21 st EPSO Conference Prishtina Kosova June 2016

21 st EPSO Conference Prishtina, Kosova, June 2016 Republic of Kosova - Country Profile- Ardita Baraku, MD, Spec. & MSc. Public Health Chief Inspector, Health Inspectorate Ministry of Health, Prishtina, Kosova

General Information Location: Balkan Peninsula Territory : 10 908 km 2 Capital town: Prishtina Population : 1. 8 million, 61. 7% rural in 2011, Average family: 5. 68 members in 2013 Ethnicity: 91% Albanians; serbian, bosniac, turk, montenegrian, roma, Language: Albanian, and Serbian. Religion: Prevailing Muslim; Orthodox, Christian

Prizren Prishtinë Gjakovë Prizren

• • Political development A part of Yugoslavia / Serbia between years 1945 -1999 Severely suppressed by Serbian regime Reçak massacre, January 1999 Under United Nations protectorate 1999 -2007 In year 2008, Independent State, Recognized by 111 UN member states Current president The Newborn monument (stylized NEWBORN) is a sculpture and tourist attraction in Prishtina, Kosova, unveiled on 17 February 2008, the day that Kosovo declared independence from Serbia.

Natural Resources • The richest mineral resources in all of Europe: gold, silver, pure lead, zinc, cadmium, nickel etc. (World Bank, 2008).

Brezovica ski resort Gadime Cave Mirusha Waterfalls Rugova canion

Çiftelia, sharkia, lahuta. . . Vallja e Rugovës Fli-ja Folc costumes of Has area Sofra – traditional dining table Filigran

World Famous … • Kosova Albanians – Rita Ora: MTV Awards, World Music Awards – Majlinda Kelmendi, judo champion 2013 – Luan Krasniqi, European box champion – Lorik Cana, Xherdan Shaqiri, Valon Behrami – soccer player • Albanian origin – Mother Tereza, humanitarian worker

Indicators

Population Pyramid 53% of population are under age 25 (ECLO Kosovo, 2011) 6 % above age of 65

Health system (1) • Public health-care : – Primary care – family medicine, over 400 facilities – Secondary care – 5 regional + 2 city hospitals – Tertiary care – university clinical center, and other. – 13 568 employees (in 2013): 67% of them females; 94% of them Albanians % of employment by level of health care

Health system (2) • Private health care : – 1000 smaller facilities, general or specialized services, – 21 hospitals. – 3472 employees, from them 1666 nurses • Reform of the health system - May 2013 – Introduction of independent organization of public healthservices, – Introduction of line-services – Introduction of payment by performance

Utilization of public health-care • KAS for year 2011: http: //esk. rks-gov. net/ – Primary Care: • 4. 4 million registered visits, • 1080 doctors, • 18. 6 visits per working day – Secondary Care: • • • 1128 doctors 1908 beds 85415 hospitalized 382057 treatment days 834 deaths – Terciary Care: • • • 870 doctors 2164 beds 84824 hospitalized 510365 treatment days 1324 deaths Regional Hospital Gjilan Gjakove Peje Prizren Vushtrri Ferizaj Mitrovice Total avg. University Clinical Center of Kosova Indicators Average Utilisation Hospitalised Surgeries days capacity /doctor /nurse / doctor 5. 4 4. 6 5. 3 4. 5 3. 7 3 2 4. 07 34. 5 40. 8 41. 5 48 59. 5 120 94 62. 6 161 353 162 184 268 234 67 204 69 77. 62 105 106 95. 2 85 52 84. 3 27. 1 56 32. 6 37. 8 97. 9 68 53. 2 Indicators Average days 6. 01 Utilisation Hospitalised Surgeries capacity /doctor /nurse / doctor 64. 6 97. 5 44. 8 81. 43

5 most frequent groups of diseases • Source: NIPHK 2013, HFA –DB/ WHO

Challenges – New health law and health reform – No health insurance, striving to start soon. – Low expenditure, low financing, low investment, low bed utilisation – Patient satisfaction survey in 2012, 84% of patients consider good to excellent the services provided • Health Sector Strategy 2014 -2020 – Improve health promotion, prevention, treatment and care – Riorganise health sector – Ensure sustainable and sufficient resources for health care financing

Health Financing • 6, 7% of government expenditures or 135 Euro per citizen/year • Mainly tax financed • Patient copayment, Local budget, Donations, Kosova consolidated budget • In 2013, private sources contribute 40%. • Expenditures divided %(SOK, 2011) • S Wages and salaries • S Consumables and services • S Municipal expences - facilities • S Subvenctions and transfers • s 2, 5 10, 0 4, 4 45, 2 37, 8 Capital expences

Organizational structure of Ministry of Health

Thank you ! Questions? • Ardita Baraku, MD, MSc Public Health • Prishtina, Kosova, arditabaraku@yahoo. com