Albania’s high infant mortality rates call for urgent intervention

TIRANA, Sep 9 – World Vision issued a report, entitled Millennium Development Goals 2007, detailing how Albania continues to have one of the highest infant mortality rates in Europe.
Infant mortality in Albania is more than three times higher than the target set by the European Union, with 18 deaths per 1,000, compared to a target of 5.4.
Acute lower respiratory infections, particularly pneumonia, are among the leading causes of child mortality in Albania. Other causes included newborn diseases in the first 28 days following delivery, congenital anomalies and gastrointestinal diseases. The phenomenon appears to be more pronounced in isolated, rural areas.
However, infant mortality rates are not only the problem, but also a symptom and indicator, of other problems faced by Albanian society.
‘Rural areas are more affected by child health problems than urban areas because of lack of access to information and health facilities, as well as low educational levels especially among mothers,’ said Mike O’Brien, World Vision Albania’s Health Manager. Limited financial resources and poor living conditions are other contributing factors.
‘It doesn’t take much to notice that these children suffer malnourishment and lack of care,’ said Valbona Iljazi, a specialist pediatrician and family doctor, currently assisting World Vision in providing child rearing training for young mothers.
‘In rural areas, the culture of treating illnesses at home or through traditional medicine is more common. The problem with that is the home remedies are usually outdated, and in many cases worsen a child’s condition,’ added O’Brien.
After the fall of communism in the early 90’s, accompanied by the collapse of most state run services, health care services also crumbled. The effects of the aftershock are still being felt today – some 15 years later. Most health centers lack basic equipment and hygiene conditions and many don’t even have water. Although health care services are supposed to be free, bribery remains commonplace.
The decentralization of the healthcare system in Albania has also resulted in a lack of accountability at the local level, especially at the village level. Unresponsiveness towards patients and a lack of qualifications among the health staff further increases the problem.
‘The health staff at the village level lack motivation to reach out to people and run awareness raising campaigns or pass along information and advice to community members,’ said doctor Iljazi.
‘The village nurses do the minimum and, sometimes, less than the minimum. The village health centers are supposed to be fully operational eight hours a day. Right now, they are only working two of the eight hours’, added O’Brien.
Librazhd, in central Albania and Lezha in northwest Albania, particularly lack adequate health services, according to World Vision Albania’s assessments in the Area Development Programmes (ADPs). In Librazhd, the community, itself, raised the issue of children’s health as a specific priority.
World Vision is responding to this dire call for intervention by providing training through the Community Integrated Management of Childhood Illnesses (CIMCI) initiative and, particularly, targeting mothers. CIMCI is one of the most effective and accepted ways to provide education regarding the health of children under the age of five.
‘Any training in the villages is truly beneficial,’ said Hajdie Karaj, 31, a mother of three young children.
‘The villages are forgotten and no one thinks of our needs. There are so many things I don’t know about child rearing, and I wish I could learn,’ she continued.
‘We don’t want to raise our children the same way as our parents and grandparents, but not knowing a different way means we end up doing the same things,’ said Valbona, 26, also a mother of three.
Training teaches mothers how to recognize signs and symptoms of certain illnesses and how to seek advice or support from the healthcare centre. World Vision is also providing them with basic healthcare kits that they can use at home.
‘I am so grateful for the training- I didn’t know most of these things’, said Hajdie Karaj.
‘This training is very practical and easily adapted to the local context and, therefore, easily understood by mothers. I believe that it is going to make a difference in children’s health and the approach to childrearing,’ said Eliverta Alisufi, Health Coordinator for Librazhd ADP.
In the area surrounding Librazhd, World Vision is also looking to bringing clean drinking water to the health centers and some schools. Further, World Vision is helping the community as it seeks government funding for providing needed resources and equipment for local health clinics.
‘We are also using advocacy as a way of increasing health care access for people in rural communities. We are training the community about their rights as patients and training and helping healthcare specialists to understand what their duties are,’ said Mike O’Brien.
O’Brien concluded, ‘The CIMCI project is trying to respond to immediate needs, while the advocacy and rights-based approach is trying to address root causes and provide long-term solutions to these health problems in the community’.