Kosovo has some of the poorest health indicators in the whole of south-eastern Europe. In particular, the high cost of healthcare, discrimination and corruption are obstacles to effective healthcare. Furthermore, investment in the healthcare sector (2.9% of GDP in 2015) is not enough to cover the cost of care for everyone, and patients are often required to pay for good-quality services from their own pocket. Against this backdrop, the first casualties of the system are vulnerable groups that lack the means to pay . For example, studies have shown that in certain Roma groups the rate of vaccination is only 30% compared to 78% of the general population. In addition, people in Kosovo often lack knowledge about health matters – such as the right moment to go to the doctor or how to live healthily.
For the first time, the government of Kosovo has made health an objective for the 2015–18 period. In this vein, the SDC is supporting a project that aims to improve the quality of medical services, strengthen organisational capacities among those responsible for public health services, and raise public awareness about health matters. The project is taking place in 12 municipalities. Its objective is to improve the quality of medical services in Kosovo to reflect the needs of the population, ensure better access to healthcare services and make healthcare more efficient. These measures are complementary to additional support to health sector reforms such as the establishment of a mandatory health insurance in cooperation with the World Bank.
Higher quality care and a better managed system
To improve primary healthcare, efforts need to focus on improving the quality of services in order to win back public confidence in the system. That is why clinical teams are given better training and infrastructure to do their work. Based on World Health Organization guidelines, follow-up protocols including treatment and counselling have been put in place for certain non-communicable diseases like diabetes and hypertension. This allows the teams to provide patients with vital services that will help improve their quality of life.
Another aim of the project is to develop the management and administrative capacities of healthcare systems in order to help medical establishments be more independent, efficient, and exercise oversight more fully. It also offers modular healthcare management courses aimed at improving current shortcomings in the system and providing skills in areas such as service and technology management, budget planning, communication and consulting. In addition, the project supports those responsible for public health services to evaluate the system and identify potential areas for improvement.
Including vulnerable groups
The project is intended to be inclusive for the population as a whole, with a particular focus on vulnerable groups in Kosovo such as women, disadvantaged people living in rural areas, elderly people, young people, people with disabilities and ethnic minorities. The municipalities have a key role to play in understanding the needs of the population and raising people’s awareness of their rights. One example from the project is the implementation of outreach strategies for people who tend to be marginalised. Developing community services helps to supplement outpatient treatment. Citizens also have the chance to rate healthcare services and make complaints.
Besides these measures, the project includes a number of activities to raise public awareness of health issues and help people adopt healthier lifestyles, with a view to preventing and managing certain non-communicable diseases in the long term.