The 130th Annual Meeting of APHA

4053.0: Tuesday, November 12, 2002 - Board 8

Abstract #47578

Rehabilitating health systems, engaging the community: Lessons from improving primary health care in Albania

Arian Pano, MD1, Sameh Youssef, MB, ChB, DTM&H1, Richard Brennan, MBBS, MPH2, Robin Nandy, MBBS, MPH2, and Abigail Chua2. (1) Albania Health Program, International Rescue Committee, c/o Abby Chua, Health Unit, 122 E. 42nd St., 12th floor, New Yok, NY 10168, 212-551-3068,, (2) Health Unit, International Rescue Committee, 122 E. 42nd Street, 12th floor, New York, NY 10168

The program conducted a baseline survey of 12 health centers proposed for rehabilitation by the Ministry of Health in 5 districts. Both quality of care and physical state of the facilities were factored into the assessment. Quality of health care services was assessed at the beginning (late 2000) and end of the program (June 2001). The assessment was conducted based on methodology developed by the Aga Khan Foundation (Primary Health Care Management Advancement Programme). The IRC team sought participation of community groups in the proposed projects which were aimed at structural and functional rehabilitation of the health centers. Program components included community mobilization, physical rehabilitation of the health centers and training of health staff. These groups participated in physical rehabilitation of health centers as well as provided input into the design of health promotion and education interventions. Following a training needs assessment, IRC provided didactic and practical training and on the job supervision of health staff. Topics covered included health management, primary health care, reproductive health, communication with clients, and community mobilization techniques. Using indicators from the Aga Khan assessment tool, the project resulted in an overall 76.2% improvement in the quality of services. Initial quality of service indicator was 50% and at the end topped at 88.1%. In a 10 month period clinics were physically rehabilitated and equipped. Community involvement was key in the success of the program. They provided input into the design of health promotion and education interventions and their participation in contributing to the rehabilitation of health centers is estimated to have totaled 10% of the cost of the project. This has proven to be a good model for rehabilitating and reforming primary health care systems in Albania. This is the first time in Albania that a quality of PHC service survey was conducted at both project inception and completion. The approach used in Albania could serve as a replicable model for post-conflict rehabilitation of health care systems elsewhere.

Learning Objectives: At the conclusion of this session participants will be able to

Keywords: Primary Care, Quality of Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: International Rescue Committee
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Medical Care Section Poster Session #3

The 130th Annual Meeting of APHA