IANPHI Directors visited our National Institute of Public Health (IPH) in Tirana, Albania on 24-25 April 2014. This is an introduction of organizational development analysis and background assessment of the health indicators in Albania.

1. Introduction to Institute of Public
Health,
R&D and Innovation in Albania.
IANPHI Meeting in Tirana, Albania on 24-25 April 2014
Genard Hajdini
Partnership Specialist
Department of Health Information, Technology & Communication
Institute of Public Health (IPH) Albania

2. 2
INTRODUCTION
“The greatest wealth is health.” ~Virgil
 The Institute of Public Health presentation was developed in
response to the IANPHI National Survey and “Evaluation
Tool” preliminary data based on the…
1) National Program for Research and Development 2007-2009;
2) National Strategy for Health in Albania 2007-2013;
3) National Strategy of Science, Technology and Innovation of
Albania;
4) National Background Report on Health for Albania;
5) Public Health Law; and
6) Cross-sectional data gathered by different ministries in the
Albanian government and desk review process at Institute of
Public Health (IPH) in Albania.
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 Institute of Public Health (IPH)
 Founded on the basis of the Research Institute of
Hygiene and Epidemiology and Immune-biological
Products (created in 1969).
 In 1995, it became Institute of Public Health.
 IPH Basic Functions:
 IPH supports technically the MOH with information and
advice.
 Researches and collects data on public health issues.
 Performs continuous public health education for
healthcare professionals.
 Center of Laboratories of Expertise and Reference.
 Administers Vertical Prevention Programs delegated by
MOH.
 National Epidemiological Observatory.
INTRODUCTION
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INTRODUCTION
 Public R&D institutions in Albania:
 Institute of Public Health (IPH)
 Founded on the basis of the Research Institute of Hygiene and
Epidemiology and Immune-biological Products (created in 1969).
 Faculty of Medicine at UT (Est. 1957).
 Mother Teresa University Hospital Center.
 Private R&D institutions in Albania:
 Lady of Good Council (Catholic) University (accredited)
 U.F.O University (accredited).
 Kristal University (accredited).
 Medikadent (accredited).
 Private R&D Clinics and Laboratories:
 Lady of Good Council Clinic
 Orthodox Clinic
 IKEDA Clinic
 Globus Clinic
 Didaktalba (Science Equipments Store), etc.
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INTRODUCTION
 Country: Albania
 General Population: 2,831,741
 Regions: 12
1) Berat 140,9642; 2) Dibër 136,6303; 3) Durrës 265,3304
4) Elbasan 296,0825; 5) Fier 310,9896; 6) Gjirokastër 75,1727
7) Korçë 220,4388; 8) Kukës 85,2399; 9) Lezhë 135,60910
10) Shkodër 217,375; 11) Tiranë 763,63412; 12) Vlorë 184,279
 Urban: 53.7% / Rural: 46.3% = Ratio 1.16
 Age Structure: 0-14 years: 30%, 15-64 years: 63%, 65 years and over:
7%. (2000 est. Index Mundi)
 Average Number of Household Members: 3.8
 Age distribution according to ethnicity: No complete data, since the
ethnicity question was optional in Albania’s Census 2011.
 (Source: Albanian Preliminary Data for Census 2011).
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6. Health Systems Org. Chart in Albania
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7. Regional vs. District
7
De Jure De Facto
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8. Health Care Expenditure
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 The Public Health Law No. 10 138, date 11.5.2009.
 The role of Institute of Public Health (IPH) defined in
Chapter IV: Organization and Functioning of the Institute
of Public Health (IPH) in Articles: 12, 13, 14, 15, 16… 40.
PUBLIC HEALTH LAW
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 Article 12: The organization of the IPH
 IPH is a public, budget institution,
administratively under the Minister of Health.
 IPH is a research center for public health, a
reference center for the public health services,
university training center for public health and
information center for public health.
INTRODUCTION
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 Article 13: Organizational structure
 Leading bodies of IPH are:
 The director,
 The scientific council
 Appointment and release from duty of the director of the IPH is done by
the Minister of Health. The requirements and criteria for the appointment
and release of the director are defined by an order of the Minister of
Health
 The scientific council is an advisory body of the PHI. Its establishment,
organization and functions are approved by a decree of Council of
Minister.
INTRODUCTION
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IPH
 Article 15: Functions
The Institute of Public Health performs the following functions:
a. Surveillance of communicable and non-communicable diseases
b. Management of national registers
c. Scientific research in public health
d. Following up the latest international health news including system and
practices
e. Training and education in public health
f. Reference center in public health
g. Informing population about public health issues.
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13. Financing IPH
 Article 16: Financing
The Public Health Institute is funded by:
1 - State budget
2 - Revenues from scientific and education activities
3 - Grants, funds for scientific activities, development
programs
4 - Donations, gifts
5 - Other legal sources.
