UNMIK/FR/0062/01
FEATURE RELEASE - 3 August 2001

Health - New health strategy for Kosovo: Focus on primary health care

The cornerstone of Kosovo's health care system will be primary health care (PHC). PHC will be based on family health teams composed of family doctors, nurses and other health professionals working in Family Health Centres and punctas (small outreach health centres). By focusing on prevention, these teams should be capable of addressing and solving 80-90 per cent of common health problems.

This is the essence of the new health policy developed by the Department of Health and Social Welfare (DHSW). The strategy also envisions less emphasis on in-bed patient treatment: this means downsizing hospitals while focusing on higher quality service.

Bengt Stalhandske, DHSW Co-Director also envisages an upgrading of medical personnel. "A modern system should involve divided responsibilities and higher qualifications for nurses and other medical support staff," he says. "In general, health care systems like Kosovo's are very heavily dependent on doctors. Their duties often involve tasks performed by nurses in a more advanced system. Thus efficiency suffers : doctors become overloaded, nurses do secretarial jobs. We want to change that."

A PHC's location and size will be determined by the number of people (target population) to be served. The DHSW will support the rehabilitation and operation of only those PHC facilities on its facility master plan. The facilities will have to adhere to standard equipment and service lists issued by the Department.

Delivery services will be available in all hospitals and initially in selected family health centres. To increase the safety of mothers and babies, deliveries will be concentrated more and more in hospitals as their capacity increases. Emergency transport will initially ensure only basic life support, but the capacity will be increased as resources permit. Essential oral health, with emphasis on promotion and prevention, will be part of PHC. Mental health services will be increasingly based in the communities. The drug supply system will ensure the availability of essential drugs.

Existing general hospitals will continue to provide in-bed patient care. But access to secondary and tertiary care (cases requiring hospitalization and surgery)--except in emergency cases--will require PHC referral. Non-family health specialists will work in hospitals or be affiliated with them. Rehabilitation will be an essential part of care.

The guiding principles of health care organization include: equity and non-discrimination; protection of the rights of the most vulnerable groups; acceptability (cultural, social and professional); accessibility (geographic and economic); effectiveness; cost-efficiency; appropriateness; quality of care; and sustainability.

The new health system will be mostly public-based, financed from the Kosovo Consolidated Budget, but it will also have a separate private component. The DHSW will monitor the potential adverse effects of the private system. Some form of pre-payment or health insurance will be introduced.

Stalhandske says the new health care will take many years to be built up. After 17 November, political parties will want to input into Kosovo's health policy-so it will be affected by political considerations. Nevetheless, "health policy is not a cooking book, " he says. " Our blueprint is an expert plan of how the health sector should be organized, but political factors will also come into play. Therefore our journey will probably involve manifold compromises, and our policy may take in some new angles. But the strategy should not change. "

After the elections, the DHSW will merge with the Department of Environmental Protection to form one ministry, and the international staff will be gradually reduced. The overall UNMIK role will shift to monitoring and advising. But the new ministry will still be in need of international expertise for some time, Stalhandske points out.

Note for editors
The full document may be consulted online in English at http://www.unmik.org/. Albanian and Serbian versions can be provided.

For a selection of photographs, please contact Mr Ky Chung at 038 504-604 ext. 5467