• The National Primary Health Care (PHC) strategy 2020-2025 calls for the transformation of primary care based on the prevailing burden of diseases, aging of the population, internal/external migration and domestic financial resources available.
• The health system is highly centralised with a top down approach by the Ministry of Health and Social protection (MoHSP). Key health sector actors operate most of the time ineffectively. The Health Services Operator has not yet been able to strengthen substantially its capacities after 4 years from its establishment. The Agency of Quality Assurance was established in 2021. It’s resources are limited and the challenges ahead for achieving its mission are important.
• The sector faces an important shortage of doctors, and at a minor degree of nurses. Albania is one of the countries with the lowest ratio of physicians/population in the European region. Given prevailing demographic and migration patterns of health workers, nurses take a higher importance in respect to PHC services delivery.

Chronic patients in general including the elderly (420’ 000) 

People with disabilities (30’000 homebound with severe disability and mental health disorders in 7 regions) and victims of domestic violence (approximately 26’000 in 7 regions)

General population (over 2 million) and PHC doctors and nurses (3000 health workers) 

MoHSP, health service operator the agency of quality assurance and local CSOs 

Outcome 1: MoHSP and its affiliated entities steer and manage more effectively and efficiently primary health care and home care services

Outcome 2: Citizens have access and use effectively primary health care and home care services of better quality  

Expected results:  

• Under the lead of MoHSP, the home care service, clinical protocols and peer groups are up scaled at national level. 
• Planning and monitoring capacities of health service operator/local health units and the agency of quality assurance are strengthened. 
• Digital health solutions for PHC on NCDs protocols, and e -learning are developed and implemented 
• Role and capacities of CSOs is fostered to improve health system governance 

Results from previous phases:  

• Development and piloting in 9 health centers in two regions, of the new model of home care services targeting homebound patients and elderly. 300 patients with disability and about 2400 home consultations were provided since May 2021. MoHSP approved the home care model and decided for its upscaling first to selected regions and later at the national scale. 
• Elaboration of 10 new profiles of nurses and other professionals operating in PHC, including the new positions of social worker and physiotherapist, that allow MoHSP to elaborate and implement integrated models of health and social care in PHC.
• Elaboration and implementation of protocols for treatment of 5 most common Non Communicable Diseases (NCDs) at PHC. The protocols are formally approved by MoHSP and have started to be implemented by MoHSP in 7 out of 12 regions of Albania. 40’000 patients already benefitting. 
• Under the lead of the health services operator and facilitated by the project, peer groups in PHC, as a continuing education and knowledge management tool are implemented in 10 regions out of 12. 
•  Jointly with the Agency of Quality Assurance, a comprehensive set of documents for accreditation of PHC centers has been developed and used.