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14. Reference Laboratory: IPH
 Article 37: Reference laboratory
 The reference laboratories should assess the public health laboratories
within the regional structures of public health, according to the
respective guidelines that are approved by the MoH.
 The laboratories of the public health within the IPH are reference
laboratories. One laboratory could be a reference laboratory for one or
more analyses .
 An independent institution should accredit the reference laboratories.
The reference laboratories should provide support for laboratory
activities, technical standards and analyses methods.
 The reference laboratories should guide and guarantee the use of the
system of internal management of the quality in each laboratory of
public health.
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 Article 40: Surveillance
 The National Epidemiological Observatory and specific National Registries
are in place for the surveillance of the risk factors and burden of
diseases .
 National Epidemiological Observatory of risk factors and specific national
registries are located in the IPH.
Surveillance at IPH
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R&D Organizational Infrastructure of IPH in Albania
DIRECTOR
IPH
MINISTRI
OF HEALTH
Zv/Drejtor
Shkencor
Zv/Drejtor
Ekonomik
Sektori i
Administratës
Sektori i
Burimeve
Njerëzore
Sektori i
Financës
Asistent i
Drejtorit
Department of Control of
Infectious Diseases
Sektori
Survejancës të
Sëmundjeve
Infektive
Sektori
Vaksinimit
Sektori
Kontrollit të
Vektorëve
Sektori
Programit
Kombëtar të
HIV/AIDS/SST
Qëndra e
Këshillimit
Sektori
Laboratorëve
1. Laboratori i Virologjisë
2. Lab. i Imunologjisë (HIV/AIDS dhe hepatite)
3. Lab. i Bakteriologjisë dhe Mykologjisë
4. Kontrolli i Infeksioneve Spitalore
5. Lab. i Biologjisë Molekulare
6. Laboratori i Parazitologjisë
7. Laboratori i Preparatorisë
8. Lab. i Prodhimit të Antigeneve dhe Serumeve
Diagnostike
Department of Sanitary
Expertise
Seksioni i Ujit
Sanitetit
Seksioni i Fizikës
Sanitare
Seksioni i Kontrollit
të Cilësisë së Ajrit
Seksioni i Shëndetit
në Punë
Seksioni i Ujit
Sanitetit
Seksioni i
Laboratorëve
1. Zyra e Sigurimit dhe Kontrollit të Cilësisë; 2. Lab. i Mikrobiologjisë së Ushqimeve dhe Mykologjisë; 3. Lab. i
Biokimisë; 4. Lab. i Kimisë së Ujit dhe Sanitetit; 5. Lab. i Kimisë së Ushqimeve; 6. Lab. i Kimisë Analitike
Instrumentale; 7. Teknika Kromatografike; 8. Teknika e Absorbimit Atomik.
Department of
Epidemiology and Health
Systems
Seksioni i
Epidemiologjisë dhe
Indikatorëve
Shëndetësor
Seksioni i Shëndetit
Riprodhues
Sektori i Politikave dhe
Sistemit Shëndetësor
Department of Education
and Health Promotion
SCIENTIFIC COUNCIL
Seksioni i Shëndetit
Komunitar
Seksioni i Shëndetit
në Shkolla
Seksioni i Shëndetit
Riprodhues
Seksioni i Shëndetit
Mendor
Seksioni i Abuzimit
me Substancat
Sektori i Merëmbajtjes
së Kafsheve (Vivarium)
Sektori i Botimeve
Sektori i
Radiombrojtjes
Qëndra e Trajnimit
Department of
HI,TCH&COM
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HUMAN CAPACITIES
R&D Personnel Number
TOTAL FEMALE
1 Scientists 73 47
2 Technicians 38 22
3 Supporting Staff 84 50
TOTAL 195 119
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HUMAN CAPACITIES
Scientists + Technicians
+ Support Staff
Number
TOTAL FEMALE
1 Engineering 1 1
2 Natural Sciences 39 25
3 Medical Sciences 53 32
4 Agricultural Sciences 4 2
5 Social Sciences 8 5
6 Humanitarian Sciences 8 5
TOTAL 113 70
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HUMAN CAPACITIES
Title/Grade Age Total
<30 31-40 41-50 51-60 61-65 >65
Academic - - - - - - 0
Academic w/o functions - - - - - - 0
Professor 1 1 2 4
Prof. Assoc. 1 3 3 7
Dr. 5 6 1 12
Researcher & Assistants 7 24 10 9 1 51
Total Scientific 7 29 18 14 6 74
Assistant Scientists (Lab)
a-university degree
b-high school degree
5
3
11
7
6
14
4
24
1
5
27
53
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R&D Financing in Health
Sectors/Year
2007
GDP
(000 €)
(Sector GDP/
Total GDP) %
National economy 15,000 0.2
I sector: Health 3,743 0.05
II sector: Education 5,240 0.07
III sector: Agriculture 4,491 0.06
IV sector: Environment 1,497 0.02
V sector: -- - -
Table 2. Performance of economy and sectors relevant for S&T field:
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R&D Projects
Table 3. List of Completed and Continues Projects at Institute of Public Health (IPH) in Albania.
Title of Project: Financed ~(USD) Donor Organization
1. Demographic and Health Survey
2. Behavioral & Biological Survey (HIV/AIDS)
3. School Surveys (YRBS, ESPAD)
4. Hepatitis Sero-prevalence Survey
5. PHC Service Capacities and Gaps
a. Vaccination
b. Cancer
c. CVD
6. Iodine Deficiency Survey
7. Nutrition and Obesity Surveys
8. Stress and Mental Health at the Workplace
9. Other Research (outbreak investigations, air & water
pollutions, health indicators)
10. Virology Laboratory
11. Molecular Biology Lab.
12. Chemistry (iodine)
13. Clinical Lab.
14. Air Pollution
15. New Vaccines
16. Detection Programs STI (VCT)
17. Detection Program Chronic Disease
18. New Surveillance Systems (abortion, STI, birth defects)
19. Family Planning
20. Food Safety Assessment
$1,800,000
100,000
30,000
30,000
100,000/40,000/10,000
100,000
20,000
10,000
50,000
100,000
100,000
30,000
10,000
100,000
1,000,000
50,000
10,000
20,000 x 3 = 60,000
100,000
15,000
USAID/Swiss/UNFPA
Global Fund (GF)
UNFPA
MASH (MOES)
GAVI/UNFPA/MoH
UNICEF
MASH (MOES)
MoH
MoH
World Bank
MoH
MoH
MoH
WHO
MoH + GAVI
Global Fund
MoH
UNFPA
UNFPA
MASH (MOES)
(Source: IPH) Genard Hajdini

