneva to discuss the following
issues:
- Follow-up of the ongoing collaboration between our institutions,
mainly the preparation of the Reproductive Health Manual for Albania
- a project financed by UNFPA; and the final elements of implementation
in the Institutional Partnership financed by the Swiss National
Science Foundation.
- Principal lines for preparing a national programme for improving
the reproductive health in Albania, mainly oriented to the primary
health care services, in collaboration with WHO Collaborating Centre,
Geneva. The main activities of this programme will be: training;
exchange of national and international experiences; support towards
equipment and furniture for the different reproductive health structures;
technical assistance in scientific research, mainly on the field
of reproductive health, formal twining between the University Clinics
of Paediatrics and OB/GYN of Tirana, Faculty of Medicine of Tirana,
and WHO Collaborating Centre for Research in Human Reproduction,
Dept. of OB/GYN and the Dept. of Paediatrics, Geneva University
Hospital, Geneva.
- Possible funding agencies for future collaboration was mentioned:
IAMANEH, the Swiss National Science Foundation, UNFPA/WHO, industry
and other private donors.
Conclusion
Based upon the above-mentioned activities, we must repeat
once again that this study tour was very fruitful and interesting for both
of us. During our stay in Switzerland, we had the opportunity to meet relevant
officials and to create a large network of contacts for future collaboration,
which will help and support our Directory in the difficult work to reorganise
and integrate the reproductive health services in Albania.
We thank once again the Swiss National Science Foundation
and the WHO Collaborating Centre for Health Policies, Planning and Management,
Dept. of Social Affairs, Canton of T icino, Bellinzona, who supported us
financially during this eight days study tour and hope that it will be possible
to continue this collaboration in the future.
Petrit VASILI Nedime CEKA
Director, Primary Health Care Chief, Reproductive Health Sector
Ministry of Health, Albania Ministry of Health, Albania
26 October 1998
Editor : Eva Mathur

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Edited by Aldo Campana,
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