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Health Research Priorities on the Basis of
the Country’s Readiness
Health research priorities on the basis of the country readiness
are:
1) Prevention of diseases and risk factors;
2) Mental health;
3) Non-infectious diseases with special importance;
4) Infectious disease;
5) Quality Assurance of Health Systems.
Also other points to be considered are:
1) Emergency alert and quick response toward natural and humanly caused
catastrophes, accidents, and urgent situations;
2) Response to epidemics and pandemics in the country and region;
3) Allocation of resources toward public health research and response;
4) Clinical studies toward the most killing disease in the country both:
infectious and non-infectious;
5) Accreditation and quality assurance of the laboratories and medical
facilities in the country;
6) Public health and medical personnel capacities for country’s readiness;
7) Facility and infrastructure building with contemporary standards with a
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Challenges & Opportunities
S.W.O.T Analysis
Strengths
Strong laboratories infrastructure.
Tradition and Knowledge Transfer.
Some Human Capacities.
Strong Logistics in the Field.
Center of Information on PH.
Weaknesses
Fragile Quality Assurance System
In Process of National &
International Accreditation.
High Turnover Rate-Brain Drain.
Lack of R&D Coordination Office.
Low Absorption of Funds for R&D.
Opportunities
Strong National Network with DPH.
Well-positioned between University
and MOH.
Supportive Legislation in Progress.
International Networks &
Partnerships.
R&D has become a Priority:
National & International Funds
Threats
New Governmental Structures
overlapping with IPH Functions.
PH Emergencies & Program
Administration diverts energy &
resources.
Aid Funds & “Easy Money” create a
dependency on low expectations and
impedes competitiveness
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Health Research Priorities on the Basis of
Future Potential
 The health research priorities on the basis of future potential are:
1. Public Health (Genetic Screening);
2. Health Information Systems—the build up of Database Warehouses;
3. Biotechnology and clinical research;
4. Accreditation and Quality Assurance of all healthcare system: hospitals, clinics,
institutes through the national and international entities;
5. Establishment of high financial management of the Hospital and University
Hospital Systems;
6. Albanian Centers for Excellence;
7. New Departments in Albanian Universities for PhD accredited programs in
health sciences.
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R&D and Innovation Examples
 SURVEYS’ Research:
 Demographic and Health Survey.
http://www.measuredhs.com/
 Behavioral and Biological Survey (HIV/AIDS).
 School Surveys (YRBS, ESPAD, etc.).
 Hepatitis Sero-prevalence Survey.
 PHC Service Capacities and Gaps (Vaccination, Cancer, CVD).
 Iodine Deficiency Survey.
 Nutrition and Obesity Surveys.
 Stress and Mental Health at the Workplace
 Other research based on existing information systems
(outbreak investigations, air & water pollutions, health
indicators, etc.)
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R&D and Innovation Examples
 Innovation Agenda of IPH
 New laboratories/technologies:
 Virology
 Molecular Biology
 Chemistry (iodine)
 Clinical Lab.
 Air Pollution Monitoring new technologies
 New Interventions:
 New vaccines
 Set up of early detection programs for STI (VCT) & chronic
disease
 New Surveillance Systems (abortion, STI, family planning,
birth defects, etc.).
 Social mobilization and healthy schools.
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R&D and Innovation Examples
 TRAININGS:
 MPH (with the Faculty of Medicine at UT).
 Health Planning & Management.
 Field Epidemiology.
 Basics on Environmental Health.
 Occupational Health.
 Vaccination Programs.
 International Partnerships.
 ASPHER (Joint-Member with Faculty of Medicine at UT).
 IANPHI (Member).
 Stability Pact Partnership.
 Other Joint-Project Collaborations with different institutions.
 Conference Participations & Publications.
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0.0
20.0
40.0
60.0
80.0
100.0
2002 2003 2004 2005 2006 2007 2008 2009 2010
Circulatory System Disease (incidence per 10.000)
Meshkuj Femra

29. SDR, Disease of Circulatory System
all ages per 100,000
29

30. 30

31. SDR, Ischaemic heart disease,
all ages per 100,000
31

32. 32

33. SDR, Cerebrovascular Disease,
all ages per 100,000
33

34. 34
0
50
100
150
200
250
300
SKV Tumoret Simptoma e
shenja të
sëmundjeve
Trauma, Helmime
dhe Aksidente
286.2
82.2
50.4
28
Main Causes of Deaths per 100.000 inhabitants

35. 35
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
2002 2003 2004 2005 2006 2007 2008 2009 2010
Incidence of neoplasm by gender
Meshkuj
Femra

36. SDR, Malignant neoplasm female
breast, all ages per 100,000
36

37. SDR, Malignant neoplasms,
all ages per 100,000
37

38. Genard Hajdini 38
Albanian DHS 2008-2009
Indicator 2002 RHS 2008-09
 Percentage of women with no education 0.3
 Percentage of women with access to newspaper, television and radio 21.5
 Total fertility rate (children per women) 2.6 1.6
 Percentage of teenagers who have begun childbearing 6.4 2.8
 Percentage of married women currently using any method of family planning 75.1 69.3
 Percentage of married women currently using any modern method of family planning 8.0 10.6
 Median age at first marriage for women age 25-49 (years) 21.8
 Median age at first sex for women age 25-49 (years) 20.9
 Percentage of married women who want no more children 72.8
 Percentage of married women with an unmet need for family planning 12.8
 Mean ideal number of children 2.6
 Infant mortality rate (per 1,000 live births) 26.8 17.6
 Under-five mortality rate (per 1,000 live births) 30.7 21.5
 Percentage of live births receiving antenatal care from a trained health professional 97.3
 Percentage of live births delivered at a health facility 94.0 96.7
 Percentage of live births receiving assistance at delivery from a trained health professional 99.3
 Percentage of children fully immunized 95.1
 Percentage of children with acute respiratory infection or fever taken to a health facility 69.6
 Percentage of children with diarrhea who received either ORS or RHS 67.8
 Median exclusive breastfeeding duration (months) 3.6
 Percentage of children underweight (-2 SD) 5.9
 Percentage of children stunted (-2 SD) 15.6
 Percentage of children wasted (-2 SD) 6.5

39. Conclusions
39
 Public Health Law in Albania is among the best in our
country.
 IPH has a research and education status.
 IPH is the technical support for MoH in Albania.
 It houses the best research scientists in the country.
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THANK YOU
 To All IANPHI Directors and dedicated staff
members.
 To IPH Leadership: Director, Heads of
Departments, Senior and Junior Managers.
Genard Hajdini

41. Genard Hajdini 41
Q&A
You have questions,
And I have answers…
Skype: genard1977
E-mail: genard_hajdini@yahoo.com
Work Cell: +355.67.20.52.947
The End…